It's comparable to driving a car without a seatbelt -- a new investigation from Consumer Reports Health finds that drug labels sometimes lack key safety warnings and some pharmacies fail to include the medication guides required by the federal government.
For its investigative "spot check," Consumer Reports Health sent staffers to five individual drugstores in Yonkers: Costco, CVS, Target, Walgreens and Walmart, to fill prescriptions for warfarin.
Warfarin (Coumadin and generics), a blood thinner used to prevent strokes, is one of the 20 most commonly prescribed drugs in the United States, according to IMS Health.
Most alarmingly, four of the five pharmacies failed to provide a federally mandated medication guide that's required for certain drugs, including warfarin. And while all of the pharmacies provided their own patient materials, known as consumer medication information (CMI), they differed from the FDA-approved guide for warfarin and contained conflicting warnings about alcohol.
Warfarin can cause severe internal bleeding that can be life-threatening. It is the second most common drug implicated in emergency room visits in the United States.
Consumer Reports Health also wanted to see how drug labels, warning stickers and consumer drug information sheets varied from among pharmacies. While the findings are not nationally representative for each chain, they raise significant concern.
Part of the problem, according to Lisa Gill, prescription drug editor, Consumer Reports Health, is that there's no nationwide standard like "Nutrition Facts" on food packages or the "Drug Facts" on over-the-counter medication.
While the U.S. Food and Drug Administration requires certain details on labels such as a patient's name and dosage instructions, it does not monitor drug labels; rather, each state's board of pharmacy is responsible for their overall content. And whether there are warnings on the bottles is left to the individual pharmacist.
According to the report, available online at www.ConsumerReports
Health.org, there are approximately 1.5 million preventable medication errors each year, a third of which take place outside of hospitals. Research suggests that consumers are confused by the printouts that accompany their prescriptions and rely heavily on the label that's affixed directly on the bottle.
Some highlights from the report:
*Four of the five pharmacies failed to provide a federally mandated medication guide that is required for certain drugs, including warfarin.
*The prescription filled by Target included four warnings printed directly on the label and a directive to "read the medication guide that comes with this medicine." Walgreens also had four warnings printed on the label; CVS had three warnings; Costco had two positioned sideways; and Walmart had no warnings of any kind on the bottle. However, a second trip to Walmart did yield three warning stickers on the bottle, as did a third trip to another Walmart in the area.
*All of the pharmacies provided their own patient materials, known as consumer medication information. However, they differed from the FDA-approved guide for warfarin and contained conflicting warnings about alcohol. While Costco and CVS advised patients to "limit or avoid alcohol," the FDA-approved guide recommends abstaining from alcohol.
*Target's bottle design and labels stood out from the pack, thanks to the chain's triangular containers, which provide ample space for detailed instructions.
Consumer Reports Health recommends these steps to stay safe:
*Understand the basics of your medication. Talk to your doctor about how much you should take, when and how often -- and talk to the pharmacist.
*Ask about food, medications, supplements and vitamins that should be avoided, including alcohol.
*Ask about possible side effects, both common and rare.
*Read the patient information sheets that accompany prescriptions.
*Determine when you can stop taking the medication.
By the editors of Consumer Reports at www.consumer reports.org.