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    • esuhl
    • By esuhl 14th Oct 16, 5:24 PM
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    esuhl
    Being prescribed an overdose (again)
    • #1
    • 14th Oct 16, 5:24 PM
    Being prescribed an overdose (again) 14th Oct 16 at 5:24 PM
    I was just wondering how "normal" it is for doctors to prescribe overdoses of drugs?

    Last year I was prescribed a month-long course of steroids along with antibiotics to treat an infection. The drug information leaflet, however, said several times in bold print that the drugs should never be used for more than 10 days.

    I queried this with my GP, who said that it was perfectly safe to ignore any warnings given by drug manufacturers as they're just trying to cover themselves against legal action. Baffled by my hesitancy, he said that it wasn't really necessary to take the steroids at all if I didn't want to, and he'd only prescribed them to speed up my recovery by a day or two.

    It seems odd to prescribe an overdose when it isn't even necessary... :-/

    Anyway, I've just been prescribed a month's course of nasal-drops. Again, I've read the leaflet, which says three times in bold print that the drops should never be used for more than seven days.

    There is absolutely no qualification (e.g. "unless directed by your doctor").

    These drugs are for minor ailments. It's not as if I'm in a bad way and don't care about the risks.

    Is this normal?! It seems incredibly dangerous for patients to be told to ignore the official dosage limits.
    Last edited by esuhl; 14-10-2016 at 5:29 PM.
Page 1
    • Jackieboy
    • By Jackieboy 14th Oct 16, 5:26 PM
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    Jackieboy
    • #2
    • 14th Oct 16, 5:26 PM
    • #2
    • 14th Oct 16, 5:26 PM
    Some people take steroids on a permanent basis so taking them for a month is hardly an overdose.

    Can't comment on the nasal drops.
    • esuhl
    • By esuhl 14th Oct 16, 5:45 PM
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    esuhl
    • #3
    • 14th Oct 16, 5:45 PM
    • #3
    • 14th Oct 16, 5:45 PM
    Some people take steroids on a permanent basis...
    Originally posted by Jackieboy
    Sure. At a lower dosage, the steroids I was prescribed could be taken for longer.

    ... so taking them for a month is hardly an overdose.
    Originally posted by Jackieboy
    You don't think that taking more than the safe dose as advised by the manufacturer constitutes an overdose? What does "overdose" mean, if not that?
    • teddysmum
    • By teddysmum 14th Oct 16, 5:56 PM
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    teddysmum
    • #4
    • 14th Oct 16, 5:56 PM
    • #4
    • 14th Oct 16, 5:56 PM
    An overdose is expected to cause harm.


    My dog recently had an infection in both eyes, but could only have steroid in one eye, as it inhibits the healing an ulcer, which he had in the other eye. Both lots of drops (the other antibiotic) were for 10 days.


    However, the problem recurred in the eye r-that didn't have the steroid, so he was given a course of steroids for that eye and I was told to give him a 'good 10 days' dose', by which the vet meant to dose for about 12 days.


    That eye appeared to have another flare, this week, so the vet suggested using the rest of the drops (still in date and stored correctly) for 10 days (but the inflammation disappeared by itself, this time). He wouldn't suggest two lots of 10 days, if it was dangerous.
    • Bogalot
    • By Bogalot 14th Oct 16, 5:58 PM
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    Bogalot
    • #5
    • 14th Oct 16, 5:58 PM
    • #5
    • 14th Oct 16, 5:58 PM
    Have you spoken to a pharmacist about your concerns? They are the experts on drugs.

    I would agree with Jackieboy, most of the drugs I take are prescribed off license, outside of their licensed usage. That's not an overdose or negligent prescribing, it's a doctor using their expertise to help me manage my condition.
    • DomRavioli
    • By DomRavioli 14th Oct 16, 6:28 PM
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    DomRavioli
    • #6
    • 14th Oct 16, 6:28 PM
    • #6
    • 14th Oct 16, 6:28 PM
    The reason the leaflet says to not use for more than 7 days, is because most of these things are available over the counter or on the minor ailments scheme, and if you're still sick after a week of treatment you need to see a doctor.

    It's that simple. Nothing to do with an overdose in either case; the LD50 of steroids is HUGE.
    Observe, Adapt, Overcome.
    SPC 2015 #497
    • mel48rose
    • By mel48rose 14th Oct 16, 6:30 PM
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    mel48rose
    • #7
    • 14th Oct 16, 6:30 PM
    • #7
    • 14th Oct 16, 6:30 PM
    If you don't trust your doctor then something's wrong. Would you rather put up with the infection then? You've got 2 options either take the medication or don't take it and get worse. It's not rocket science is it
    If you change nothing, nothing will change!!
    • esuhl
    • By esuhl 14th Oct 16, 7:11 PM
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    esuhl
    • #8
    • 14th Oct 16, 7:11 PM
    • #8
    • 14th Oct 16, 7:11 PM
    If you don't trust your doctor then something's wrong.
    Originally posted by mel48rose
    Maybe it's got something to do with the fact that the NHS killed my father, and when my mother was ill she was fobbed off for well over a year before they even attempted a diagnosis. By then she was so ill that she died, so the NHS indirectly contributed to her death too.

    There have been a huge number of other events of sheer incompetence exhibited by NHS staff/systems. So, no I don't trust my doctor over printed advice that is presumably very strictly regulated.

    Would you rather put up with the infection then? You've got 2 options either take the medication or don't take it and get worse. It's not rocket science is it
    Originally posted by mel48rose
    I can't believe anyone would be so gullible to not question it. I wonder how many people die every day because of that misplaced attitude...?

    I'd also expect drug companies to be required to not contradict professional medical advice. It's not brain surgery, is it?!
    • Jackieboy
    • By Jackieboy 14th Oct 16, 7:16 PM
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    Jackieboy
    • #9
    • 14th Oct 16, 7:16 PM
    • #9
    • 14th Oct 16, 7:16 PM
    As a matter of interest, were the steroids Prednisolone and what dosage were you prescribed?
    • esuhl
    • By esuhl 14th Oct 16, 7:16 PM
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    esuhl
    The reason the leaflet says to not use for more than 7 days, is because most of these things are available over the counter or on the minor ailments scheme, and if you're still sick after a week of treatment you need to see a doctor.
    Originally posted by DomRavioli
    It just seems strange that the leaflet explicitly contradicts the doctor's advice. Most drug info leaflets say something like, "Do not exceed the stated dose unless advised by your doctor".

    It's that simple. Nothing to do with an overdose in either case; the LD50 of steroids is HUGE.
    Originally posted by DomRavioli
    Don't steroids cause problems with the immune system? Is it possible that the LD50 of steroids might be huge, but the complications that can occur indirectly due to overdose might be significant...?

    I really don't know much about medicine, so maybe I'm worrying about nothing. But it makes it hard to know who to trust when the people making the drugs are giving different advice to doctors. There should be some kind of campaign to stop people being given contradictory messages over something so important.
    • Bogalot
    • By Bogalot 14th Oct 16, 7:20 PM
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    Bogalot
    Maybe it's got something to do with the fact that the NHS killed my father, and when my mother was ill she was fobbed off for well over a year before they even attempted a diagnosis. By then she was so ill that she died, so the NHS indirectly contributed to her death too.

    There have been a huge number of other events of sheer incompetence exhibited by NHS staff/systems. So, no I don't trust my doctor over printed advice that is presumably very strictly regulated.



    I can't believe anyone would be so gullible to not question it. I wonder how many people die every day because of that misplaced attitude...?

    I'd also expect drug companies to be required to not contradict professional medical advice. It's not brain surgery, is it?!
    Originally posted by esuhl
    You don't have to use the NHS. You're free to pay for private healthcare if your confidence in the NHS is quite so low.
    • esuhl
    • By esuhl 14th Oct 16, 7:25 PM
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    esuhl
    As a matter of interest, were the steroids Prednisolone and what dosage were you prescribed?
    Originally posted by Jackieboy
    I can't remember which steroids I was prescribed. It was quite a while ago. The name "Prednisolone" doesn't ring a bell, and the Wikipedia page doesn't sound familiar, so I don't think it was that.

    But I do remember looking at the "normal" dose ranges for a variety of ailments, and being amazed at the dosage I was given. Especially when I queried it and was told that I don't really need the drugs at all.
    • esuhl
    • By esuhl 14th Oct 16, 7:27 PM
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    esuhl
    You don't have to use the NHS. You're free to pay for private healthcare if your confidence in the NHS is quite so low.
    Originally posted by Bogalot
    Ha ha ha! Are you on the right website? Have you looked at name of it?



    Anyway, what's that got to do with anything? Why would I trust a doctor I've paid any more that one that I haven't?
    Last edited by esuhl; 14-10-2016 at 7:30 PM.
    • Hermia
    • By Hermia 14th Oct 16, 7:44 PM
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    Hermia
    Don't steroids cause problems with the immune system? Is it possible that the LD50 of steroids might be huge, but the complications that can occur indirectly due to overdose might be significant...?
    Originally posted by esuhl
    Maybe the doctor thought an "overdose" was appropriate in your case? A couple of years ago I had a really bad chest infection and my asthma started to cause me serious problems. My doctor gave me two different antibiotics and a week's worth of a high dose of steroids. She said we needed to hit the infection with everything because I was so ill. If my asthma hasn't been so bad she might have been more cautious, but she didn't want to risk the chest infection hanging around if I didn't respond to one antibiotic.
    • mel48rose
    • By mel48rose 14th Oct 16, 8:17 PM
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    mel48rose
    It just seems strange that the leaflet explicitly contradicts the doctor's advice. Most drug info leaflets say something like, "Do not exceed the stated dose unless advised by your doctor".



    Don't steroids cause problems with the immune system? Is it possible that the LD50 of steroids might be huge, but the complications that can occur indirectly due to overdose might be significant...?

    I really don't know much about medicine, so maybe I'm worrying about nothing. But it makes it hard to know who to trust when the people making the drugs are giving different advice to doctors. There should be some kind of campaign to stop people being given contradictory messages over something so important.
    Originally posted by esuhl
    You say you don't know much about medicine but are quick to rubbish your doctors care. Nobody's forcing you to take the medicine's are they
    If you change nothing, nothing will change!!
    • esuhl
    • By esuhl 14th Oct 16, 11:38 PM
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    esuhl
    You say you don't know much about medicine but are quick to rubbish your doctors care.
    Originally posted by mel48rose
    Well, I know enough from experience that you're a fool to think you can trust the medical profession to get it right every time.

    Why are you so quick to rubbish the professional advice given by the company that actually make the drug? Since I don't know much about medicine, shouldn't I trust them as much as any other professional source?

    Maybe the doctor thought an "overdose" was appropriate in your case? A couple of years ago I had a really bad chest infection and my asthma started to cause me serious problems. My doctor gave me two different antibiotics and a week's worth of a high dose of steroids. She said we needed to hit the infection with everything because I was so ill. If my asthma hasn't been so bad she might have been more cautious, but she didn't want to risk the chest infection hanging around if I didn't respond to one antibiotic.
    Originally posted by Hermia
    I can't see why it would be appropriate for me, since I don't have any serious health issues that would justify breaking the official safe dosage. It just seems really odd...
    • Riverbird
    • By Riverbird 15th Oct 16, 12:48 AM
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    Riverbird
    Patient leaflets with regard to prescription drugs are intended for patients taking that medication under normal circumstances. Doctors have far greater information concerning the possible variables on any prescribed drug, which still fall within safe limits, and can be used in different ways for a variety of reasons. The manufacturer sets those limits, only where available, and which are outside the norm. For obvious reasons, these are not on patient leaflet information. I am sure no doctor would knowingly overprescribe to cause harm, except possibly in error. If you feel your doctor has made a mistake, phone or go back to the surgery and get clarification, this forum is probably the wrong place to get the answers you seek. I can understand why you do not trust the NHS, going by what you say about your parents, but millions of people are actually saved by it every year. It might just help, even at this late stage, and if you can bear it, discussing the events surrounding your parents with the appropriate doctor, so that you can get some factual answers, and it may help you put to rest your fears or maybe not. It may also enable your GP to understand where you are coming from, as he probably detects your evident mistrust. Either way, a decent doctor, and there are tons around, will listen and help. Hope you get your answers.
    • warby68
    • By warby68 15th Oct 16, 7:07 AM
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    warby68
    If you don't trust your GP, the medicines are 'optional' and the ailments relatively minor, you can choose not to take them.

    Using the word 'overdose' is quite dramatic and is usually taken to mean taking too much of something in a single dose to cause harm not taking a lower risk drug in a normal dose for a longer period than expected.

    I'm sorry you are so fearful of your GP's competence but I think that is the main issue here and the advice above is very good to help with your future peace of mind and confidence level.
    • FBaby
    • By FBaby 15th Oct 16, 9:06 AM
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    FBaby
    You are getting all confused. Leaflets are written for patients, not doctors. It doesn't tell you when to stop medication no the basis that exceeding the dose, even slightly will result in an overdose! If that was the case, the drug would be a controlled one.

    Leaflets are written to consider the absolute safest dosage for even the most vulnerable person not you as a person and your doctor will know what is right for YOU.

    One day, I made a mistake and took two 500mg paracetamol rather than two 250mg. I called my friend who is a pharmacist to ask if I should go to A&E. She laughed and said that I would need to take a lot more than that to make it an emergency. However, it might have been different if I had specific medical conditions.
    • Jackieboy
    • By Jackieboy 15th Oct 16, 11:17 AM
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    Jackieboy
    There may also be quite different prescribing strategies (with different leaflets to match) depending on where you live.

    As an example, in the UK the normal Amoxicillin dosage is 500mg, very rarely doubled up for severe infections - in France the normal dose is double that (1g) for everything and they consider that the UK undertreats infections.
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