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Supreme Court Justice Ginsburg’s Drug Interaction Is a Reminder to Pay Attention to Meds

Worst Pills, Best Pills Newsletter article December, 2009

In mid-October, Supreme Court Justice Ruth Bader Ginsburg was kept at a hospital overnight after she became drowsy, fell from her airplane seat and had to be taken off the plane before it departed. Ginsburg had an apparent adverse reaction to a sleeping aid combined with cold medication that she took immediately after boarding the overnight flight.

She is not alone. Many Americans also have similar reactions when their sleeping aids and cold medications interact.

In this case, the sedative...

In mid-October, Supreme Court Justice Ruth Bader Ginsburg was kept at a hospital overnight after she became drowsy, fell from her airplane seat and had to be taken off the plane before it departed. Ginsburg had an apparent adverse reaction to a sleeping aid combined with cold medication that she took immediately after boarding the overnight flight.

She is not alone. Many Americans also have similar reactions when their sleeping aids and cold medications interact.

In this case, the sedative effect of the sleeping pill was compounded by the sedative effect of the cold medication. Multiple-ingredient cold medications often contain an antihistamine, many of which have sedative properties. We urge our readers not to use multiple-ingredient cold medications because they usually contain ingredients to treat more symptoms than people usually have with a cold.

In November 2007, in the first installation in our regular drug interaction column, we discussed the three ways in which drugs can interact. Justice Ginsburg’s interaction falls under the category of those that occur when the patient takes multiple drugs which have the same effect, compounding the effect of both, in this case sedation.

The other two categories of interactions discussed in the November 2007 issue are:

Kinetic Drug Interactions

These occur when one drug affects the way another drug is handled by the body. These drug interactions usually result in changes of the levels of the affected drug in the blood or in specific tissues. Because of this, one drug causes the level of the other one to be too high or too low, resulting in either toxic levels or reduced effectiveness of the second drug.

Combined Toxicity

This occurs when two drugs have toxic, adverse effects on the same organ, resulting in damage to that organ that would not have occurred if either drug had been used alone. Examples of this include kidney damage from each of two drugs you are taking and suppression of the bone marrow, resulting in fewer infection-fighting white blood cells from two or more drugs being used to treat cancer.

What You Can Do 

Take as few drugs as possible. Make sure you let your physician and other prescribers know that you only want to take medications that are clearly necessary. Read the labels on over-the-counter drugs to find out the ingredients, asking the pharmacist to explain them if necessary.

Use Worst Pills, Best Pills News as a resource to help you avoid unnecessary medications and medications that have a poor safety record. To access more information from Worst Pills, Best Pills News, become a subscriber to WorstPills.org.

Make sure all of your physicians and your pharmacists know all of the medications you are taking, including herbal and alternative medications. Many herbal and alternative medicines, such as St. John’s wort, interact with many prescription drugs. Your health professionals cannot monitor effectively for drug interactions if they don’t know all of your medications.