Medication Names & Herb Safety

Alias confusion can cause duplicate dosing and medication reconciliation errors.

Ask for the package name, active ingredient, and dose, then document both the local and US name.

Herbs can increase bleeding, lower seizure threshold, or reduce AED and anticoagulant effectiveness.

Ask directly about teas, powders, botanica products, and healer remedies before finalizing medication plans.

Buscapina and Buscapina Compositum are not reliable aliases for metamizole. Ingredients vary by country and formulation. Spain's plain Buscapina 10 mg coated tablets contain hyoscine butylbromide alone. Colombia's Buscapina Compositum NF coated tablets contain acetaminophen (paracetamol) 325 mg plus hyoscine butylbromide 10 mg; neither of these formulations contains metamizole.

Ask: '¿Puede mostrarme la caja o una foto? ¿En qué país lo compró?' Confirm the full product name, formulation, active ingredients, strength, and dose taken. Apply the metamizole warning only if metamizole is listed; check duplicate acetaminophen use if acetaminophen is listed. Do not infer ingredients from the brand name alone.

Antibiotics are sold without prescription at many Latin American pharmacies. Patients may have completed an informal antibiotic course before the US visit. This affects culture sensitivity, resistance profiles, and treatment selection.

Ask: '¿Ha tomado algún antibiótico recientemente, aunque no lo haya recetado un médico?' Also: '¿Trajo algún medicamento de su país?'

• Outside the US, paracetamol is the dominant name. Medication reconciliation must check both names.
• Double dosing is the main bedside risk when the chart says acetaminophen but the patient says paracetamol.

• Patients may not recognize the US word albuterol at all.
• Confirm whether they mean the rescue inhaler or a controller inhaler.

• Not approved in the US because of a rare risk of agranulocytosis; available over the counter across most of Latin America. Patients may have taken it for years without thinking of it as a prescription drug.
• For combination products, verify the country, exact formulation, active ingredients, and strength on the package before recording metamizole exposure.
• Can cause severe hypotension when given IV, which is a common route in Latin American hospitals.

• Do not infer metamizole exposure from the Buscapina or Buscapina Compositum brand name alone. Ingredients vary by country and formulation.
• Spain: plain Buscapina 10 mg coated tablets contain hyoscine butylbromide (butilescopolamina bromuro) alone, without metamizole.
• Colombia: Buscapina Compositum NF coated tablets contain acetaminophen (paracetamol) 325 mg plus hyoscine butylbromide 10 mg, without metamizole.
• Ask to see the package or a photo. Record the country of purchase, full product name, formulation, active ingredients, strength, and dose taken. If metamizole is listed, apply the metamizole safety warning; if acetaminophen is listed, check for duplicate acetaminophen use.

• Flanax is the dominant brand in Mexico. A patient denying naproxen use may be actively taking Flanax.

• Prilosec brand unfamiliar outside US/Puerto Rico. Losec is the common brand across Latin America.

• Available in oral AND injectable forms OTC across Latin America. Much more freely used than in the US.
• Patients may have received IM injections at pharmacies without physician oversight.

• Caribbean patients (PR, DR, Cuba) call their inhaler 'la bomba' and may not recognize 'inhalador.'
• A patient who doesn't understand 'inhalador' may appear non-adherent when they simply don't know the word.