When you’re still in the doctor’s office:
Ask questions: Once a disease or condition is diagnosed, ask your doctor for the medicine that offers the best balance of price and results or outcomes. This is a simple, but powerful request. It tells your doctor that goals for therapy need to be set, evaluated, communicated, and achieved. Also–If you’re over 60, or if you have kidney disease; and any new medicine being considered is removed by the kidneys, ask your doctor if the dose has been adjusted. Many doctors miss this one.
Talk about taking medicines:
Be honest about how good you are at taking medicines. If four times a day won’t really work for you, ask your doctor if a once-a-day medicine is available for treatment.
Ask that the name of the disease your medicine treats be put on the label: Sometimes doctors wonder why the medicines they prescribed weren’t doing their job. Often, people have become confused, and take one medicine to treat a first disease when it should have been used differently to treat a second disease that they also had. This kind of mix-up can be stopped. For example, when your doctor writes prescriptions, it’s easy to change “Digoxin 0.5 mg. One tablet by mouth once a day.” To “Digoxin 0.5 mg. One tablet by mouth for congestive heart failure once a day.” This step also gives the pharmacists a second check when they take a final look at your prescription.
When you go to the pharmacy:
Open the prescription bag. Unfortunately, many pharmacies put the prescription bottle and a brief patient information sheet together in a bag, and then staple it closed. This discourages discussion and can deprive you of valuable information your pharmacists can give.
Read the label:
Some people spend more time reading the label on a peanut butter jar than they do looking at prescription labels. Often auxiliary labels (those added labels on the bottle) tell you what to take the medicine with (such as a Take with Food label on a Motrin bottle. Please read the label carefully, and if you have any questions.
Get your medicines mapped:
Medication mapping can save your life. The idea is a simple one, yet outlines a major flaw in the current prescription filling. For example: If a patient is given four new prescription medicines, they often get four separate sheets of paper that give brief descriptions of each medicine. No one organizes the four medicines for the patient on a single piece of paper, helping the patient fit their medicines into their lives. In short, the patient is left to organize their medicines themselves. This can be a prescription for disaster.
A medication map organizes all medicines into a daily schedule, makes sure that the medicines are taken at the ideal times daily, gives a final check for any drug interactions, separates any medicines that should not be taken together, and is a golden opportunity for patients to be honestly involved in their health care.
Consider a medicine alert bracelet or other ID:
If you were prescribed a medicine that is life-sustaining, (such as Lanoxin (Digoxin, others), or that can interact with other medicines, (such as warfarin (Coumadin), a medicine alert bracelet makes a lot of sense. It is also prudent to carry a card in your purse or wallet that says that you are taking such a medicine. Many pharmacies carry the bracelets or alert cards and can help you on the spot!
Use one pharmacy for all your medicines:
This is a simple yet effective way to get the best results from your medicines. This helps ensure that one pharmacy has a complete medication history, a list of current medicines, and adverse reactions to medicines that you may have had. It also gives you a chance to develop an ongoing professional relationship with your pharmacist.
When you get home:
Organize your medicines: If you use a medication calendar to help you remember to take your medicines, add the new medicines to the calendar. If you’ve kept a personal drug profile (such as in The Essential Guide to Prescription Drugs), add your new medicines to the profile.
Take your medicines EXACTLY as they were prescribed:
I can’t even begin to count the number of times I’ve been asked if it “really matters” if you take each dose exactly as prescribed. YES IT DOES. Taking too little blunts or even negates the benefits of taking medicines at all. Taking too much can lead to toxicity. For example, current estimates for taking (adhering to) AIDS medicines are that 90-100% of the medicines must be taken. In the case of medicines where narrow blood levels must be maintained, (such as digoxin (Lanoxin)-for heart failure or phenytoin (Dilantin)-to prevent seizures, missing a single pill (in digoxin loading) can keep the medicine from reaching a level high enough to do any good at all.
Learn about your medicines:
Knowing about any laboratory testing required because you take a medicine (such as magnesium and potassium blood levels if you take a water pill or diuretic such as hydrochlorothiazide) can be a lifesaver. Finding out about possible adverse effects can also protect you and help you get the best results from your medicine. For example, some fluoroquinolone antibiotics can cause a change in thinking. This is a kind of reaction called idiosyncratic. It does not mean that these antibiotics are “bad,” it simply means that you need to respect the possibility of something happening. Check the drug’s generic name and the drug class to make sure the new prescription does not duplicate the one you are already taking or is not a medicine that you’ve reacted to before.
If you think you are reacting:
CALL YOUR DOCTOR. Hesitating can lead to more difficult problems. For example, that little rash that may have started while you are taking penicillin can become a life-threatening anaphylactic reaction. If the problem is discovered early and the medicine changes, the rash may be the only sign you ever have.
Call your doctor or pharmacist:
Ask if you’re unsure is always appropriate. If your doctor or pharmacist won’t make time to listen, it may be time to replace them. MAKE CERTAIN that you ask your pharmacist or doctor before adding ANY nonprescription medicines vitamins or herbal products to those medicines you already take.
Check an objective reference:
The Essential Guide to Prescription Drugs (HarperCollins-16th edition) has an extensive list of Do’s and Don’ts and Points for Consideration by Patients. While the author admits that he is biased in suggesting them, many letters from readers have found those sections very useful.
