Drugs 101: Everything You Need To Know
To be a smart, informed consumer, consider the following information about drugs. The information applies to over-the-counter drugs as well as prescription drugs. [For information about related subjects, see: Supplements, Herbs]
Before a drug is prescribed: Be sure the doctor knows everything relevant to the situation, including whether finances are an issue for you. Doctors are not mind readers.
When a drug is prescribed:
- In general:
- Keep in mind that you have the right to determine whether you will take a drug, and if so, which one(s).
- Think about your objectives before agreeing to take a drug to help find out if a drug fits your needs. For example, do you need to be alert for work? If so, look for a drug that doesn't make you sleepy during the day.
- Only take a drug with "Informed Consent." Basically, informed consent means that you understand:
- What would happen if you do not take the drug
- What the drug is supposed to do (the benefits)
- The risks that may be involved
- The alternatives
- Whether the drug under consideration is for an off label use. If so, why is the drug recommended?
- The cost to you
- If you have health insurance, is the drug covered? If so, what will your share of the purchase price be? (To learn how to check your insurance coverage, click here.)
- Are there any related costs such as ongoing tests? Are they covered by your insurance?
- There are a variety of methods to use to reduce your cost - possibly to a very low cost. One way to reduce costs is to purchase a generic version of a drug. A generic drug is a drug that is equivalent to a brand-name product in dosage, strength, route of administration, quality, performance, and intended use. If the drug is not generic, is there a generic alternative? (Generic drugs are less expensive than drugs under trademark or patent protection). To learn about other ideas for reducing cost, click here
- Likely side effects, and how the doctor suggests dealing with them. For information about dealing with a variety of side effects, click here. NOTE: If information does not include when to call the doctor or go to an emergency room, ask your doctor or pharmacist for this information..
- If your drug taking regimen is complex, ask your doctor for help in creating a regimen that can work for you.
- Ask any other questions you may have. For example, what to do if you miss a dose, or what to do if you travel across time zones. In case it helps trigger questions which are important to you, see Questions To Ask About A New Drug.
- You can learn additional information about a drug from your pharmacist and a variety of other sources.
- You can also do research on your own. If you do research, always look at the source of information so you can know if it is objective or biased.
- If there is a choice between a newer and older drug, remember that the longer a drug is on the market, the more experience we have with it. Experience becomes the ultimate proof about the benefits and risks of a drug.
- When a drug is prescribed, get a legible copy of the prescription so you can compare what you receive with what is prescribed (including instructions for how to take it).
- Think about the best place to purchase the drug. It may not be the closest pharmacy. Also consider tips about how to save money when purchasing.
If there is a choice between two or more drugs:
- If you are insured, check to see whether each drug is covered by your plan and, if so, how much you have to pay out-of-pocket for each refill.
- Look for a drug that fits your life. For example:
- If you need to be alert for work, it is preferable not to take a drug that will make you groggy during the day time.
- The easiest dosing schedule.
- The least amount of side effects.
- Ask your health care provider to prescribe the minimum amount that will treat your condition.
- As a general matter, the lower the dose, the less likely there will be side effects.
- Perhaps you can start with a lower dose of a drug and build up if the lower dose doesn't work for you. Alternatively, you can start with a normal dose and ask the doctor to decrease it until you find the minimum that works for you.
- For more information about avoiding overmedication, click here.
- If the choice between two or more drugs is difficult, we provide a tool that helps you decide which is best for your needs. See:Drug Evaluator
When you pick up a prescription drug at the pharmacy or receive it in the mail:
Do your part to help avoid errors. For example:
- Ask the pharmacist to check for negative interactions with any other drug you take. If you do not have a list of your medications, take the bottles to the pharmacist.
- Look at the actual drug you receive. If it is a renewal, make sure the drug looks the same as your last batch. If it doesn't - ask why.
- Review the instructions printed on the label.
- If your eyesight is failing, ask for large-type labels. If large type labels are not available, consider using a magnifying glass and reading the label under a bright light.
- If the instructions are not clear, ask your pharmacist and/or your doctor for clarification.
- If you want more information about a drug, look at the inserts available on the National Library of Medicine website . While the inserts are not designed for non-physicians, there is usually a section for patients (with a "Patient Package Insert" tab.)
- If arthritis makes it difficult to open a bottle, ask for an oversized, easy-to-open bottle.
If written instructions come with the drug, it is advisable to read them and then store them in an easy-to-access file, perhaps with your copy of your Medical Records.
Live with drugs wisely to maximize effectiveness and save money.
If you want a drug to do its job, it is important to do yours. Not doing your job results in poorer health, more doctor visits and hospitalizations, and unnecessary deaths. Your job is to do the following:
- Follow the directions about how much of a drug to take, when to take it, how to take it (for instance, with food), and for how long as well as possible food and drink to avoid.
- Don't take more than one dose unless specifically permitted. Two doses are not necessarily better than one - and may be harmful.
- If you have difficulty complying with the drug regimen (taking a drug the way it is prescribed):
- Create your own compliance aids to help you take your drugs on schedule. For example, if you take a drug in the morning, store it near your coffee mug.
- Buy a container that lets you sort your drugs for each day of the week. Available containers range from simple boxes with a slot for each day of the week, to high tech containers which have a variety of features, such as a reminder at preset times when to take which pill. For more information about compliance helpers, click here.
- If you have difficulty swallowing a pill, consider tips such as taking it with a carbonated drink. For additional tips, click here.
- If you are experiencing memory loss, ask for help keeping on schedule.
- Do not stop taking a drug before you are supposed to, even if you begin to feel as if it is no longer needed.
- Do not be surprised if you experience mild side effects you're warned may accompany a drug. Patients who are forewarned about possible side effects are more likely to have them. This generally occurs with mild symptoms such as headaches, drowsiness and dizziness, rather than rare, serious side effects.Doctors call this the "nocebo" effect (the reverse of the placebo effect where healing occurs when an inert substance is given without the patient's knowledge instead of a drug).
- If you have difficulty sticking with your drug regimen, contact your doctor or his or her nurse by telephone or e-mail or at your next appointment if it is very soon. (Do not wait for your doctor to ask whether you are taking your drugs as prescribed. Doctors generally assume patients take drugs as prescribed unless they are told this is not the case.) The doctor may have suggestions, or be able to change the drug to one that is easier for you to take.
- If you miss a dose, ask the prescribing doctor what to do. Do not take a double or triple dose to catch-up without asking first. You may end up hurting yourself.
- Continually monitor your body to look for changes. This is particularly true when you first start taking a new drug, and when you stop taking an old one. Report any changes to your doctor or other health care provider. Let him or her decide what is important - and what to do about the changes. If you can't get to your doctor, at least report the changes to your pharmacist and ask him or her whether it's important, and, if so, what to do about it.
- For drugs you take over a long period of time:
- One way to save money is to purchase a larger quantity at each renewal, such as 90 days. (For additional information about saving money when purchasing or using a drug, click here.)
- Ask whether the drug depletes aspects of your body that you can replace with specific foods or supplements.
- Let the prescribing doctor know that you would like to avoid overmedication. Overmmedication can cause unnecessary side effects and unnecessary expense. If you are not dealing with a drug relating to a life threatening situation, you can try decreasing the dose - but only under a doctor's supervision.
- If you take a drug in liquid form, watch for separation over time which can lead to inconsistent dosages.
- Sign up to automatically be alerted if a safety alert arises concerning any of your medications (and supplements).
- To help stay motivated to take your drugs on schedule, it can help to remind yourself periodically why you are taking the particular drug. For example, make an alert on your calender every week or so about a particular goal you have in mind. If it is something like a vacation, post a picture in an area that you see frequently.
- If you travel:
- Carry drugs with you rather than pack them in luggage that will be stowed.
- Take enough supply of each of your drugs to last for the entire trip, plus at least a few extra days in case you get stuck away from home. Keep in mind the drugs that you "may" need as well as those you take regularly.
- If you don't want to take your supply with you, you can send it ahead, such as via overnight express.
- It can be helpful to carry a copy of each prescription with you in case you're checked, such as at airport security. This is a must if you're traveling outside the United States.
- If you are going to travel through different time zones, ask your doctor or pharmacist what to do about scheduling. (For travel tips, click here. Also see: How To Pack For Travel; Purchasing Prescription Drugs Outside the U.S.,; Travel With A Serious Health Condition 101
- Store drugs appropriately:
- In a dry, cool place - not in the bathroom or in a refrigerator (unless instructed to keep a drug refrigerated).
- Out of reach of underage children.
- Secure from all children if they are pain or mood related.
- If unexpected side effects appear, or expected side effects are severe, contact your health care provider immediately. (To learn how to cope with various side effects, click here.)
- Refill drugs on time. When you refill a prescription, make sure the drug you receive looks like the one you are refilling. If it doesn't ask why.
- If you have difficulty remembering to refill a prescription before it runs out, consider using a local or online pharmacy that sends you alerts.
- If you move drugs from the prescription bottle to an organizer or otherwise, consider keeping at least one of each different drug in the bottle in case you have a question about what pill is what medication. If there are no more medications in the prescription bottle, you can learn the identity of a pill by shape, color and markings online at websites such as: www.drugs.com/pill_identification.html
- Don't automatically say "yes" if an insurer or benefits manager switches a prescribed drug for one of the company's choice. The alternative is usually less expensive than the prescribed drug. It is not nessarily better for you. Sometimes the switched drug doesn't even have the same effect as the previous drug. If it is not acceptable, get your doctor involved to help convince the insurer to do the right thing. If the insurer still refuses, file an appeal (some companies call this procedure relating to a drug exception a "complaint.") To learn about health insurance appeals, click here.
- Keep track of the expiration date of each of your drugs. Check potency and potential harmfulness of drugs beyond the stated expiration date. (Drugs are usually potent beyond the so-called expiration date. To learn more, click here.)
- Be alert for drug recalls. Visit www.Recalls.gov frequently.
- Dispose of unused drugs appropriately (not in the toilet.)
- It is advisable to create and keep a List of Medications with you at all times in case there is a medical emergency. It is also advisable to take your list with you to each appointment with your doctor or other health care provider to see if you still need all the medications you take. Also check to determine whether:
- You can decrease the dosage or stop taking a drug all together.
- There is new information about one of the drugs you take.
- There are new alternatives that better fit your priorities.
- If a drug is past the noted expiration date, check with your doctor or pharmacist to find out if it okay to take. (To learn more, click here.)
- In case of a disaster, keep a few days supply of your drugs off premises. For example, if you live in a flood prone area, leave a supply with friends who live on high ground.
- Run out of pills.
- When you receive a prescription, it is advisable to put a note in your calendar giving yourself sufficient time to renew before you run out. If this is a hassle for you, buy your drugs from a pharmacy that contacts you when it is time for a drug to be renewed. For additional tips about refills, click here.
- If you do run out of pills when your doctor's office is closed, ask your pharmacist to advance you a few pills until you can obtain a renewal prescription.
- Allow the expense of a particular drug to be an excuse. See our article: Saving Money When Purchasing Or Using Drugs.
- Worry about possible side effects. If they occur, speak with your doctor about how to minimize them, or about alternative medications. For information about practical tips for dealing with side effects, click here. If dry mouth makes it difficult to take your pills, click here. If mouth sores are a problem, click here.
- Stop taking a drug because it interferes with your lifestyle. Instead, ask your doctor if there are alternatives.
- Stop taking a drug because of fears of long terms effects and dependence. Instead, discuss them with your doctor.
- Stop taking a drug during a fast, even a fast for religious purposes, if not taking the drug then would be injurious to your health.Speak with your clergy person if you have a question whether this is okay.
If you have drugs left over when no longer needed
- Check to see if a local non-profit organization distributes unused drugs to people who cannot afford them.
- Dispose of unused drugs appropriately. (Not down the toilet.)
Keep in mind that drugs do not work in a vacuum. Do your best to maximize the setting in which they work. Pay attention to your diet and exercise. Reduce stress where ever possible. Get appropriate sleep.
For more information, see:
- Before a drug is prescribed
- When a drug is prescribed
- Drugs and Treatments: Your Legal Rights
- Questions To Ask About A New Drug
- Research about drugs
- How To Choose Which Drug To Take
- How To Avoid Drug Errors (when prescribed, at receipt, at home, when taking)
- How To Save Money When Purchasing Or Using Prescription Drugs
- Online Pharmacies: Red Flags To Watch For
- How To Avoid Over Medication
- Adults Over Age 65 And Medication
- Underage Children And Medications
- How To Find Out What Your Health Plan Includes About Drugs
- What To Do If An Insurance Carrier Insists You Switch Drugs (Therapeutic Substitutions)
- Living with a drug
- If there is any question in your mind whether a doctor's recommendation about a particular drug is influenced by a drug company, check ProPublica, a nonprofit organization that has a data base which lists payments from pharmaceutical companies to doctors. See: http://Projects.ProPublica.org/docdollars
- If you have a pill that you cannot identify, there is an easy-to-use pill identifier at Drugs.com
- When seeing a drug ad in print or watching a drug ad, Consumer Reports advises being cautious about ads that:
- Imply that the drug is always effective. Few clinical studies show 100 percent effectiveness for any medication.
- Gloss over side effects, present them in highly technical language, or announce or display side effects so quickly that they're unintelligible. All medications have side effects. Warnings that are not understandable are useless.
- Don't mention lifestyle changes you could do on your own such as diet and exercise that may make the use of the medication unnecessary.
- Offer incentives such as rebates or reimbursements for the cost of seeing a doctor. Those initial incentives may not be such a bargain.