Since medical errors involving medications harm thousands of people each year, it's important to understand basic information about your medications and how they may affect you.

Many medications have "contraindication" warnings -- meaning they should not be used under certain circumstances (some antibiotics, for example, ought not to be taken by pregnant women; other medications may be harmful to patients with high blood pressure or autoimmune disease). Some of these warnings are absolute -- meaning they apply to everyone who takes the pills, and some of them are just relative contraindications, meaning that the stated risks depend on your own individual characteristics. Find out from your doctor or pharmacist which, if any, of these warnings apply to you.

Some side effects are common, and some are rare. It's good to ask your doctor or pharmacist which side effects associated with the medication are routine and which rare reactions you should watch out for. Among other things, he should tell you which side effects are of an expected kind (for example, sensitivity to the sun), and others which might signal an emergency (for example, symptoms of shock or sudden, or unusually high blood pressure).

Always let your doctor know which other medications you're using, including herbs and over-the-counter (OTC) remedies such as cough or cold remedies. Pharmacists can also help you figure out whether the over-the-counter medications you are thinking of using will interfere with the medications your doctor is prescribing.

In some cases, mixing medications can be dangerous and even life threatening. Harmful interactions can also occur when combining prescription medications with OTC drugs, home remedies, and herbal supplements. This is because the chemicals that make up the medications or supplements can sometimes interact and produce a completely different effect.

Here are some questions you may want to ask your doctor about the medication he or she has proposed:

•What is the name of the drug, and how do you spell it?

•What do you expect the medication to do? How long will it take to achieve that result, and what kind of track record for effectiveness does it have?

•How many times a day should the medication be taken?

•How much should be taken in one dose?

•Are there any foods or liquids I should take the medication with, or that I should avoid?

•What are the common side effects? Is there a way to reduce the chance of developing them?

•Do you have any patients who've used this medication? If so, how have they done?

•What are my other options, aside from taking this medication?

•What will happen if I don't take it?

•What if I miss a dose?

•What if I take too much?

•Do I need to take all the medicine I've been given?

•How should the medication be taken? (for example, orally, intravenously, or as a suppository)

•Should I avoid alcohol, any herbs, foods, or medications, or activities while taking the drug?

•Can I take this medication if I get pregnant or breastfeed (if applicable)?

•What are the risks associated with the medication?

•Which side effects are normal and require no action on my part? Which symptoms mean that I should give you a call?

•What are the symptoms of an allergic reaction?

•What symptoms (if any) indicate that I should seek emergency medical help?

•What symptoms suggest the dosage should be changed or the medication stopped?

•When it's time to go off the medication, does the dosage need to be 'tapered' (reduced gradually -- as in the case of drugs like like prednisone, or antidepressants)? What will happen if I just stop taking it?

•Do you have any free samples of this medication? (Many doctor's offices don't stock these for ethical reasons, since free samples may strongly influence a physician's prescribing practices. It's all right to ask if they are available, however.)

•Where can I get more information about this medication?

•I'm having trouble understanding the prescription. What do all those abbreviations mean?

When your doctor prescribes medication, it's important for you to know how to read and understand the directions he gives for taking it. Many times physicians and pharmacists use abbreviations (based on old Latin terms) to indicate how drugs should be taken. Here are some common abbreviations. (If you have any questions, call your doctor or pharmacist for clarification.):

prn: as needed

qd: every day

ac: before meals

bid: twice a day

pc: after meals

tid: three times a day

hs: at bedtime

qid: four times a day

po: by mouth

ea: each

Here are some other questions you may want to ask your doctor about your medication:

•Is it a cure or is it something I have to take for the rest of my life?

•Will it keep me healthy or prevent further damage to my health?

•Is it to take away bothersome symptoms, like pain or nausea?

•Will I be using it short-term, or for long-term maintenance? If so, how long?

•Is it used to replace substances my body no longer produces (such as insulin)?

•Is it meant to be taken in place of another medication I'm currently taking?

•What kind of follow-up is required to make sure the medication's working?

•Will there be routine testing (for example, to make sure my liver isn't being harmed by a statin drug)? If so, will there be routine visits to the lab (for urine or blood tests, for example)?

•When taking the drug, will I be expected to do self-monitoring at home (for example, a blood sugar test, checking my pulse, or a blood-pressure check)?

Questions for your pharmacist

If your doctor doesn't have time to answer these questions to your satisfaction, discuss them with your pharmacist. Your pharmacist is an expert in how medications work, how to take them appropriately, and how they interact. (Pharmacists are often the most convenient source of information on medication, since they are available every day in your pharmacy, and you don't need an appointment to see them!) Your pharmacist also keeps a record of all the prescriptions you've had filled at his her pharmacy. In addition to the questions above, ask the pharmacist:

•What should I do if I forget to take the medication?

•Does the medication contain anything that might give me an allergic reaction? What should I do if that occurs?

•How should I store it?

Also, ask your pharmacist to give you the package insert information about the medication (these are written by the manufacturer). It's good to ask for the inserts given to both consumers and physicians, since the latter contains more detailed information (some of the relevant information in the physician's insert may be difficult to understand, however, so you may want to ask your pharmacist to explain those parts). You may also want to go online to look up information about the medication from a reputable source, such as the National Institutes of Health.

How can I save money on my medication?

When purchasing your medication, you'll want to be aware of price, quality and sources. Generic drugs are usually cheaper than brand-name versions, but not always. You may want to ask your pharmacist the following questions:

•Will my insurance cover the medication? (If the price is unexpectedly high, and the pharmacist can suggest alternatives, it may be helpful to ask the pharmacist to communicate this to your doctor either before dispensing the medication or before it is refilled again.)

•If the medication is costly, is there a cheaper and equally effective generic equivalent?

•Is there a low-income program from the company for the drug, or another way that I can obtain the same drug more cheaply?

-- Diana Reiss-Koncar is a medic who has worked at the Berkeley Free Clinic in Berkeley, California, among other places. She is also a freelance health writer and illustrator whose work has appeared in Hippocrates, Consumer Health Interactive, Salon, and numerous other outlets.

References

Last updated December 7, 2009
Copyright © 2004 Consumer Health Interactive