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Many older adults take several different medications every day. If you do, and you aren’t careful about managing prescribed and over-the-counter (OTC) drugs, you may suffer potentially harmful side effects. These can stem from taking drugs that shouldn’t be combined, taking the wrong dose of a drug, or forgetting to take medications when you should. Other problems can arise from not storing drugs correctly, or running into issues when it comes to traveling abroad with drugs. A range of medication management strategies can help you avoid these issues.
#1- Read the Patient Information Guide
This is a keystone of medication management, since thoroughly reading the instructions that accompany medications can help you avoid dangerous side effects and drug interactions, as well as help you get the most benefit from your medication.
Medication guides are packed with vital information you need for safe medication management. It explains what illness and/or symptoms the drug treats, and includes the details of precautions you may need to follow while taking the drug (for example, a warning about not operating machinery or driving after a dose, or an instruction to avoid alcohol while taking the drug). It also will detail common drug side effects you need to stay alert for, and what to do if you experience any of these. It also will clarify other medical conditions (such as allergies, or liver or kidney disease) that could be adversely affected by the drug, as well as list other drugs, herbal supplements, and vitamins that could interact negatively with the medication. You also may see specific circumstances in which the drug should be stopped (for example, prior to or immediately after a surgical procedure).
There also will be general advice on what time of day the medication should be taken, and whether you need to eat (or avoid eating) when taking it. It is important to follow this advice, since some medications can irritate the stomach if you take them without food, while the absorption of other medications (including some antibiotics) may be slowed by food. This section also will clarify whether or not you can split or crush pills to make them easier to take, and what you should do if you miss a dose or inadvertently take too much of the drug.
#2- Store Medication Correctly
Good mediation management also requires you to store drugs correctly, so check the medication guide for this information. Some drugs are altered by light, heat, cold, and moisture, and must be stored as indicated to work as intended. It also is vital to store medication out of reach of young grandchildren who visit regularly.
#3- Schedule Regular Medication Reviews
Whenever you visit your primary care physician, take a list of all of the medications you are taking (include the dosage and time you take them), or take the drugs with you. It is important that your doctor is fully aware of your medication regimen, particularly if you are seeing several doctors for multiple conditions and each has prescribed a medication. You may be taking “duplicate” drugs that have the same or similar effects, but proper medication management means you may be able to drop one of the drugs in these circumstances. Ask your doctor exactly why you are taking a medication, and whether lifestyle changes might help alleviate the need to continue with it indefinitely. Your doctor also can keep an eye on your long-term use of certain drugs, since this may not be advisable—for example, proton pump inhibitors (PPIs) such as omeprazole (Prilosec/Prilosec OTC), which are used to treat gastroesophageal reflux disease (GERD), should only be taken for six months or so before you take a break.
#4- Your Pharmacist Can Help You with Medication Management
Don’t forget that your pharmacist is also a useful source of information when it comes to medication management. He or she also may be able to assist if you are finding it difficult to follow your medication regimen. Something as simple as finding it difficult to open a medication container (if your manual dexterity has been affected by arthritis, for example) can affect whether or not you take a drug, but your pharmacist can supply medication in an oversize container that is easier to open. If you find it difficult to swallow pills, it also may be possible to get your medication in liquid form or tablets that melt in your mouth. And, if you are tempted to split or crush pills so they are easier to take, you should check with the pharmacist to ensure this is safe.
#5- Use a Timed Pillbox if You Are Forgetful
Many older adults have memory lapses that may interfere with medication management. One of the simplest ways to remember to take one daily medication is to schedule it at the same time as you do another routine daily care activity, like brushing your teeth or going to bed. If you have a smartphone, you also can download a medication reminder app that will alert you.
Timed pillboxes also can be a useful medication management tool. Several designs are available, catering to a simple morning/bedtime medication regimen as well as more complicated regimens that involve several medications throughout the day. Keep in mind that it is important that your pills are correctly dispensed into the timed compartments, to avoid overdosing or underdosing. If you have a memory disorder, oversight by a family member or trusted friend is essential—ask that individual to pre-load your pill box and then have that person check on a weekly basis to make sure the medications have been taken.
#6- Avoid Drugs You Don’t Really Need
If you develop a sore throat or a runny nose, don’t ask your doctor for antibiotics. The common cold , flu, bronchitis, and other acute respiratory infections are caused by viruses, not by the bacteria antibiotics are designed to fight. Unfortunately, antibiotics are often prescribed when they aren’t really needed, and this has led to the development of potentially dangerous antibiotic-resistant bacteria. Each year at least two million Americans are infected with these “superbugs,” and at least 23,000 die as a direct result. If you take antibiotics unnecessarily, you may develop resistance to them. This means that if you develop an infection, the antibiotic of choice may not work—you’ll need different antibiotics that may be less effective, and may put you at risk for side effects. You also risk serious diarrheal infections caused by Clostridium difficile, which can grow out of control if antibiotics destroy too many of your normal, helpful bacteria alongside the bacteria causing your illness.
#7- Opt for Generic Drugs
Less expensive generic drugs contain the same ingredients and are just as reliable and safe as branded versions—plus, they are typically much less expensive. If you make a note of the ingredients in any branded OTC drugs you regularly take, you’ll likely find a store-brand generic that is just as good at half the price. However, with some popular pain-relieving drugs there may be several different versions, and versions that combine ingredients, making it difficult to ensure you are getting “like for like” with the store-branded option. If you are unsure whether a generic or store-brand medication is comparable to the branded version, ask the pharmacist to advise you. Also, keep in mind that you also can ask your doctor or pharmacist if there is an approved generic counterpart for any expensive branded prescription drug you take. But keep in mind that here may not always be, and it also may be that your doctor genuinely believes that a branded drug is your best option.
If you find you are struggling to pay for medications, consider using a discount drug program such as GoodRX (www.GoodRX.com)—enter the name of your medication and your zipcode and you may find there is a discount coupon that takes the cost lower than your usual insurance co-pay.
#8- Medication Management on the Road
If you are traveling abroad and need to take regular medications, be aware that the Transportation Safety Administration has strict regulations for flying with prescription drugs (for full details, visit www.tsa.gov). Drugs can be packed in your checked baggage and your carry on baggage—however, while you aren’t limited in the number of prescription drugs that you bring on board with you in your carry-on baggage, liquid medicines that are not either in bottles of three ounces or less or stored in a one-quart plastic bag must be declared for inspection before clearing security.
Aside from that, there are other precautions and tips that will help you maintain your drug regime safely. Take a complete list of your medications with you on your trip, as well as contact details for your doctor and pharmacist (pack this separately from your medications in case you lose or misplace them). Always pack more medication than you think you will need, and carry it in the original, labeled containers. If your medication requires a syringe, this must have the manufacturer or pharmacy label attached (also ask your doctor for a note explaining your condition and the need for a syringe). If you are traveling by car anywhere and the weather is warm, don’t leave medication in the glove compartment or trunk for long periods of time, as drugs can degrade quickly in humid conditions. Always carry a bottle of water with you to take medications if they can’t be taken with other fluids or beverages. Lastly, be aware of medications that make you more sensitive to sunlight (check the label and instructions that came with your medication for any alerts about increased photosensitivity), and, if necessary, use extra sunblock.