Ask the Geriatrician: Medication Management
Ask the Expert
Amy Ehrlich, MD
Geriatrics Fellowship Program Director
Associate Professor of Clinical Medicine
Albert Einstein College of Medicine/ Montefiore Medical Center
Medicines can keep you feeling well, but can be hard to manage. If medicines are misused they can be dangerous. It is important to include all prescription, and non-prescription medicines, as well as herbal and alternative therapies, vitamins, and eye drops when you make a list of your medicines to show to your doctor or pharmacist. Here are some questions and answers to help you manage your medicines.
Q: What are the names of my medicines?
A: The name should be clearly printed on each container, with the dose, and how often and when you should take the medicine. This is the best source of information about your medicines. Take all your pill bottles with you when visiting your doctor.
Q: What is each one for?
A: Ask your doctor or pharmacist about this, and make a note of it on the bottle or in another location.
Q: Are all my medicines really necessary? I’ve been taking some of them for years.
A: Ask your doctor about this. Some diseases, for example high blood pressure and diabetes, usually need life-long treatment. Other diseases clear up after a while, and the medicines might not be needed anymore.
Q: I have started a new medicine. How long will it be before it starts to work?
A: Some medicines start to work right away. Others take longer. You need to know how long it will take for the medicine to work so that you will know to keep taking the medicine even if there seems to be no immediate result.
Q: Whom can I contact if I experience a new symptom?
A: You need to have a reliable contact person to speak to if you have any problems with your medicines. It is important to know whether a new symptom is due to disease, or a side effect of your medicines. Your pharmacist is a good starting point.
Q: Why does my health care provider need to know all the medicines I am taking, prescription, non-prescription, herbal or other remedies?
A: It is important that one health professional know all this, to avoid doubling up of similar or the same medicine and interactions between medicines that can make you sick.
Q: Surely non-prescription medicines I buy at the pharmacy are weaker and less effective than the ones my health care provider prescribes?
A: Over-the-counter (OTC) drugs can be powerful medicines, with their own actions and side effects. They can interact with each other and with prescription medicines and make you sick.
Q: Herbal medicines are natural, so surely they are safe?
A: Some of the most powerful prescription medicines are made from plants, so could be considered "natural", and have both good and bad effects. Herbal medicines have their own effects and side effects and can react to other medicines, either OTC or prescription.
Q: Why should I use only one pharmacy for my medicines?
A: A pharmacist who knows all the medicines you are taking can be very important for you. He or she can quickly pick up medicines that may react to each other, and can let you and your doctor know there is a possible problem.
Q: How can I set up a system to remind me when to take my medicines?
A: There are many good systems available, for example, a pill box with spaces labeled for each day of the week. There are also different kinds of cards you can fill in and carry in your wallet, and even something as simple as an egg box to put your medicines in, with spaces labeled with the days of the week.
It is easier for many people to think about taking a medicine with an event that happens each day rather than a time of day. For example, if you need to take a medicine at 8 am and 10 pm, it might be easier for you to remember to take your first dose when you brush your teeth each morning, and the nighttime dose when you get ready for bed at night.
There are many other good ideas for reminders. Another example is one person who set up a timer to switch on a table lamp at certain times of the day to remind his father to take his medicine.
Q: What should I do if I miss a dose?
A: Ask your doctor or pharmacist about this; don't just double up the next one, this does not work well for certain medicines.
Q: Do any of my medicines react with foods?
A: Yes, for example some antibiotics don't work as well if taken with dairy products, and the "statin" group of medicines for cholesterol should not be taken with grapefruit juice. Ask your doctor or pharmacist about this for your specific medicines.
Q: Do any of my medicines react with alcohol?
A: It can be dangerous to combine alcohol with many medicines. This can cause drowsiness and mental confusion, causing falls, injuries and road accidents. Some medicines should not be taken if you are a regular alcohol user due to serious medication side effects. Discuss this with your doctor.
Q: Could my daily vitamins react with my other medicines?
A: Yes, particularly if you are taking blood thinners. This is why it's important to tell your doctor and pharmacist about everything you are taking, including vitamins.
Q: Is it safe to drive while taking my medicines?
A: Some medicines slow reaction time, and driving should be avoided while taking them. Ask your doctor about this.
Q: Where should I store my medicines?
A: A cool, dark, dry place is best to store most medicines. Some medicines might even need to be kept in the refrigerator. For best results follow the storage instructions of your doctor or pharmacist.
Q: I would like to try the medicine my friend is taking – it helps calm her down.
A: Never take someone else’s medicine, and don’t share yours with anyone else. Doing this could be dangerous. If you need help with “nerves” or anxiety, or any other health problem, talk with doctor.
Q: This medication is expensive. Is there a generic version I could take that would cost less?
A: Ask your doctor about this. Sometimes there is a less expensive version that is just as effective.
Q: How long should I keep my medicine?
A: There is a date on prescription and non-prescription medicines that tells when the medicines will expire. If in doubt about how long to keep a medicine, ask your doctor or pharmacist.
Q: I have arthritis and can’t open childproof medicine bottles. What can I do about this?
A: Ask your pharmacist not to put childproof caps on your medicine bottles. If you do this, make sure all medicines are stored out of reach of any children who might visit your house.
Q: I am taking all my medicines. Is there anything else I can do to stay as healthy as possible?
A: Yes, eat healthy food; don't smoke; use only small amounts of alcohol or no alcohol at all. Also exercise daily, especially with friends; and stay interested and involved with every aspect of life. Keep track of the effects of your medications and get regular checkups to discuss your medicines with your doctor.
Updated: March 2012
Posted: March 2012