Ask the Geriatrician: Medication Management

Amy Ehrlich, MD

Amy Ehrlich, MD
Geriatrics Fellowship Program Director
Associate Professor of Clinical Medicine
Albert Einstein College of Medicine/ Montefiore Medical Center

Medications can keep you feeling well but can be hard to manage. If medicines are misused they can be dangerous. It is important to make a list to show your healthcare provider and pharmacist that includes all prescription, and non-prescription medications, as well as herbal and alternative therapies, or vitamins, and eye drops. Here are some questions and answers to help you manage your medications.

Q:  What does the label on my medication tell me?

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 medications. Take all your pill bottles with you when visiting your healthcare provider.

Q:  What does each medication do?

A:  Your healthcare provider or pharmacist will be able to tell you what your medications do and which conditions they treat. Make a note of it on the bottle or in another location.

Q:  Are all my medications really necessary? I’ve been taking some of them for years.

A:  Ask your healthcare provider about this. Some diseases usually need life-long treatment; for example, high blood pressure and diabetes. Other diseases clear up after a while, and the medication might not be needed anymore.

Q:  I have started a new medication. 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 it even if there seem to be no immediate results.

Q:  What do I do 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 medications. It is important to know whether a new symptom is due to disease, or a side effect of your medication. Your pharmacist or healthcare provider is a good starting point.

Q:  Why does my healthcare provider need to know all the medications I am taking, even if they are not prescription medications?

A:  It is important that at least one of your healthcare providers has a list of all medicines you take, including non-prescription, herbal, or other remedies.  This is so you can avoid taking too much of the same or similar medicines, and avoid interactions between medicines that can make you sick.

Q:  Are non-prescription medicines I buy at the pharmacy weaker and less effective than the ones my healthcare provider prescribes?

A:  You may think that over-the-counter (OTC) medications are weaker than prescription medications. However, OTCs 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:  Since herbal medicines are natural, they must be safe. Right?

A:  Some of the most powerful prescription medicines are made from plants, so they also could be considered "natural." They 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 medications?

A:  A pharmacist who knows all the medicines you are taking can be very important for you. They can quickly recognize that you have been prescribed or are taking medications that may react to each other, and can let you and your healthcare provider know there is a possible problem.

Q:  How can I set up a system to remind me when to take my medications?

A:  There are many good systems available. For example, you can put your medications in 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. You can even use 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 medication 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 setting up a timer to turn on a table lamp at certain times of the day as a reminder to take medication.

Q: What should I do if I miss a dose?

A: Ask your healthcare or pharmacist about this. Don't just double up the next one; this does not work well for certain medications and can even be dangerous.

Q: Do any of my medicines react with foods?

A: Yes, there are some medications that react with certain foods. For example, some antibiotics don't work as well if they are taken with dairy products, and the "statin" group of medications for cholesterol should not be taken with grapefruit juice. Ask your healthcare provider or pharmacist about food reactions for your specific medications.

Q: Do any of my medications 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 car crashes. Some medicines should not be taken if you are a regular alcohol user due to serious medication side effects. Discuss this with your healthcare provider.

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 healthcare provider and pharmacist about everything you are taking, including vitamins. 

Q:  Is it safe to drive while taking my medications?

A:  Some medications slow your reaction time, and driving should be avoided while taking them. Ask your healthcare provider about this.

Q: Where should I store my medications?

A:  A cool, dark, dry place is the best place to store most medicines. Some medications might even need to be kept in the refrigerator. For best results, follow the storage instructions your healthcare provider or pharmacist give you.

Q: My friend takes medicine for anxiety. I am feeling nervous and I would like to try her medication. Is that a good idea?

A:  Never take someone else’s medication, 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 your healthcare provider.

Q:  This medication is expensive. Is there a generic version I could take that would cost less?

A:   Ask your healthcare provider or pharmacist about this. Sometimes there is a less expensive generic version of a medication that is just as effective as the brand name.

Q:  How long should I keep my medications?

A:  There is a date on prescription and non-prescription medications that shows when they will expire. If you are in doubt about how long to keep a medicine, ask your healthcare provider 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 medications are stored out of reach of any children who might visit your house.

Q:  I am taking all my medications. 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.

 

Last Updated March 2012