Archive for the ‘Medications’ Category

Taking Your Medication May Just Save Your Life-tips to stay on your medication and stay healthy

August 3, 2015

Nearly two-thirds of all patients don’t take their medication as the doctor prescribed and a similar percentage don’t refill their prescriptions in a timely fashion. This problem with medication is linked to more than a third of medicine-related hospitalizations and nearly 125,000 deaths each year
Tried-and-true methods, plus the latest electronic reminders and gadgets.
Taking medications as your doctor prescribes—known as medication compliance—is a key to staying healthy and managing chronic symptoms. But noncompliance is a serious public health problem.

Why it happens
There are a number of reasons why people find it hard to stay on medication regimens prescribed by their doctors. Cost is one of the biggest. People are prescribed a brand-name drug that they can’t afford, but a more affordable generic may be just as effective. Other reasons for noncomplince include medication side effects that people don’t like, or a lack of understanding about why a medication is necessary for good health. Forgetfulness especially in the elderly is also a common problem that can sabotage a medication routine.
Tips and strategies
When your doctor hands you a prescription, make sure you understand what it’s for, what the name of the drug is, how much you need to take and when, and what will happen to you if you don’t take it. Write down the information, ask for a printout, or bring a buddy or a partner to act as your scribe or advocate.
If a drug cost is too high for you, talk to your doctor or pharmacist about more affordable options, such as generic drugs. A number of large chain stores (Walmart, Target, Kroger) offer 30- and 90-day supplies of dozens of generic drugs for as low as $4 and $10. If you must stick to a brand-name drug, shop around for prices, and see if you qualify for prescription assistance programs through the drug’s manufacturer. One useful website is GoodRx.com, which offers the opportunity to comparison shop for drug prices, as well as links to coupons.
If forgetfulness or a busy lifestyle keeps you from sticking to a medication routine, you may need to develop a strategy to stay on schedule. Suggestions include asking for reminders from family; using a seven-day pillbox; setting an alarm on your watch, phone, or clock; making a chart that shows when to take your medicine; keeping track of when you take medications in a journal; and taking a dose at the same time each day—perhaps even linking it to another daily activity, like brushing your teeth. It may also help to ask your doctor if it’s possible to reduce the number of medications by eliminating any that aren’t absolutely necessary, or to see whether combination drugs, which include two or more active ingredients in one pill, are available for your condition.
Technology, too
Computers, smartphones, and other gadgets can help improve medication adherence. Consumers can choose from such devices as automatic pill dispensers that pop out the right pills at the right times; pillboxes with timers and alarms; electronic caps that fit on prescription vials and beep when it’s time to take a medication, then record when the cap was removed, indicating that a pill was taken; and applications for computers and smartphones that can organize pill information and remind you when to take them.
Pharmacies and even insurance companies are also using technology to improve medication adherence. Some offer programs to call and remind you to get a prescription refilled, or programs that estimate when you’ll finish a medication and automatically refill the prescription, then call to remind you. Pharmacies also offer bubble or blister packs that organize several different medications into morning, afternoon, and evening packages, so you don’t have to open numerous pill bottles.
On the cutting edge is technology built right into packaging and even into pills themselves. Both can transmit signals about when you’ve taken your medications. “These aren’t widely available and are still being tested. But one day a lot of these systems could be able to integrate with your physician, all with the goal of improving adherence and health.

Bottom Line: It is important that patients take their prescription medication as directed by their physician. Noncompliance can significantly impact your health and well being. Use some of the strategies that I have outlined in this blog.

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Prescribed Pills – Don’t Take Two and Then Call in the Morning!

January 4, 2015

Millions of Americans take prescribed medications. Yet few patients ask about the medications, the purpose, if there are drug interactions with their existing medications, the cost, and most important of all, the side effects of the medications. This blog will discuss the questions you should ask your doctor when you are given a new prescription.

One study reported that doctors spent an average of 12 seconds talking about a new medication’s side effects, and in another report, fewer than 50% of physicians covered the topic of side effects at all.

Luckily, doctors love to answer questions. If you can guide the conversation with relevant questions, you’ll (1) get better information, (2) participate in the decision, and (3) leave with confidence instead of confusion about your new prescription.
Before you walk out the door with that new prescription I suggest that you do the following:
• Ask for the generic name as well as the trade name of the medication?
• What does it do? (conditions it treats, how it works)
• What are the benefits? For example:
Does it just lower your blood sugar or cholesterol, or has it actually been shown to prevent strokes, heart attacks, or other health events? There are some drugs that just change your lab results without altering your health risks and you may not want to treat your numbers on a lab report.
How many people taking the drug does it actually help? (Drugs have varying rates of response — for example, 50% for many anti depressant meds.)
What are the risks?
How many people taking the drug have side effects?
What side effects are common? Are they temporary?
Any severe side effects?
What side effects should you call your doctor about if you have them?
Are there alternatives?
◦ Other types of medications
◦ Drug-free alternatives. (Exercise is more effective than drugs at reducing your risk of death from certain causes.)
How do you take it?
Does it interact with any of your current health conditions, other medications, supplements, foods, or alcohol?
Timing: How long does it take to start working? Can you stop taking it if you feel better?
What if you miss a dose?
Is any monitoring required? (Some medications can affect kidney function, for example, so it’s checked periodically with a blood test.)
How much does it cost? Is there a generic version available?

Bottom Line: If you are armed with these questions and ask your doctor and get answers to these important questions, then you will be a better informed and a healthier patient.

What if I think my medicine is affecting my sex life?

October 22, 2014

In the previous blog I discussed the relationship between medications and sexual performance. This blog will make suggestions on how to approach your doctor and what are some of the options when drugs\medications impact your sexual performance.  If you are at all worried that your medicine may be affecting your ability to have sex, consult with your physician who prescribed the medication.

Do not stop taking your medicine without first talking to your doctor.

Do not be put off seeking help. Your quality of life is important, particularly if you are being treated for something like high blood pressure, which often has no symptoms and can require lifelong treatment.

Treatment of high blood pressure

  • Impotence seems to be less of a problem with ACE inhibitors such as enalapril.
  • Calcium channel blockers and alpha-blockers cause fewer sexual problems than diuretics (water tablets) or beta-blockers.
  • Loop diuretics such as furosemide have a lower risk of impotence than thiazide diuretics.

Treatment of depression

  • SSRIs cause the highest frequency of sexual dysfunction, followed by MAOIs (monoamine oxidase inhibitors) and then tricyclic antidepressants.

Treatment of high cholesterol levels

  • Not all statins are associated with sexual problems. Even in those that are, the risk of developing such problems is very low.
  • Statins may be less likely to cause impotence than fibrates.

Bottom Line: Your doctor may switch you to another medicine in the same class, i.e., that acts in a similar way, in the hope that the new one will not cause the same side effects.

Alternatively, your doctor may try a different type (class) of medicine altogether, providing it is suitable for you to take.

Your doctor may also adjust the dosage and prescribe a lower dose which may have the desired effect on your blood pressure or your depression and not have the unwanted side effects of ED or lowering the testosterone level. The real bottom line is to speak to your physician to help with your medications and preserve your sexual performance.

Don’t Let Your Medicines Make You Sick

February 2, 2014

Most middle aged Americans are taking 2-5 medications. These medications if not used properly, can add to your illness rather than improve your health. It is estimated that 1.5 million Americans are sickened, injured or killed each year as a result of errors in prescribing, dispensing and taking medications. Here are a few tips that you might consider regarding your medications that will lead to be better health.

Start by storing your medicines properly. Your bathroom is hot and humid and may cause your medications to deteriorate or loose their potency. It is best to store your medications in the kitchen or nightstand in the bedroom.

Inaccurate dosing. If the medications is a liquid and you are advised to take a teaspoon of medication and use a teaspoon from the kitchen drawer, the volume may vary from 2.5 ml to 7.3 ml. Therefore, it is advised that you use an accurate medication spoon which is available at every pharmacy.

Skip rope not doses. Take your medications as prescribed by your doctor and don’t skip doses or discontinue the medication as soon as your symptoms subside. This is particularly true for antibiotics and patients who have infections and stop their medications as soon as the symptoms are gone may find that they develop a worse infection because the bacteria develop resistance.

Storing your medications in one bottle is to be avoided. If you are like most Americans and have multiple medications, you can get confused if they are all in one container and take the wrong medication at the wrong time of day. I suggest that you keep the prescriptions in their original bottles with the labels placed on the bottles by the pharmacist.

Shop until you drop may happen if you are getting your medications from multiple sources. Instead of picking up medications at the neighborhood pharmacy and then filling another prescription at a pharmacy near work, may result in receiving medications that may interact and not have the desired effect or have the potential for side effects, I suggest that you obtain your medications from a single pharmacist who will have a log of your medications and will caution you about conflicting medications.

Final suggestion: Keep a record of your medical encounters and carry them in a folder to each doctor you see. This avoids duplicating tests, having drugs prescribed that cause an allergic reaction or a medication interaction. Also, carry this folder with you when you travel in case you need to see a doctor out of town or go to an emergency room that doesn’t have access to your medical records.

Bottom Line: Medications do make us better if used properly and taken as prescribed by our doctors. Be prudent about your medications and you will get well!

This blog was inspired and excerpted from an article, Avoid Common Medication Mistakes, by Jodi Helmer and appeared in June 2013 Costco Connection.

Tricks and Tips for Saving Money On Prescriptions

September 29, 2013

I truly recognize that prescription medicines are costly and often beyond the reach of many patients. I am often amazed at how expensive prescribed medications are and how the price is so variable from one pharmacy to another. Here are a few tricks and trips to save money on your prescription medications.

1. Price compare between pharmacies. Prices can be double and even triple from different pharmacies. Generic medicine prices vary more than branded/trademarked medicine prices.

For example a Z-pack 5 day antibiotic (generic) Costco- $11 OR Kmart- $55
Tricyclen birth control (generic) Target- $9 OR Osco- $33
Suggestion: call the pharmacies yourself and find out which one is offering the lowest price. The pharmacy tech or the pharmacist will give you the price over the phone. You need to be able to tell the pharmacist the strength and quantity of the medication.
Another idea: Take your “combo pill” as two separate pills. If you are taking a medication that is a combination of medicines, consider taking it as two separate pills. For example if you have an elnlarge prostate gland and the doctor has presicrbed a pill that combines two medications such as an alpha blocker and a pill to decrease the size of the prostate gland, you can ask the doctor to prescribe both drugs and you take two pills instead of one at a much reduced cost. If you are not sure if you are taking a “combo pill” try Googling the name to find out. Usually you can save money by taking the meds separately (even if there is a generic version of your combo med!)
Lotrel (generic) 10/20, #30 tabs – $81 per month OR amlodipine 10 mg, #30 tabs + benazepril 20 mg, #30 tabs= $8 + $6 = $14 per month.
Change the dosing schedule of your medication. If you are taking a medication that ends with “XL”, “XR”, “CD”, or “SR”- then you are probably taking a long acting, albeit expensive version of your medicine. Therefore, there is probably a short- acting generic version of your medication also available. The trade off would be that you might have to take a pill two or three times a day instead of once or twice a day but at a significant saving. If your doctor thinks this is appropriate for you, it could save you big bucks.
Rythmol SR 225 mg, #60 tabs (taken twice a day)- $367/month OR propafenone (generic Rythmol) 225 mg #100 tabs (taken three times a day)- $34/month

Bottom Line: Prescription medications are expensive. However, there are effective ways to reduce the costs without negatively impacting your health.

10 Actions Steps To Prevent Impotence

August 28, 2012


1. Recognize the Normal Signs of Aging. Remember, it may take longer to obtain an erection at age 60 than at age 20. More genital stimulation and foreplay are required as a man ages.
2. Beware of Medications that can Cause Impotence. There are literally hundreds of medications associated with the side effects of impotence. These common medications include tranquilizers, medication for high blood pressure and ulcers.
3. Avoid Tobacco. Tobacco it is a performance-zapper because its effect on blood vessels can decrease blood flow to the penis.
4. Drink Alcohol in Moderation.1-2 drinks per day may relax you and even protect your heart. More than 2 drinks per day may impact your sexual performance.
5. Timing can be Everything. Sexual performance is influenced by body rhythms. Hormonal levels can vary at different times of the day. It is important to find that time of day or evening that is best both mentally and physically for you and your partner.
6. Accept Occasional Failure. One episode of impotence-even if it last for weeks- does not mean that a man is permanently impotent. Stress and fatigue, and anticipation of failure, can paralyze your sex life. Accept occasional impotence as something that happens to every man at different times in his life.
7. See your Physician at least Once a Year. If you are more than 50 years of age, the cause of your erectile dysfunction is usually physical and not due to psychological or emotional reasons. You need to be sure there are not more serious, life-threatening conditions lurking behind the sexual problem.
8. Balanced Nutrition is important for Sexual Function. The American Heart Association states that a low-fat, a low-cholesterol diet prevents heart disease and arteriosclerosis which also affects a man’s erection.
9. Excess Stress. Excessive, long-term stress is “counter erotic” and affects both a man and his partner’s capability to have a happy sexual relationship.
10.Get Help. Persistent, chronic impotence needs medical attention before it interferes with relationships. Not treating erectile dysfunction may result in more severe illnesses including heart disease, stroke and diabetes.

Bottom line: If you or your loved one is suffering from erectile dysfunction see your physician because help is available and no one needs to “suffer the tragedy of the bedroom.” If you want to keep it up, get a checkup!

Purchasing Medications Online-Let the Buyer Beware

April 7, 2012

With the high cost of prescription medications many patients are frequently asked about ordering medications online. This is certainly understandable with the high cost of medications, so many of our patients on fixed income, and the high unemployment rate making affording medication difficult or impossible. Patients are looking to their physicians for advice on buying medications online. This is the advice I give the patient in a written form to help them make the decision of whether to purchase medications over the Internet.
The FDA is trying to stop the flow of illegal ED drugs, but these medicines still circulate freely on the Internet. Legitimate online pharmacies do exist. It just takes a little bit of sleuthing to find them.
Here’s what to look for when you buy ED drugs online:
• A licensed pharmacy with an address in the U.S. (Check with your state board of pharmacy or the National Association of Boards of Pharmacy.)
• A pharmacy that requires a prescription from your doctor
• Drugs that are approved by the FDA
• Containers that are clearly labeled with the name of the drug and the dosage
• A licensed pharmacist who is available to answer your questions
• A contact phone number to call if you have questions or problems
A clearly stated privacy policy that protects your credit card number and other personal information
Bottom Line: Doctors can only assume responsibility for medications they prescribe that are obtained from reputable pharmacies located in the United States. However, it may be possible to find drugs online if you follow the caveats described above.

Don’t Let Your Bladder Drain Your Travel Plans

December 21, 2011

Travel today can make anyone anxious and nervous. But traveling and worrying about urinary incontinence can make even the most seasoned traveler think twice about making plans for a trip. This article will provide ideas that can help allay those apprehensions about traveling if you have urinary incontinence.

First, if fears about having an incontinence episode are causing you to consider skipping your trip entirely, check in with your doctor. There are medications that can be taken once a day that will help with bladder frequency, urgency of urination and urinary incontinence. You may need to start taking medications a few days or a week in advance of traveling for them to work most effectively, so don’t delay.
Here are other things to discuss with your doctor:

A Kegel a day may keep you dry and comfortable. Kegel exercises are used to strengthen the muscles in the pelvis. However, it may take weeks or months to train these muscles to help control your urination. You can do the exercises at any time even while reading this article or while waiting for the lavatory sign to read “vacant.”

Some medications have side effects that can contribute to urinary incontinence. Check to make sure other drugs you take aren’t undermining bladder control. For example, people who take diuretics to manage blood pressure or swelling might need to switch medications to fight incontinence .
Creating Your Flight Plan

Here’s how to plan for flying or driving “dry”:
Book tickets carefully. If you’re flying, try to get an aisle seat and, if possible, one close to the toilet. Many booking sites let you choose the seat you want on a map of the plane.

Plan your route. If you’re driving, take a careful look at your map and consider stopping for bathroom breaks every 90 minutes or so (based on your typical time between urges or leaks).

Buy supplies. Even with good planning, you could experience a leak. Adult absorbent pads can help you feel more confident. For long trips, talk with your doctor about urethral plugs or portable catheters. Some patients may have a catheter or tube inserted into the bladder before a trip which will drain urine from the bladder to a leg bag which can be easily concealed under your clothing. The catheter can then be removed when you reach your destination. And if you’re flying, check ahead with your airline to find out what you can take in a carry-on. Generally, all prescription assistive products can go on the plane with you.

Learn foreign customs. If you’re traveling internationally, learn how to ask for a bathroom in the local language. Also check in advance to find out whether you will need change for public restrooms and tips for attendants.
Bladder Control While on Your Trip

Choose beverages carefully. Caffeine, soda, beer, and wine are all diuretics and increase the production of urine and can aggravate an already overactive bladder. You should skip these while flying or driving. Sip on water if you’re thirsty.

Ask for privacy. Should you find yourself in the awkward situation of needing a pat-down or other security screening, and you’re feeling embarrassed about your incontinence or related supplies, know that you can ask security officers for privacy. You may want to ask your doctor in advance for a note to confirm your situation.

Avoid constipation as constipation actually makes bladder control more difficult, so make sure you eat a varied diet and have regular bowel movements.

Void early and often. Instead of waiting for a leak, be proactive and seize your opportunities. Make sure you go to the bathroom before you get on the plane, during a layover, and when you have opportunities between meal and beverage cart service times. When driving, stick to your planned stops, even if you don’t feel the urge to go.

Pack a change of clothes. You want to travel light, but you should have easy access to a spare set (or two) of underwear and easy-to-wash travel pants.

Pack toilet supplies. Because you never know how well bathrooms will be maintained, you may want to carry your own flushable wipes, spare toilet tissue, sanitizing hand gel, plastic bags for disposing of trash or for storing soiled clothes, and any other supplies you think you might need.

Plan for special events. You may occasionally have to attend a gala dinner or other social engagement that could require sitting for hours while people speak or make presentations. Try to find out whether these will be on your itinerary and whether you can be seated close to a door.

Bottom Line: With proactive incontinence management, your trip should be as pleasurable and comfortable as you want and you won’t have to depend on Depends!

Article modified from Taking Incontinence on the Road, By Madeline Vann, MPHMedically reviewed by Farrokh Sohrabi, MD

Advice About Ordering Your Medications From Online Pharmacies In Other Countries

December 20, 2011

Drugs for most medical conditions are very costly. Today the cost spent on pharmaceutical agents is $307 billion per year or $728 for every American is spent each year on medications. (I am sure this is much higher for seniors who take much more medication than younger individuals.) The Medicare “donut hole”, or the failure of Medicare to pay for prescription drugs after the government has paid several thousand dollars, leaves many seniors without coverage for expensive medications for weeks or months at a time. Consequently, many seniors are going without medications or are looking to online foreign sources, i.e., Canada, Mexico, India, and China for their prescription medications. This article will discuss the caveats and pitfalls for buying prescription medications online.

I am frequently asked by patients how to buy less expensive medications including is it safe to buy medications online from another country.
The U.S. Food and Drug Administration (FDA) opposes foreign drug purchases, warning that these sales pose serious safety problems. While importing Canadian medications is against U.S. policy, the FDA has said that it will not prosecute individuals who import small amounts (three months or less) for personal use. If you are considering ordering medications from Canada, remember that the FDA cannot guarantee the safety of those medications. The FDA’s concerns include:

Medications that have not been approved for sale in the United States may not have been manufactured under quality assurance procedures designed to produce a safe and effective product.

Some imported medications — even those that have the name of a product approved in the United States — may, in fact, be counterfeit versions that are unsafe or ineffective.

Some imported medications and their ingredients, although legal in foreign countries, may not have been evaluated for safety and effectiveness in the United States. These medications may be addictive or contain other dangerous substances.

Some medications are unsafe when taken without adequate medical supervision. You may need a medical evaluation to ensure that the medication is appropriate for you and your condition. Or you may require medical checkups to make sure that you are taking the medication properly, to assess whether it is working for you, and to check for unexpected or life-threatening side effects.

The medication’s label, including instructions for use and possible side effects, may be in a language you do not understand and may make medical claims or suggest specific uses that have not been adequately evaluated for safety and effectiveness.

An imported medication may not have information that would allow you to be treated promptly and correctly for a dangerous side effect caused by the medications.

The American Association for Retired Persons (AARP), the leading non-profit, non-partisan membership organization for people aged 50 years and over in the United States, does not encourage Americans to break the present drug importation law. But with an estimated two million Americans already buying prescription medications from Canada and other countries, AARP has come up with guidelines to help consumers minimize their risk and ensure that the medications they receive are the ones their doctors have prescribed. AARP recommends that you pick an online pharmacy that:

If you are buying drugs from Canada, look for the displays the seals of the Canadian International Pharmacy Association (CIPA; see http://www.ciparx.ca/) or Internet and Mail-Order Pharmacy Accreditation Commission (IMPAC; see http://www.impacsurvey.org/). These organizations set standards for safety and service among Canadian mail-order pharmacies that sell to Americans. Those that meet the standards receive accreditation.

Requires a prescription for medication from your doctor. Reputable pharmacies may allow you to fax in a prescription but will then either confirm the prescription by a phone call to your doctor’s office or wait until they receive the original prescription in the mail before filling your order.

Expect that the pharmacy requires you to submit details of your medical history and clearly states the pharmacy’s policies for ensuring medical and personal privacy.

It is probably best to have taken a medication for at least one month before you order by mail so that you and your doctor know the medication is working and is safe for you.

Provides a full mailing address and a toll-free phone number on its website so that you can call and speak to a pharmacist to ask any questions you may have.

Displays on its website full information about shipping fees, payment policies, and refunds. Reputable pharmacies offer secure (encrypted) online payment for credit cards, alternative options for payment (such as electronic fund transfers and regular checks), and do not charge any separate fees except for shipping.

Charges the cost of the medications to your credit card only when the drugs are shipped, not when the order is first placed. An honest pharmacy refunds your money or reships medications immediately if your order does not arrive.

Bottom Line: If you’re wondering where to start looking for pharmacies online, visit http://www.pharmacychecker.com, a website run by an independent American consumer research group that provides ratings and price comparisons for more than 40 online pharmacies based mainly in the United States and Canada. This site rates them on a scale of 1–5 and notes whether a pharmacy is licensed, requires a prescription, provides its address and phone number, and offers personal privacy and payment security. The site compares prices for more than 1,000 drugs at these pharmacies and gives details on shipping fees and delivery times. Buying medication online is slight risk. However, if you follow these guidelines, you may be able to achieve considerable savings for those expensive medications.

Can’t Pee? It May Be Your Medications

May 25, 2011

Having the urge to urinate — and not being able to do so — is painful, as many men know.  Certain medications may make the emergency form of this condition, known as acute urinary retention, more likely.

Painful urination or difficulty urinating are listed as possible side effects of the drugs studied – sold under the names Atrovent, Combivent and Spiriva.

An article published in the prestigious Archives of Internal Medicine reported that men with chronic pulmonary or lung diseases who had just started taking inhaled anticholinergic medications, a common treatment for the breathing diseases, had 42% greater odds of developing the urinary problem than men who were not on anticholinergics.

Bottom Line: There is an association between respiratory inhaler use and urinary symptoms especially urinary retention.  This is particularly important issue in men who have enlarged prostate glands as they are at an increased risk of having the complication of urinary retention.