5 common rx questions - wellrx blog image

By Rosanna Sutherby, PharmD

Many people have questions and concerns about their medications. Part of my work as a pharmacist involves helping patients navigate the complexities of their medication regimens. The following are the five questions that I hear most commonly at the pharmacy.

1. Can I Drink Alcohol While Taking My Medication?

Many medications interact with alcohol. Alcohol is a central nervous system (CNS) depressant and can increase the drowsiness effect of some medicines. It can also cause nausea and vomiting with some medications, and increase the risk of bleeding with others. Because it is metabolized by your liver, alcohol can interact with other medicines that are also processed through the liver. Mixing alcohol with these medicines can decrease their effectiveness as well, or even make them toxic.

You should avoid drinking alcohol if you are taking any the following medications:

  • sleeping pills, such as zolpidem (Ambien), eszopiclone (Lunesta), and temazepam (Restoril)
  • anxiety medication, such as alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium)
  • antidepressants, such as fluoxetine (Prozac), citalopram (Celexa), and venlafaxine (Effexor)
  • attention deficit-hyperactivity disorder (ADHD) medications, such as methylphenidate (Concerta, Ritalin) and amphetamine/dextroamphetamine (Adderall)
  • warfarin (Coumadin)
    Related: Losing the War on Warfarin
  • muscle relaxants, such as cyclobenzaprine (Flexeril) and Carisoprodol (Soma)
    Related: Medications to Treat Low Back Pain
  • seizure medicine, such as gabapentin (Neurontin), topiramate (Topamax), and lamotrigine (Lamictal)
  • antihistamines, such as diphenhydramine (Benadryl), loratadine (Claritin), and cetirizine (Zyrtec)
  • nausea medicine, such as meclizine (Antivert) and promethazine (Phenergan)
  • opioid pain medication, such as hydrocodone and oxycodone
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), meloxicam (Mobic), and celecoxib (Celebrex)
  • acetaminophen (Tylenol)
  • diabetes medication, such as glyburide, metformin, and glipizide (Glucotrol)
  • metronidazole (Flagyl)

This list does not include all medicines that may interact with alcohol. Talk with your pharmacist or healthcare provider about the effect of alcohol on your medication.

2. Should I Take My Medication With Food?

It is wise to take some medications with a meal to prevent upset stomach; however, not all drugs should be taken with food. Some medicines work better when taken with a meal, while others require an empty stomach to obtain the best effect.

  • Antibiotics: Take antibiotics with food to minimize diarrhea and upset stomach. Do not take fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin, and ofloxacin) with milk or other products that contain cations (e.g., calcium, magnesium, and aluminum).
  • Acetaminophen (Tylenol): You can take acetaminophen with or without food; however, the medication is absorbed faster when taken on an empty stomach.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Always take NSAIDs with food to decrease the risk of stomach bleeding.
  • Antihistamines: Antihistamines, such as fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec) work better if you take them on an empty stomach.
  • Antidiabetic medications: To prevent episodes of low blood sugar, you should take medication to treat diabetes with your first meal of the day or 30 minutes before meals.
  • Thyroid medicine: Thyroid medication, such as levothyroxine (Synthroid, Levoxyl, Unithroid) should be taken first thing in the morning on an empty stomach.
  • Medication for osteoporosis (porous, brittle bones): Bisphosphonates (drugs that slow down bone loss), such as alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva) must be taken on an empty stomach with a full glass of water 30 to 60 minutes before eating or taking any other medication.
  • Iron supplements: Iron is absorbed better in an acidic environment; therefore, take it on an empty stomach for maximum absorption. However, if you cannot tolerate iron on an empty stomach, you can take it with food.

3. Can I Take Ibuprofen or Acetaminophen With My Antibiotic?

Generally, you can take ibuprofen or acetaminophen to reduce fever or pain while taking most antibiotics. However, you should avoid ibuprofen and other NSAIDs if you are taking a fluoroquinolone antibiotic, such as the following:

  • ciprofloxacin (Cipro)
  • levofloxacin (Levaquin)
  • moxifloxacin (Avelox)
  • gemifloxacin (Factive)
  • ofloxacin (Floxin)

4. I Forgot to Take My Medicine! What Should I Do?

Generally, if you forget to take your medicine, you can take your medication as soon as you remember if it is not close to the time for your next dose. Do not double your dose, except in the case of oral contraceptives. You can take two birth control pills if you miss one dose. If you miss more than one dose, follow the instructions provided by the manufacturer.

Talk to your pharmacist for more specific instructions on what to do if you forget to take your medicine.

5. Does My Insurance Cover My Medication?

Insurance plans have formularies that help determine what medications will be covered. Often, these formularies are further divided into tiers that represent different out-of-pocket pricing for the medicines. The cost of your medication may depend on your coverage and the tier in which it falls.

If your insurance does not cover your medication or if your medicine falls into a high tier, prescription discount cards can offer prescription savings.

What Are Prescription Discount Cards?

Prescription discount cards, or prescription savings cards, help you obtain the lowest prescription price for your medication. If your insurance does not cover your medication or the cost is too high on insurance, a free Rx savings card may save you up to 80% or more off the retail price. You can use the ScriptSave WellRx discount card for the best prescription savings at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines

www.wellrx.com/hn/us/assets/health-condition/insomnia/~default/

www.wellrx.com/hn/us/assets/health-condition/anxiety/~default/

www.wellrx.com/hn/us/assets/health-condition/depression/~default/

www.wellrx.com/hn/us/assets/health-condition/epilepsy/~default/

www.wellrx.com/hn/us/assets/health-condition/motion-sickness/~default/

www.wellrx.com/hn/us/assets/health-condition/type-2-diabetes/~default

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191675/

www.wellrx.com/prescriptions/

www.wellrx.com/family-prescription-savingswww.wellrx.com/prescription-discount-card

low back pain relief - blog image - wellrx

By Libby Pellegrini MMS, PA-C

Low back pain is one of the most common conditions that bring people in to see their healthcare providers, and about 40 percent of adults will experience low back pain at some point in their lives.

When it comes to treating low back pain, the numbers talk. A recent study published in the Journal of the American Medical Association (JAMA) shows that low back and neck pain accounts for the largest amount of healthcare-related spending in the United States compared to 153 other health conditions, with Americans spending more than $134 billion dollars annually on these conditions.

Some treatment options, such as muscle relaxants and other medications, can be less expensive than more invasive therapies like targeted injections and other procedures.

Read on to learn more about muscle relaxers and other medications used to treat low back pain.

Muscle Relaxers

A muscle relaxant medication targets the skeletal muscles, which are the types of muscle cells at issue when it comes to low back pain. Muscle relaxants can provide both analgesia (pain relief) and a degree of muscle relaxation, which can reduce muscle spasms.

Many types of muscle relaxants are available. Common muscle relaxers include cyclobenzaprine, methocarbamol, carisoprodol, baclofen, metaxalone, and tizanidine. Generally, a muscle relaxant is prescribed in addition to a nonsteroidal anti-inflammatory (NSAID) medication, and it is usually used as second-line therapy after an initial trial of just an NSAID.

Muscle relaxants can cause sedation, so they are generally not prescribed in combination with other sedating medications. If you are taking a muscle relaxant, you should not operate heavy machinery (including a motor vehicle) or perform other activities that would be dangerous if you were to fall asleep. This side effect tends to be more pronounced in older adults, so muscle relaxants are used with extreme caution in those 65 years of age and older.

If you are prescribed a muscle relaxant to help with low back pain, make sure to use ScriptSave® WellRx to save up to 80% at the pharmacy.

NSAIDs

An NSAID, also known as a nonsteroidal anti-inflammatory medication, is one of the initial mainstays of treatment of low back pain. Commonly used NSAIDs include ibuprofen and naproxen. These medications are available over the counter, and they can also be prescribed. Make sure to take them with food, and in coordination with any other guidelines from your healthcare provider, as they can have significant renal, cardiovascular, and gastrointestinal side effects.

When it comes to treating low back pain, other non-NSAID over-the-counter pain relievers, such as Tylenol (acetaminophen or paracetamol), have not shown much success. However, if no other medication can be safely taken because of allergies or other health problems, a medicine like acetaminophen may still be worth a trial.

Stronger pain medications, such as opiates, or tramadol, have historically been used to treat low back pain; however, the evidence for their effectiveness is mixed. Many clinicians no longer prescribe opiates for low back pain because of the profound risks involved with the entire medication class.

Topical Medications

A topical medication that is applied to the skin, instead of being taken by mouth, may also sometimes be used for treatment of low back pain. These medications can be useful because they provide targeted therapy at the exact site of the pain and may not have as many associated side effects as medications that are taken by mouth and processed by the liver.

Topical NSAIDs, such as diclofenac (Volteran) gel, have been found to be efficacious in helping improve low back pain. Other topical medications, such as capsaicin cream, or lidocaine (Lidoderm) patches, may also be effective.

Putting It All Together

The above medications, paired with heat/cold therapy, massage, gentle activity, and avoidance of bed rest, can be very effective at managing low back pain. Most low back pain will resolve before 6 weeks. If you have back pain that persists beyond this or worsens, or if you have new concerning associated symptoms (such as a fever, weight loss, numbness or weakness of the legs, problems walking, or bowel or bladder changes), check in with your healthcare provider immediately.

Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University.

References:

www.ncbi.nlm.nih.gov/pubmed/25395111

jamanetwork.com/journals/jama/article-abstract/2762309

www.ncbi.nlm.nih.gov/pmc/articles/PMC4103716/

www.ncbi.nlm.nih.gov/pubmed?term=27271789

www.health.harvard.edu/blog/opiates-no-solution-back-pain-201606209821

jamanetwork.com/journals/jama/article-abstract/2492858?widget=personalizedcontent&previousarticle=2762309

www.ncbi.nlm.nih.gov/pubmed/21104944

medlineplus.gov/ency/article/002119.htm



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pantoprazole vs. omeprazole - wellrx blog image

By Rosanna Sutherby, PharmD

What is the difference between pantoprazole and omeprazole? Is one better than the other? We often hear these questions in the pharmacy. Pantoprazole (Protonix) and omeprazole (Prilosec) are both medications used to treat heartburn and other stomach conditions. They are in the same category of drugs and work similarly; however, there are a few differences between the two. Before you head to a pharmacy near you for stomach acid relief, read the following comparison of pantoprazole and omeprazole.

What Type of Medication Are Pantoprazole and Omeprazole?

Pantoprazole and omeprazole both fall in the category of drugs known as proton pump inhibitors (PPIs). PPIs help reduce stomach acid by working directly in the stomach to decrease acid production.

What Do Pantoprazole and Omeprazole Treat?

Pantoprazole can be used in patients 5 years and older and is indicated for the following conditions:

  • Treatment of gastroesophageal reflux disease (GERD), a condition in which the muscle in the lower esophagus (the tube that connects your throat to your stomach) is weakened, allowing stomach acid to pass into the esophagus. The stomach acid causes heartburn and irritation in the esophagus
  • To help heal erosive esophagitis (inflammation and irritation of the esophagus) in patients with GERD
  • Treatment of Zollinger-Ellison syndrome, a condition in which the stomach secretes too much acid

Omeprazole can be used in patients 1 year and older and is indicated for the following conditions:

  • Treatment of GERD
  • To help heal erosive esophagitis in patients with GERD
  • Treatment of Zollinger-Ellison syndrome and other conditions in which your stomach secretes too much acid
  • Part of a treatment regimen to treat stomach or intestinal ulcers caused by the bacterium Helicobacter pylori (H. pylori)

How Fast Do Pantoprazole and Omeprazole Work?

  • Pantoprazole: You may start to see the effects of pantoprazole about two and a half hours after taking your first dose; however, it may take about seven days to feel the full impact of the medication. The effects of pantoprazole can last for up to seven days after you stop the medicine.
  • Omeprazole: You may start to feel the effects of omeprazole one to two hours after taking the medication, but you may not feel full relief until you have been taking omeprazole for about four consecutive days. The effects of omeprazole can last for up to five days after you stop the medicine.

What Are the Side Effects of Pantoprazole and Omeprazole?

Pantoprazole and omeprazole generally have similar side effects. The most common side effects of both drugs include the following:

  • headache
  • diarrhea
  • stomach pain
  • nausea
  • vomiting
  • gas

In addition, osteoporosis-related bone fractures have been associated with long-term use of all PPIs.

Pantoprazole can cause dizziness, joint pain, dry mouth, and blurred vision.

Omeprazole has been associated with diarrhea related to Clostridium difficile (C. diff), an infection that causes watery diarrhea accompanied by fever and stomach cramping.

This list does not represent all possible side effects. A conversation with your pharmacist will help you understand the side effects of your medications.

What Medications Interact with Pantoprazole and Omeprazole?

The choice between pantoprazole and omeprazole may be affected by drug interactions with other medications that you are taking. Some medicines interact with both pantoprazole and omeprazole, and others interact with one and not the other.

Both pantoprazole and omeprazole interact with the following medications:

  • antifungals, such as ketoconazole (Nizoral), itraconazole (Sporanox), and voriconazole (Vfend)
  • atazanavir (Reyataz, Evotaz)
  • iron supplements
  • methotrexate
  • nelfinavir (Viracept)
  • warfarin (Coumadin)

In addition, pantoprazole can produce false-positive results in urine tests for tetrahydrocannabinol (THC).

Omeprazole can also interact with the following medications:

  • anxiety medications, such as diazepam (Valium)
  • citalopram (Celexa)
  • clopidogrel (Plavix)
  • cyclosporine (Neoral, Gengraf, Sandimmune)
  • diuretics (water pills)
  • rifampin (Rifadin, Rifamate)
  • St. John’s wort
  • tacrolimus (Prograf)

The above is not a complete list of drug interactions. Talk with your pharmacist or a health care provider for more information about drugs that may interact with your medication.

Does Pantoprazole Work Better Than Omeprazole?

Generally, pantoprazole and omeprazole are equally effective. Studies comparing pantoprazole and omeprazole have found pantoprazole as effective as omeprazole in treating GERD as well as treating stomach ulcers.

How Much Do Pantoprazole and Omeprazole Cost?

The cost of pantoprazole and omeprazole varies based on your insurance coverage, where you live, and where you shop. Some insurance plans may not cover omeprazole because it is available over the counter. When you compare prescription prices, the average retail cost for thirty pantoprazole 40-mg tablets is about $69. The average retail cost for thirty omeprazole 20-mg capsules is about $46. If your insurance does not cover your medication, you can use a prescription discount card to get the lowest prescription price at a pharmacy near you.

How Do Prescription Discount Cards Work?

Prescription discount cards, or prescription savings cards, help you obtain the lowest prescription price for your medication. If your insurance does not cover your medication or the cost is too high on insurance, a free Rx savings card may save you up to 80% or more off the retail price. You can use the ScriptSave® WellRx discount card for the best prescription savings at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.wellrx.com/pantoprazole%20sodium/drug-information/

https://www.wellrx.com/omeprazole/drug-information/

https://www.wellrx.com/hn/us/assets/health-condition/gastroesophageal-reflux-disease/~default

https://www.wellrx.com/hn/us/assets/health-condition/peptic-ulcer/~default

https://www.ncbi.nlm.nih.gov/pubmed/7766739

https://www.ncbi.nlm.nih.gov/pubmed/10705625/

pneumonia vaccine - update - scriptsave wellrx blog image

By Jina Sung, Pharm.D. Candidate, Class of 2020, The Ohio State University

There are 1.7 million people in the United States visiting emergency departments with pneumonia as the primary diagnosis, according to an annual National Hospital Ambulatory Medical Care Survey, and about 50,000 people die every year due to pneumonia. This is why it’s essential for vulnerable populations to protect themselves from this disease, especially older adults.

Updates to Pneumonia Vaccine Recommendations for Adults over 65

There are two types of vaccines against pneumococcal disease: pneumococcal conjugate vaccine (PCV 13) and pneumococcal polysaccharide vaccine (PPSV23). PCV 13 is available under the brand name Prevnar 13 and PPSV23 is sold as the brand Pneumovax 23. For all adults aged 65 years or older, CDC used to recommend a routine series of Prevnar 13 and Pneumovax 23 vaccines. However, due to the decline of pneumococcal disease among seniors as a result of vaccinations, guidelines have changed. 

In June 2019, the Advisory Committee on Immunization Practices (ACIP) decided that for healthy adults aged 65 or older, the vaccine may not be necessary. ACIP now recommends that patients have a conversation with their doctor to decide whether to get Prevnar 13. However, older adults who have a high risk for pneumococcal disease should still receive both Prevnar 13 and Pneumovax 23. Additionally, Pneumovax 23 is still recommended for all adults over age 65.

Old Recommendation for Older Adults New Recommendation for Older Adults
For all adults 65 years old or older*:
Administer 1 dose of PCV 13 first, and give 1 dose of PPSV23 at least 1 year later 
For adults 65 years old or older who do not have immunocompromising condition*:
Administer 1 dose of PPSV23

For adults 65 years old or older with an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak*:
Administer PCV13 first, and give PPSV23 at least 8 weeks

* For more information, visit CDC website at https://www.cdc.gov/vaccines/vpd/pneumo/downloads/pneumo-vaccine-timing.pdf

Should Adults Over 65 Get Prevnar 13?

PCV13 (Prevnar 13) is still a safe and effective vaccine, especially if you have medical conditions or live in a place with high risk of exposure to pneumococcal strains, such as a nursing home or long-term care facility. Doctors and their patients need to consider both the exposure risk and personal risks for each patient to decide whether Prevnar 13 is necessary. If you have questions about either vaccine, talk to your doctor or pharmacist.

Find discounts on pneumonia vaccines from ScriptSave WellRx.

According to the CDC, only about 70% of adults aged 65 and older ever receive a pneumococcal vaccination, either PCV13 or PPSV23. Hopefully, the new recommendations will encourage more people to get vaccinated since healthy adults now only need a single dose rather than two doses.

What is Pneumonia?

Pneumonia is an infection mostly caused by streptococcus pneumoniae bacteria that inflames the air sacs in one or both lungs. People with the infection may experience cough with phlegm, fever, and difficulty breathing. The severity of pneumonia can range from mild to life-threatening. People with health problems, such as asthma or COPD, or weakened immune systems have a higher risk of getting more severe pneumonia. 

Who Should Get Pneumonia Vaccines?

The Center for Disease Control and Prevention (CDC) recommends routine pneumococcal vaccinations for children younger than 2 years old or adults 19 and older. There are additional pneumonia vaccine guidelines for people with certain medical conditions or weakened immune systems.

Find Discounts on Prevnar 13 and Pneumovax 23

Without insurance, pneumonia vaccines can be expensive. Find discounts from ScriptSave WellRx on the out-of-pocket cost of Prevnar 13 or Pneumovax 23.

insomnia meds - wellrx blog image

By Rosanna Sutherby, PharmD

According to the American Sleep Association, insomnia is the most common sleep disorder, and 10% of Americans report that they have chronic insomnia. Insomnia is the inability to fall asleep or to stay asleep. Some people have difficulty falling asleep when they go to bed, while others can fall asleep but are not able to sleep through the night. Still, others wake early in the morning and are not able to return to sleep.

If you have insomnia, you may have tried over-the-counter sleep aids or lifestyle changes to help you sleep. If these methods do not work, your doctor may prescribe a medication that treats insomnia.

What Are Medications That Treat Insomnia?

Several types of medications are used to treat insomnia. Some are prescribed specifically for insomnia; some medications that may be prescribed for other conditions cause drowsiness and can be used for sleep. Prescription medications used to treat insomnia include the following:

Benzodiazepines

Benzodiazepines slow down brain activity to promote sleep. Medications in this class include:

Because they are long-acting, both temazepam and estazolam can help you fall asleep as well as stay asleep. Triazolam works better to help you fall asleep. Benzodiazepines used for insomnia are indicated for short-term use. You should consult your doctor if your sleep problems are not resolved within 7 to 10 days. Benzodiazepines have the potential for abuse and dependence, and you should not use more than your doctor prescribes.

Antidepressants That Help With Sleep

Some older antidepressants called tricyclic antidepressants cause drowsiness and can help with sleep. Medications in this category include the following:

Trazadone is used in low doses to treat insomnia, and doxepin helps if you have trouble staying asleep.

Non-Benzodiazepine Sleep Medications

Non-benzodiazepine sleep medications were developed as an alternative to sleep aids that may cause dependence or addiction. Medicines in this category include the following:

  • zolpidem (Ambien, Edluar, Intermezzo)
  • zaleplon (Sonata)
  • eszopiclone (Lunesta)

Zolpidem is available as immediate-release (Ambien) and controlled-release (Ambien CR) formulations. The immediate-release version helps you fall asleep. The controlled-release formulation enables you to fall and stay asleep through the night. One layer of the tablet releases the medication immediately, while the second layer releases the drug slowly and is effective for 3 to 6 hours after you take the medication.

Zaleplon (Sonata) works rapidly and has a short duration of action, which makes it ideal for helping you fall asleep again if you tend to wake up in the middle of the night.

Eszopiclone (Lunesta) can be used for long-term treatment of insomnia. It has a long half-life, meaning that it stays in your body for a long time. You should use Lunesta only if you have at least 7 to 8 hours available to sleep.

Ramelteon (Rozerem)

Rozerem is a melatonin agonist that helps you fall asleep faster if you have trouble falling asleep. Rozerem works similarly to your body’s natural melatonin, which lets your brain know when it is time for sleep.

Suvorexant (Belsomra)

Belsomra is in the category of drugs known as orexin receptor antagonists. Orexin is a substance in your body that helps regulate wakefulness. Belsomra enables you to fall and stay asleep by blocking the action of orexin.

Lemborexant (Dayvigo)

Dayvigo was approved by the Food and Drug Administration in December 2019 for the treatment of insomnia. Dayvigo is an orexin receptor antagonist like Belsomra. The manufacturers of this drug believe that it may be especially helpful for seniors with sleep problems related to Alzheimer’s disease because it does not have side effects that affect memory.

What Precautions Should I Take With Sleep Medications?

You should not drink alcohol or take other medicines that cause drowsiness if you are taking medications for sleep. Take your sleep medication shortly before you are ready to go to sleep, and do not drive or do anything that requires alertness after you take your sleeping pill. Be sure you have at least 7 hours available to sleep after you take your sleep medication to avoid drowsiness and difficulty waking in the morning. Never take more medication than your doctor prescribes.

Does My Insurance Cover My Sleep Medication?

Many insurance plans pay for sleep medications. You can ask your pharmacist or your insurance company if your plan covers your sleep medicine. If your insurance does not cover your medication, you can use a prescription discount card to get the lowest prescription price at a pharmacy near you.

What Are Prescription Discount Cards?

Prescription discount cards offer prescription savings when your insurance does not cover your medication or when the price with insurance is higher than the cost with a prescription savings card. Using a free Rx savings card can save you up to 80% or more off the retail price. You can use a ScriptSave WellRx discount card for the best discount at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.


References:

https://www.sleepassociation.org/about-sleep/sleep-statistics/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634348/

https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959

https://medlineplus.gov/druginfo/meds/a684003.html

https://medlineplus.gov/druginfo/meds/a684004.html

https://medlineplus.gov/druginfo/meds/a691003.html

https://medlineplus.gov/druginfo/meds/a681038.html

https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022036lbl.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021774s018lbl.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021476s030lbl.pdf

https://www.merck.com/product/usa/pi_circulars/b/belsomra/belsomra_pi.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/212028s000lbl.pdf



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sdoh - wellrx blog image

By Jonathan Bosold, PharmD
SinfoniaRx

Every day, people are affected by issues like food insecurity, housing concerns, transportation to and from the doctor and pharmacy, financial strain and more. These types of issues make up what is called “Social Determinants of Health” (SDOH), which are the conditions where people live, learn, work, and play.

How Social Determinants Affect Health

Believe it or not, SDOH have been shown to account for more “unhealthy days” than diagnosed health conditions. For instance, within a given 30 day period, loneliness and food insecurity account for approximately 24 and 26 unhealthy days respectively, whereas health conditions like diabetes and depression account for approximately 15 and 22 unhealthy days respectively. 

Despite this, there is a healthcare gap in managing SDOH. Healthcare providers are trained to identify and treat conditions like high blood pressure, not food insecurity or homelessness. It can also be uncomfortable for both patients and healthcare providers alike to address these issues.

Often times, SDOH are not isolated – meaning people frequently experience more than one of these problems at the same time.

Social Determinants of Health and Medication Adherence

SDOH have a big impact on medication adherence (taking medications as prescribed by a doctor). In a scenario where someone cannot afford basic necessities, medication adherence is on the bottom of the priority list. Ensuring we can feed ourselves ranks higher than taking medications correctly.

If cost is preventing you from taking your medications, know that there are ways to save, even if you don’t have insurance. ScriptSave WellRx offers a prescription discount card at no cost. There are no eligibility requirements. Just download the card or mobile Rx app, and then show it at the pharmacy to save money.

Related: Getting Medication Discounts without Insurance

Addressing SDOH in a Healthcare Setting

Now more than ever, healthcare providers and insurance companies are recognizing the importance of SDOH. They are treating these issues as a healthcare gap, similar to if someone had unmanaged heart failure. One example of this is highlighted by Ohio State University’s Family Medicine practice. Primary care providers at the practice are teaming up with a local foodbank to provide food-insecure patients with greater access to fresh produce. 

Care may also be provided for other SDOH like transportation, housing, and loneliness. In the long run, addressing SDOH may even lower your total treatment costs. Imagine having uncontrolled diabetes and being prescribed well-balanced meals or access to healthy foods at a food pantry. The cost of those meals is quickly offset by the decrease in medication cost, decreased doctor visits, and reduced emergency room visits where care is most costly. 

How to Address SDOH in Your Own Healthcare

If you’re surrounded by negative social determinants, these factors are likely affecting your overall mental and physical health. What can be done to address that? 

First, have a discussion with your doctor about these issues. There are now medical codes where doctors can document SDOH within your patient profile, allowing you to get help from your insurance company. 

Next, you can talk to your insurance provider or Medicare/Medicaid plan to see how you can receive assistance. While many patients within the healthcare system qualify for services, many do not use them. Taking advantage of community or insurance-based programs will contribute to your health in a positive way while potentially saving your insurance plan money. 

Lastly, talk to your doctor or pharmacist about strategies to save on treatment. Medication non-adherence can damage your health and make chronic conditions worse. Be honest with your healthcare providers about your financial situation and don’t be afraid to ask how you can bring medication costs down.




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cold and cough - blog image

By Rosanna Sutherby, PharmD

The cold and flu season is in full swing, and hacking, persistent, and annoying coughs are at their peak. If you are suffering from these symptoms, your doctor may prescribe a cough medication, such as benzonatate (Tessalon Perles). Before heading to a pharmacy near you to pick up your medication, here some facts you should know about benzonatate.

What Is Benzonatate?

Benzonatate is a nonopioid (nonnarcotic) antitussive (cough suppressant) that is used to relieve cough if you have a cold or the flu, or if you have a chronic cough that does not respond to opioid cough suppressants. It is not used for chronic cough related to smoking, asthma, or emphysema, or when your cough produces large amounts of phlegm or mucus.

Looking for the best price on benzonatate?

How Does Benzonatate Help with Cough?

Benzonatate is related to a type of drug called ester local anesthetics. It works locally by numbing the stretch receptors in your lungs, throat, and airways. When you breathe, you stimulate these stretch receptors, which causes you to cough. By numbing the stretch receptors, benzonatate inhibits their action and reduces your cough reflex. It begins to work within 15 to 20 minutes of taking the medication and generally lasts for 3 to 8 hours.

What Is the Best Way to Take Benzonatate?

If your healthcare provider prescribes benzonatate, you should follow the instructions on your medicine label. Prescribers may dose this medication differently for different people.

Typically, patients take 100 mg to 200 mg of benzonatate up to three times per day, or every 8 hours. The maximum dose of benzonatate is 600 mg per day. If you take benzonatate capsules, you should swallow them whole. The capsules should not be opened, chewed, broken, dissolved, cut, or crushed. The liquid inside benzonatate capsules can temporarily numb your mouth and throat, suppress your gag reflex, and place you at risk of choking. If you accidentally chew or break a capsule in your mouth, do not eat or drink until the numbing effects have worn off.

Who Can Take Benzonatate?

Benzonatate is indicated for adults and children 10 years and older. It is vital to keep benzonatate capsules in childproof containers and away from children. The Food and Drug Administration (FDA) warns that benzonatate can cause death in children under 10 years of age who accidentally take the medication. In fact, children younger than 2 years of age have overdosed with as few as one or two capsules.

If your child accidentally takes this medication, call the poison control center (1-800-222-1222) and immediately get emergency care.

You should not use benzonatate if:

  • You are allergic to ester local anesthetics, such as benzocaine, procaine, or tetracaine. Lidocaine is not an ester anesthetic.
  • You are allergic to para-aminobenzoic acid (PABA).
  • You have difficulty swallowing.

Can I Take Benzonatate If I Am Pregnant or Nursing?

If you are pregnant, you should talk with your obstetrician-gynecologist (ob-gyn) before taking any medication.

Benzonatate is pregnancy category C, meaning that it should be used if the potential benefits of the medication outweigh the potential risks. A conversation with your ob-gyn will help you decide if benzonatate is safe for you and your baby.

According to the manufacturer, it is not known if benzonatate passes to breast milk. Given the lack of information, you may prefer to use an alternative cough medication if you are nursing.

What Are the Side Effects of Benzonatate?

All medications have side effects, but not everyone experiences them the same way. If you are taking benzonatate, you should be aware of the following potential side effects:

  • Allergic reactions
  • Headache
  • Drowsiness
  • Dizziness
  • Mental confusion
  • Visual hallucinations
  • Constipation
  • Nausea (upset stomach)
  • Itching or rash
  • Chills
  • Nasal congestion
  • Numbing of the chest
  • Hypotension (low blood pressure)
  • Eye irritation

If any of these side effects are severe or bothersome, let your healthcare provider know right away.

How Much Does Benzonatate Cost?

The cost of benzonatate varies depending on where you live, where you shop, and your insurance coverage. The average retail price for thirty 100 mg benzonatate capsules is about $20. If your insurance does not cover cough medications, you can use a free Rx savings card to get the lowest prescription price.

How Do Prescription Discount Cards Work?

Prescription drug cards, or prescription savings cards, help you obtain the lowest prescription price for your medication. Sometimes, you may find that your insurance plan does not cover your medication or that the price with insurance is higher than the cost with a prescription savings card. Using prescription savings cards may save you up to 80% or more off the retail price. Be sure to compare prescription prices before filling your prescription. You can use ScriptSave WellRx discount card for the best discount at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/011210s053lbl.pdf

https://www.mayoclinic.org/drugs-supplements/benzonatate-oral-route/description/drg-20062223

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415124/

https://www.mayoclinic.org/drugs-supplements/benzonatate-oral-route/proper-use/drg-20062223

https://www.pdr.net/fda-drug-safety-communication/tessalon?druglabelid=1327&id=8411https://www.pdr.net/drug-summary/Benzonatate-benzonatate-3512.5759#11



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drug take back programs - blog image

By Joel Yambert, MS, BCMAS, Pharm.D. Candidate, Class of 2020
University of Arizona College of Pharmacy

Have you had a doctor tell you to stop taking a certain medication, or maybe you forgot to continue taking it for it a little bit—maybe the drug is even expired? What are you supposed to do with all these extra pills, patches, inhalers, or other medicines you no longer need? Luckily, there are a couple of different ways to get rid of unwanted or expired medications. These methods help keep the general population safe, and the environment, too.

DEA Drug Take Back Days

The DEA Diversion Control Division posts the next “Drug Take Back” dates on their website to inform people when and where they can dispose of their prescription drugs, while also providing education about potential abuse of medications.The drug take back days generally happen in April and October of each year. The next take back day (at the time of writing this article) is scheduled for April 25th, 2020.

The Legislative Agenda

Many states are creating laws and regulations in hopes that more people will be able to return their medications. In New York, the Drug Take Back Act (DTB) of Chapter 120 Laws of 2018 states that manufacturers establish, fund, and manage a New York state approved drug take back for the safe collection and disposal of unused covered drugs. Certain laws are pushing for it to become easier to return unused drugs for safe and proper collection at any time and not just on certain take back dates.

Drug Return, Recycle, and Reuse

There are other reasons to return your unused drugs, other than just freeing up space in your medicine cabinet. In many states, you can even donate the prescription drugs and return them to be recycled and reused for other patients. As of Fall 2018, there were 38 states that enacted laws for reuse and donation.

For example, Iowa started a program in 2007 and it has since helped 71,000 patients and redistributed $17.7 million in free supplies and medications to people in need. That is a huge help to others who are struggling to afford their prescriptions by simply returning your unused medications.

Are you paying too much for your medications?

What Cannot be Taken Back

Although it is encouraged to return almost all of your unused and expired medications to these take back locations, there are certain items that cannot be returned:

  • Needles, syringes, or other sharps
  • Thermometers
  • Empty containers
  • Bloody or infectious waste
  • Hydrogen peroxide
  • Illicit drugs (marijuana, cocaine, etc.), and more.

Almost every other prescription-medication related can be taken back. But, if the location is not able to take an item back, then they will likely be able to tell you the best place to get rid of it instead.

Safety Above All Else

The main concern for these drug take back programs is the safety of people, animals, and the environment. Drugs can end up in drinking water or being ingested by animals. Even when people use the restroom, there can sometimes still be trace amounts of unmetabolized drug making it back into drinking water after treatment. 

Programs like “National Prescription Drug Take Back Day” are vital in protection and well-being of our water supply and lives. The 2016 National Survey on Drug Use and Health found 6.2 million Americans misused controlled prescription drugs, mostly from family and friends—frequently from the medicine cabinet.

With current events like the opioid crisis occurring, it is not in anyone’s best interest to keep those kinds of drugs around. Additionally, it is not a good idea to throw them in the trash. People seeking drugs often dig through garbage looking for these particular drugs. So the next time you open the cabinet and see your unused or unfinished medications, it may be time to find when and where your next drug take back is taking place.

References:

  1. https://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html
  2. https://www.health.ny.gov/professionals/narcotic/drug_take_back.htm
  3. https://www.ncsl.org/research/health/state-prescription-drug-return-reuse-and-recycling.aspx
  4. http://www.takebackyourmeds.org/what-you-can-do/what-can-you-take-back/
  5. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf


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overprescribing antibiotics

by Joel Yambert, MS, Pharm.D. Candidate, Class of 2020
University of Arizona College of Pharmacy

It’s another intense flu season and it may seem like everyone around you is getting sick. That sick person may even be you! People rush to the doctor to see what medications they can be given to make them feel better and “back to normal” quickly. The truth is, whatever is causing your sickness may not need antibiotics at all.

A recent study from the Centers for Disease Control and Prevention (CDC), states that around one-third of antibiotic prescriptions given to people to take are unnecessary. Illnesses where antibiotics aren’t needed, but taken anyway, may be putting you and others in an even tougher, sicklier situation in the future. This is due to bacteria (or “bugs”) gaining resistance to antibiotics, creating so-called Superbugs.

How Do Bacteria Acquire Resistance?

It’s a commonly believed myth that your body gets used to certain antibiotics and forms its own resistance to them. The fact is, bacteria, like humans, can change and can obtain their own methods of resisting antibiotics. Another way is, bacteria are able to gain deoxyribonucleic acid (DNA) from other bacteria through gene transfer to gain resistance.

Bacteria are very dangerous in this way. One of these superbugs, Methicillin-resistant Staphylococcus aureus (MRSA), is a type of bacteria whose resistance has grown more common in recent years. It accounts for more deaths of Americans every year than homicide, emphysema, HIV/AIDS, and Parkinson’s disease combined.

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Policies and Ideas to Prevent Antibiotic Resistance

There are many procedures and policies suggested to fight against overprescribing of antibiotics that are discussed among healthcare groups:

  • Use of antimicrobial programs – having an antimicrobial expert review and consider correct antibiotic use in hospitals and other healthcare locations.
  • Use of rapid point-of-care tests – strep throat and similar rapid tests can correctly identify bacteria or lack of them.
  • Delayed antibiotic prescribing – having patient not pick up antibiotics right away and only get medication if sickness continues or gets worse.

Some doctors say the need of antibiotics’ prescriptions for breathing infections, the most likely cause of a clinic visit, is thought to be less than 20%. Many factors can cause overprescribing, from a push for increased profits to the lack of time to properly assess patients in healthcare settings. 

Hopefully, further action is taken to prevent the increasing rate of antibiotic-resistant bacteria. This concept of a “superbug” is on a global scale, showing a worldwide overuse of these drugs. Unfortunately, there’s also a lack of progress for newer antibiotics from the drug companies, due to the increased cost of drug creation.

Ways to Fight the “Superbug”

The CDC has a goal to lower inappropriate outpatient antibiotic use by 50% by the end of 2020. There are ways you can personally fight superbugs as well:

  1. Finish your antibiotic prescriptions—even if you are feeling better, continue taking the antibiotics per your doctor’s instructions
  2. Don’t take someone else’s antibiotics to treat your own sickness without getting advice from a medical professional.
  3. Have good hygiene – Thoroughly washing your hands, and food before cooking and maintaining clean living conditions can go a long way to reducing infections.

Trust Your Healthcare Provider

You should continue to trust your healthcare workers (doctors, nurses, pharmacists, etc.) to evaluate your sickness and provide the care and medications you need. A doctor can usually run tests that can identify what bacteria may be causing your sickness.

Steps are being taken through academic programs and other health groups to teach about proper antibiotic use. Trust that your doctor will prescribe the right antibiotics (or not prescribe them at all!) to make the best outcome for your present and future health.

References:

  1. https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html
  2. Infectious Diseases Society of America (IDSA), Spellberg, B., Blaser, M., Guidos, R. J., Boucher, H. W., Bradley, J. S., … Gilbert, D. N. (2011). Combating antimicrobial resistance: policy recommendations to save lives. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America52 Suppl 5(Suppl 5), S397–S428. doi:10.1093/cid/cir153
  3. Llor, C., & Bjerrum, L. (2014). Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic advances in drug safety5(6), 229–241. doi:10.1177/2042098614554919
  4. Ventola C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T: a peer-reviewed journal for formulary management40(4), 277–283.
  5. Uchil, R. R., Kohli, G. S., Katekhaye, V. M., & Swami, O. C. (2014). Strategies to combat antimicrobial resistance. Journal of clinical and diagnostic research: JCDR8(7), ME01–ME4. doi:10.7860/JCDR/2014/8925.4529


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common food and drug interactions - scriptsave wellrx blog image

by Stephanie Forbes, PharmD

We’ve all gone to the pharmacy to pick up a new medication and been counseled on interactions with other drugs. But, what about foods that might interact with the new medication?

Oral medicines are absorbed into the bloodstream through our gastrointestinal tract (GI tract). For this reason, food or drinks can sometimes interact with the absorption of the medicines we take.  In some cases, food can actually help with absorption, but in other instances it can be a hinderance, and cause less of our medicine to be taken up into the bloodstream.

Some antibiotics, like amoxicillin/clavulanate extended release (Augmentin) and cefuroxime (Ceftin) are better absorbed when we take them with food. Lovastatin is another example of a medicine that has improved absorption when taken with food. In contrast, some medicines (bisphosphonates like alendronate, antibiotics like ampicillin) are absorbed less when taken with food, and should be taken on an empty stomach.

Foods That May Interact With Drugs

Below are some foods and environmental aspects that can interact with the frequently prescribed medications .

Calcium Rich Foods

When we think of calcium, we tend to think of dairy products. In addition to milk, cheese, and yogurt, calcium supplements and some antacids containing calcium can interact with some medicines. Most commonly interacting with calcium are antibiotics, like ciprofloxacin, tetracycline, and doxycycline. The calcium may bind to the antibiotics creating a substance that prevents them from being absorbed.

Grapefruit

Grapefruit and grapefruit juice an affect the metabolism of drugs through a pathway called CYP450, a metabolism pathway through the liver. The impact of grapefruit (and juice) on this can increase the effects of some drugs to a dangerous level.  Furanocoumarin chemicals, compounds found in grapefruit, can interact with enzymes in the liver and small intestine. Some examples of medicines that interact with grapefruit are simvastatin, felodipine, and ticagrelor.

Vitamin K Rich Foods

Patients who are prescribed the blood thinner warfarin are likely familiar with this drug-food interaction. Anticoagulants like warfarin inhibit vitamin K, which an essential component in the process that makes clotting factors, which help prevent bleeding. A frequent misconception with this interaction is that vitamin K rich foods should be avoided; however, that is not the case. Most important is to keep a consistent intake of vitamin K in your diet, and avoid adding in new foods like kale, spinach, or other leafy greens.

Key Takeaways

Keep in mind, this is not a comprehensive list and other foods and beverages may interact with medications (alcoholic beverages, pickled, cured, and fermented foods, etc.). Always check with your pharmacist or doctor for any dietary considerations when starting a new medication. For additional help between doctor & pharmacy visits, it may be possible to turn to technology. For example, by searching for a given prescription drug on the ScriptSave WellRx website (or mobile app), a patient can click through to the “Lifestyle Interactions” tab, where upon they will see details of known dietary interactions for that drug (the example linked to here is for Atorvastatin/Lipitor, and shows details of the aforementioned MAJOR interaction with grapefruit juice).

Technology tools like ScriptSave WellRx are not just able to flag dietary/lifestyle interactions. They can also highlight potential interactions between the different medications in a patient’s personal prescription regimen. Patients are able to create a free account either on the ScriptSave WellRx website or through the mobile app and, by unlocking the free virtual Medicine Chest, they are able to load details of their own medication to a secure account. The medicine chest is then able to flag not just the known food/dietary interactions with the patient’s own specific drug list, but also potential interactions between the different prescription medications themselves.

References:

  1. Gilchrist, Allison. 5 Dangerous Food-Drug Interactions. Pharmacy Times. September 17, 2015. https://www.pharmacytimes.com/news/5-dangerous-food-drug-interactions. Accessed November 25, 2019.
  2. Technician Tutorial, Drug Interactions 101. Pharmacist’s Letter/Pharmacy Technician’s Letter. October 2016.
  3. Avoid Food-Drug Interactions: A Guide from the National Consumers League and U.S. Food and Drug Administration. April 4, 2017. https://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/GeneralUseofMedicine/UCM229033.pdf. Accessed November 25, 2019.
  4. Bushra, R., Aslam, N., & Khan, A. Y. (2011). Food-drug interactions. Oman medical journal26(2), 77–83. doi:10.5001/omj.2011.21


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dangers of some drugs in older adults - scriptsave wellrx blog image

by Gabriel K. Rallison, PharmD Candidate Class of 2020,
University of Arizona College of Pharmacy

As we age, many of us may struggle to do things that were once so easy. With age, the way your body handles medication can change, too. Side effects may become more noticeable and last longer than they used to.

Potentially Inappropriate Medications for Older Adults

Due to these changes, the American Geriatrics Society published a list of medications that are potentially inappropriate for use by persons over 65 years old, commonly called the Beers Criteria.1

There are several common over-the-counter (OTC) medications on this list that should be avoided.

Antihistamines

The first OTC drug to avoid is diphenhydramine (Benadryl). Diphenhydramine is an antihistamine drug commonly used to treat cold and allergy symptoms and as a sleep aid. However, in older adults, diphenhydramine can cause very unpleasant and sometimes dangerous side effects. Side effects include confusion, dry mouth, difficulty urinating, constipation, and blurred vision.2 Diphenhydramine will often be found alone in products, or in combination with other medications. When buying cold or allergy medicine, make sure to check the active ingredient list to make sure it doesn’t contain diphenhydramine.

A sister drug to diphenhydramine, chlorpheniramine (ChlorTabs), can cause many of the same side effects in older adults and should likewise be avoided.3 As alternatives for treating cold and allergy symptoms, look for products that contain loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec).2 These are newer medications of the same type as diphenhydramine, but without the side effects that make diphenhydramine dangerous.

Aside from treating allergy symptoms, drugs from this class are also used to treat motion sickness. These drugs, including dimenhydrinate (Dramamine) and meclizine (Antivert), cause many of the same side effects are diphenhydramine and chlorpheniramine, and should likewise be avoided.1

Non-drug options for prevention of motion sickness should be used instead. To prevent motion sickness, current advice is to keep your eyes closed or looking at the horizon, while avoiding close-up visual tasks like reading when moving.4                      

NSAIDs

NSAIDs, or non-steroidal anti-inflammatory drugs, are a class of medications including ibuprofen (Advil, Motrin) and naproxen (Aleve).2 These drugs are generally used to treat mild to moderate pain, but also have side effects that become more noticeable and dangerous in older adults. NSAIDs can cause stomach ulcers, stomach bleeding, increased blood pressure, kidney damage, and can even make heart failure worse.3 Additionally, these medications can interact with blood thinner medications such as warfarin and increase your risk of bleeding.

While occasional use may not present as great a risk, regular use of either ibuprofen or naproxen should be avoided unless closely followed by your doctor. As an alternative to NSAIDs, you can use acetaminophen (Tylenol). When using acetaminophen, it is important to limit your dose to 1,000 mg or less per dose, and less than 3,000 mg per day to avoid causing liver damage. If you regularly drink alcohol, you should use even less acetaminophen.

Are There Other Medications Older Adults Should Avoid?

The medications mentioned are by no means an exhaustive list, and there may be other medications, OTC or prescription, that should be stopped or adjusted for use in older adults. You should never stop taking a prescription medication without first talking to the doctor who prescribed it, even if it is on the Beers Criteria.

Any questions you have concerning any prescription medication you may be taking should be directed to your doctor or pharmacist. Your pharmacist can recommend OTC medications to help treat what ails you while minimizing undesirable side effects. While we all get older, you can rely on the direction and training of health professionals around you to make the trip as comfortable as possible, helping to minimize the bumps along the way.

References

  1. For Older People, Medications Are Common; Updated AGS Beers Criteria® Aims to Make Sure They’re Appropriate, Too. (n.d.). Retrieved October 10, 2019, from https://www.americangeriatrics.org/media-center/news/older-people-medications-are-common-updated-ags-beers-criteriar-aims-make-sure.
  2. Eng, M. (2008, June 19). Potentially Inappropriate OTC Medications in Older Adults. Retrieved October 11, 2019, from https://www.uspharmacist.com/article/potentially-inappropriate-otc-medications-in-older-adults.
  3. Ten Medications Older Adults Should Avoid or Use with Caution. (n.d.). Retrieved October 11, 2019, from https://www.healthinaging.org/tools-and-tips/ten-medications-older-adults-should-avoid-or-use-caution.
  4. Brainard, A., & Gresham, C. (2014, July 1). Prevention and Treatment of Motion Sickness. Retrieved October 24, 2019, from https://www.aafp.org/afp/2014/0701/p41.html.


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patient doctor communication image - scriptsave wellrx blog

by Gabriel Rallison, PharmD. Candidate, Class of 2020
University of Arizona

Have you ever left your doctor’s office feeling more confused than when you arrived? Maybe even felt like your doctor didn’t understand your concerns? You’re not alone. When over 300 patients were interviewed after being released from the emergency room, only 6 in 10 patients were able to correctly describe their doctor’s directions.1

Good healthcare begins with good communication. If the doctor doesn’t understand your concerns and you don’t understand the doctor’s directions, you may not be getting the best care possible.

There’s a growing awareness in the medical community regarding the need for effective doctor-patient communication. We have several simple recommendations to help you in that process.

Eight Things to Consider on Your Next Doctor Visit:

  1. Write down your concern(s). When thinking about your health concerns, write down when it started, what you think may have caused it, how often it happens, what it feels like, things that make it better, things that make it worse, in as much details as possible.

    Having written notes will help you organize your thoughts during the short time you have with the doctor. Additionally, they will help you better answer the questions your doctor will have. The more information you can give them, the better they will be able to help you.
  2. Consider bringing someone who can support you. A friend or family member can help catch things that might otherwise be missed, ask questions you may have not thought of, and help keep track of the information and instructions shared by the doctor.
  3. Be honest and straightforward about any concerns you have. Your doctor is required to protect your privacy and will only share your information with other healthcare professionals as required for your care. Even if it may be embarrassing, or you feel it may be irrelevant, it is important to share everything. Your doctor should be nonjudgmental and understanding. When you share openly, it will help the doctor see the full picture and catch things that may otherwise be missed.
  4. Don’t be afraid to ask questions! Doctors can sometimes use terms that are overly complex and hard to understand. It’s perfectly okay to ask for clarification in simpler terms or ask them to explain it again. Then, once you think you understand, repeat the information back to your doctor in your own words. This technique, called teach-back, can help you to internalize information and let the doctor know if anything was missed.
  5. Create and maintain a medication list. It can be frustrating for everyone (healthcare team and patients alike) when in response to the question “What do you take?” the answer is, “the little round white pill.” Hospitals can, and do, call pharmacies to find out what patients are taking, but having a list up front can save time and prevent potentially harmful prescribing.

    In not knowing what you are taking, your doctor may mistakenly prescribe medication that could interact with what you are already taking. This could lead to your medications being less effective or additional side effects, so it’s important to create and maintain an up-to-date medication list.

    When making your medication list be sure to include, at a minimum:
    – medication name
    – strength, dose, and frequency of dose
    – reason for taking, and any special instructions that medication may have.

    For example:
    – levothyroxine (name)
    – 125 mcg (strength)
    – One tablet (dose) every morning before breakfast (frequency)
    – For low thyroid hormone (reason for taking), take levothyroxine by itself ½ hour before any other food, medicine or drinks (special instructions).

    When making your list, make sure to include any medicated creams, patches, inhalers, implants, suppositories, or any other less conventional forms of medications, like medical marijuana (MMJ).

    Make sure to include any over the counter medications and supplements you take as well, as many of these may interact with other medications you are taking. 
  6. Consider any language barriers. There can often be language barriers between a doctor and their patient. This can lead to problems in receiving quality medical care.

    In the United States, you have a legal right to oral interpretation and written translation of any medical communication into your preferred language. This may take the form of written instructions or drug labels in your language or having an interpreter in the room or on the phone when you are with your doctor. These resources can help break the language barrier that could otherwise make it hard to get care.
  7. Include other members of your healthcare team. Questions about a medication? Talk with your pharmacist, especially when starting a new medication! Your pharmacist can advise you about side effects to watch out for, possible issues with other medications or supplements you may be taking and give you additional advice about how to improve your medication regimen.
  8. Work together with your doctor for the best outcome. If you have concerns with the treatment plan, ask about them! Work actively with your doctor to decide the plan that will work best for you.

Good medicine is not one size fits all, and as you voice your concerns and strive for better communication, you and your doctor can work as a team to make sure you get the best care possible.

References

  1. Crane, J. A., Patient comprehension of doctor-patient communication on discharge from the emergency department. J Emerg Med. 1997 Jan-Feb;15(1):1-7. https://doi.org/10.1016/S0736-4679(96)00261-2 Accessed Sep 24 2019.
  2. Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: a review. The Ochsner journal, 10(1), 38–43. Accessed Sep 24 2019.
  3. Clancy, C. M. How to Talk to — and Understand — Your Doctor. American Association of Retired Persons. https://www.aarp.org/health/doctors-hospitals/info-09-2010/finding_your_way_how_to_talk_to_8212_and_understand_8212_your_doctor.html Accessed Sep. 25 2019.
  4. Howley, E. How to Make Sure Your Doctor Understands Your Medical Condition. U.S. News. Jan. 16 2018. https://health.usnews.com/health-care/patient-advice/articles/2018-01-16/how-to-make-sure-your-doctor-understands-your-medical-condition Accessed Oct 1 2019.
  5. Don’t Be Shy: 4 Tips for Talking to Your Doctor. Johns Hopkins Medicine. N.d. https://www.hopkinsmedicine.org/health/wellness-and-prevention/dont-be-shy-4-tips-for-talking-to-your-doctor Accessed Sep 24 2019.
  6. Health Literacy | Understanding What Your Doctor Is Saying. American Heart Association. N.d. https://www.heart.org/en/health-topics/consumer-healthcare/doctor-appointments-questions-to-ask-your-doctor/health-literacy–understanding-what-your-doctor-is-saying Accessed Sept 25 2019.
  7. Executive Order 13166. Limited English Proficiency (LEP).gov. https://www.lep.gov/13166/eo13166.html Accessed Oct 2 2019.


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