A VNSNY SELF-CARE GUIDE Taking Your Medicine Visiting Nurse Service of New York 1
Table of contents Introduction Taking Your Medicine.... 1 Get Started by Managing Your Medicines.... 2 Drug Interactions.... 5 Ways to Help Taking Medicine Easier.... 8 Other Helpful Hints to Make Sure Your Medicine Works for You.... 17 Your Life With Your Medicine.... 18 More Information and Resources.... 19 Notes....20 2
INTRODUCTION TAKING YOUR MEDICINE It is important to take your medications exactly as prescribed by your medical provider (doctor, nurse practitioner or physician assistant). This will help you get the most benefit from the medicines. Your medicines help to treat your illness, but only if you take them as your medical provider tells you. Medicine can prevent and control illness, relieve pain and fight infection. Problems can occur if your medication is not taken as told to you by your medical provider. This guide will help you to safely take your medicine so it works as it should to improve your health and well-being. 1
Get Started by Managing Your Medicines Step 1: Collect all your medicines. You should include the medicines prescribed by your doctor and any medicine you buy over the counter (at the pharmacy, supermarket, or on the Internet without a prescription) as well as any medicine you get from your neighbors or friends. All medications such as eye drops, creams, lotions, suppositories, patches, vitamins and supplements should be included. Be sure to check all the different places you keep your medicines. Step 2: EXP: FEB 2016 Check the expiration date on each medicine label. The expiration date tells you how long your medicine is safe to take, because medicines do not last forever. If you take out-of-date medicine, it might make you sick. Medicines that you buy without a prescription also have an expiration date. Ask your pharmacist if you have any questions about the safety of taking your medication if you have had it longer than a year. Step 3: Throw out all of your old or expired medicine. When a medicine has expired or it is no longer needed, it is important to get rid of them properly to avoid harm to others. There are a number of ways to throw out your expired medicine to reduce the chance that others may accidentally take the medicine. 2
Ways to Safely Throw Out Medicines Follow the instructions on the medicine label. Some medications will tell you how to best dispose of that medication. Medicine take-back programs are a good way to safely dispose of medications. You can ask your pharmacist if he or she knows of any medicine disposal programs in your area. You can also contact your city or county government's household trash and recycling service to see if there is a medicine take-back program in your community. Disposing in household trash requires some simple steps to safely get rid of the medications: Take the old medicine out of the medicine bottle and mix it in things that no one would eat such as coffee grounds and kitty litter. Place the mixture in a container such as a sealed plastic bag so it will not leak or break out of garbage. Throw the container (sealed plastic bag) with the medication mixture into your household trash. Before throwing away the empty medicine bottle, remove the label or scratch out information on label to make it unreadable. This will help protect your identity. Only flush medications that have special instructions to do so. There is a small number of medicines that may be especially harmful if they are used by someone other than the person for whom the medicine was prescribed. These medicines have specific instructions that they should be flushed down the sink or toilet as soon as they are no longer needed. Ask your pharmacist before flushing your medication if you are not sure. Never share your medications with friends or family. A medication that works well for you might be dangerous for someone else. 3
Get Started by Managing Your Medicines Step 4: Create a list of your medicines and take it with you to all of your medical appointments. Write the name of each of your medicines, the dose you take and the time of day when you take it. MEDICATION NAME AMOUNT IN EACH TABLET (example: 2.5 mg or ml) AND HOW MANY EACH TIME YOU TAKE THE MEDICINE? WHAT TIME OF DAY DO YOU TAKE THE MEDICINE? 4
Step 5: Get a printed information sheet about each medicine from your pharmacist. Often, you will get these information sheets with your prescriptions, but if you don't get one, ask for it. These information sheets will tell you: The name of your medicine and how to say it. What your medicine is supposed to do or what condition it treats. How to take your medicine (for example, some medicine should be taken with food and some without food). Possible side effects. Where to keep your medicine (for example, some medicines can be kept at room temperature, and others must be kept in the refrigerator). What medicines you should not take with other medicines to avoid drug interactions. Some medicines don t work well when taken with other medicines (this is called a drug interaction). Drug Interactions Drug interactions are more likely to happen when you see different doctors or different pharmacists, who may not know about every medicine you take. You can avoid drug interactions by: Using the same pharmacy all the time. The pharmacist will keep a complete list of your medicines in one place. Asking your pharmacist to check whether your medicines can be taken together. If the medicines interact, the pharmacist will call your doctor to find out what to do. When you are buying over-the-counter medicines (the ones you buy without a prescription). Ask the pharmacist if the over-the-counter medicine can be taken with the prescribed medicines you take. 5
Get Started by Managing Your Medicines Step 6: Ask questions about new medications. Your medical provider (doctor, nurse practitioner, or physician assistant) may prescribe new medication for you if you have new medical problems, or if the medications you have been taking are not working well for you. When you get a new medication, these are some of the questions you should ask. Be sure to write down the answers so that you can read them again when you get home. 1. What is the name of this medication? 2. What condition is it treating? 3. What is the active ingredient? 4. Am I or will I become allergic to any of the ingredients? 5. How long do I have to take it and where should I store it? 6. What medications can be substituted for this medication if it is too expensive? How do I take this new medicine? In order to take your medicine safely, you need to know the right way to take it. Ask questions if you are not sure or if you don't understand the instructions given. These questions may include: 1. Should I take it every day or only when I feel sick? 2. What time and how many times per day should I take it? 3. Do I need to take it with food, water or anything else? 4. How long will I have to take it? 6
What to expect when I take this medication: 1. How will I feel once I start taking this medication? Will I experience dizziness, nausea, vomiting, weakness or constipation? 2. How will I know that the medication is working? 3. What should I do if I miss a dose? 4. What side effects can I expect and what should I do? 5. Will this medication react with my other medications? 6. Do I have to stop taking any medications while I am taking this medication? 7. Can I afford it? Step 7: Keep your medication list up to date. Keep your list of medicines at home, and also keep a copy in your wallet, pocket, or purse. Always keep your medicine list up to date. Each time you go to a doctor, a clinic, or a hospital show your list to the doctor or nurse. Always remember to tell he or she what over-the-counter medicines (the ones you buy without a prescription, including herbal medicines, vitamins, supplements, creams, eye or ear drops, and patches) you also take. It is very important to tell each doctor who takes care of you about all the medicines you take. This avoids serious problems, especially when hospitalized or in emergency situations. 7
Ways to Help Taking Medicine Easier There are ways to make it easier when it comes to taking your medicine. The following list contains common reasons you may find it difficult to take your medicine. Check the ones that apply to you. I don t have enough money for my medicine. I have trouble getting my medicine. My pills taste bad. My pills are too big to swallow. My pills are too small to handle. I have trouble opening my pill bottles. I take too many pills. I have a hard time remembering to take my medicine. My medicine makes me feel worse instead of better. I really don t believe my medicine will help me. I m tired of taking medicine. I prefer natural or herbal remedies. 8
Here are some ideas that may help you deal with the problems you checked. 1. I don t have enough money for my medicine. If your medicines are too expensive, here are some suggestions: Insurance: Does your insurance cover some of the cost of medicine? Check your plan to find out what medicines you have coverage for. Generic medicine: Generic medicines are the same drug as brand names and costs less. Ask your medical provider if generic medicine is a choice for you. Free medicine: Some drug companies will give free medicine to people in need. Ask your medical provider or pharmacist for more information. 2. I have trouble getting my medicine. If it s hard for you to get your medicine, here are some suggestions: Speak to your medical provider or pharmacist. Arrange for your pharmacy to deliver the medication. Delivery service Mail order Help from family and friends Prescription for longer periods of time Multiple refills 9
Ways to Help Taking Medicine Easier 3. My pills taste bad. This is often hard to deal with, but you can try: Chewing on ice to dull your taste buds before taking your pills. Suck on popsicles or spoonfuls of partially frozen orange or grape juice, if your diet allows. Having a mint or hard candy, or chew a piece of gum after you take your pill (use sugarless gum or candy if you are on a sugar-free diet.) Eating peanut butter (if your diet allows) before you take your pills. Peanut butter coats your mouth and you will taste less of the pill. Using a mouthwash after taking your pills to take away any bad taste. 4. My pills are too big to swallow. You can cut pills which are too big or you may be able to crush them and mix them into liquid or food. Some pills don t work if you crush them. Always check with your pharmacist before you crush a pill! Sometimes there may be a liquid form of the medicine, so ask your doctor or pharmacist. 5. My pills are too small. Try putting a small pill in a spoon with applesauce or pudding so it s easier to take, or ask for help from a family member or friend. 6. I have trouble opening my pill bottles. EASY-TO-OPEN CAP If you have trouble opening childproof caps, ask your pharmacist to give you easy-to-open caps. Just be sure to keep any easy-toopen medicine bottles away from children or pets. 7. I take too many pills. Talk to your doctor to find out if the number of pills you take can be cut down. Sometimes medicine comes in a long-acting form or in combination form so you can take it fewer times a day. 10
8. I have a hard time remembering to take my medicine. Here are some tips that may help you remember to take your medicine. You can also be creative and come up with your own reminders! Pill boxes. Use daily or weekly pillboxes to help you set up your pills. Keep the pillbox in a place where you can see it, such as a kitchen counter or bedroom dresser. Keep other medicines such as eye drops or inhaled medicine in the same place as your pillbox. Organize your pill bottles. Line up your pill bottles according to the different times you take them. Mark your pill containers with different colors for the different times you take your medicine. Alarm clocks/watches. Try an alarm clock or watch with multiple alarms that can be set to go off when it s time to take your medicine. Beepers. Buy a medicine reminder beeper that you can set to beep when it is time to take your medicine. Telephone reminders. Ask your family or friends to call and remind you to take your medicine. Your community may have outreach programs that do the same. Medicine diary. Use a notebook to keep track of your medicine and write down when you take it. 11
Ways to Help Taking Medicine Easier Calendar. Hang a calendar in your home to write down each time that you take your medicine. You can check whether you took your medicine by looking at you calendar. Take pill at 3pm Reminder notes. Post reminder notes in your kitchen or bathroom (or both). Someplace where you re sure to see it. Daily habits. Link taking your medicine to a daily activity, such as your morning coffee, brushing your teeth, getting dressed, an afternoon snack, or watching your favorite TV shows. Use the activity as a reminder to take your medicine. Plan for expected changes. Your daily habits often change on weekends and holidays, and when you travel. Think about ways to adjust for weekends/holidays and plan ahead. If you travel often: Fill a pillbox with all your medicines for as long as you ll be away. Continue to take your medicine on the same schedule. Ask your doctor how to adjust for any change in time zones. - Take your watch alarm or electronic reminder with you. - Eat a snack if you cannot eat a full meal and you must take your medicine with food. - Keep your list of medicines with you at all times. 12
9. How do I take my topical medications (creams, sprays, patches, lotions)? Here are some tips that may help you remember to take your medicine. You can also be creative and come up with your own reminders! Topical medications such as creams, gels, sprays, patches or lotions should be used exactly as prescribed. If you are not sure ask your medical provider before leaving the clinic, office, hospital or nursing home. You can also ask your pharmacist when you pick up your medication(s). Write down or ask them to write down instructions for you so you will have it when you get home. Some topical medications might burn the skin so do not use more than the prescribed dose. Some topical medications, such as the patches, may need to be changed every 12 hours, daily, every three days or should be used only when necessary. Be sure of the directions in order to prevent injury and possible hospitalization. Tell your nurse at every visit how you take your medications and any unusual feelings or thoughts you might have about continuing the medications. DO NOT stop using any medications without speaking with a health care professional. 13
Ways to Help Taking Medicine Easier 10. My medicine makes me feel worse instead of better. Think about which medicine helps you, and which one doesn t. Some medicines may make you feel sicker. This is because they have more side effects than others do. You should: Report all new signs and symptoms that you feel to your doctor and your visiting nurse, nurse practitioner, physician assistant as appropriate. Ask your doctor if you can change to a different medicine without the same kind of side effects. Sometimes after you take the medicine for several weeks, side effects may lessen or go away. You may have to live with side effects for a while. Discuss this with your doctor or nurse. Food may make side effects better or worse. Check with your doctor or nurse. When you feel sick to your stomach, you can take something to settle it. When you have diarrhea or frequent loose bowel movements, you can take medicine to slow your bowels. If you are constipated or cannot move your bowels you can take medicine to help. Ask your doctor or nurse about medicine for nausea, loose bowel movements or constipation. If you continue to have side effects and are finding it hard to take your medicine, do not stop taking your medicine before you discuss this with your doctor. 14
11. I really don t believe my medicine will help me. How you feel about your medicines is very important. It helps to know that your beliefs and attitudes affect how you deal with illness and how you feel about medicine. Take a moment to think about your beliefs about illness, and how easy or hard it is for you to take medicine. Write down your concerns and talk about them to your doctor or nurse. Circle your responses below. Do you think your medicines are helping you? 5 4 3 2 1 Absolutely Mostly Not sure Not much Not at all Do you think you would be better or worse if you didn't take your medicines? 5 4 3 2 1 Better Somewhat better Not better or worse Mostly worse Worse Are you afraid of any of the medications you are taking? Yes No If yes, why? Are there any medicines that you have been given that you do not take? Yes No If yes, why? Note: If you don't believe your medicine works, talk to your doctor or your visiting nurse. They will help you with choices that are best for you. 15
Ways to Help Taking Medicine Easier 12. I m tired of taking my medicine. Medicine can be a bother, especially when you don t feel it makes any difference. You may feel like giving up. This is the time to ask for help. Talk about your feelings with your doctor or primary care provider, nurse, family, and friends. Be honest about what you are doing. Don t tell the doctor, primary care provider, or nurse that you ARE taking your medicine if you are NOT taking your medicine. Nurses and doctors know that most people forget once in a while, or have problems taking their medicines, so you are not the only one. They can help you get back on track. Consider joining a support group for people who have the same illness. Try to avoid giving up. If you stop your medicine, it may be harmful. 13. I prefer natural or herbal remedies If you believe in herbal medicines, folk medicine or family remedies, talk to your doctor or your visiting nurse. They can help you get good results from all of the medicines and remedies you are taking. You should know that sometimes natural or herbal medicines will make you sick if you take them with other medicines. Be sure to write all natural or herbal remedies you are taking on your medicine list. 16
Other Helpful Hints to Make Sure Your Medicine Works for You Take your medicine the way your doctor, nurse practitioner or physician assistant orders it and: Always take your full dose of medicine. Do not take half a pill if you should be taking the whole pill. If you think you need less medicine, talk to your doctor who prescribes your medicine. Do not take more medicine than prescribed by your doctor. More of a good thing can be dangerous. Take your medicine the number of times a day written on the medicine container. You may feel fine, but you still need to take your medicine as often as prescribed. If you take all your medicine but still feel sick, talk to your doctor, nurse practitioner or physician assistant. Don t take extra medicine or stop taking. Always take all your antibiotics, even if you feel better after a few days. When you stop antibiotics too soon, you may get sick again because some of the stronger germs may still be active. These strong germs then change so the antibiotics can t kill them. This is called drug resistance. If you get an infection that is resistant to certain medicines, it becomes harder to treat you and make you well. Don t share medicine with your family or friends, even if they have the same health problem as you. What works for you may not be good for them. It s better for you to suggest they see a doctor. Do not stop taking your medications suddenly. If you have some illnesses such as hypertension (high blood pressure), stopping suddenly may cause a change in blood pressure. 17
Your Life With Your Medicine You can read this guide again whenever you think you can benefit from some of its tips. It gives you reminders about how to make your life easier when you take medicine. It may be most helpful when you want to give up; when it seems as if your medicine is no longer making any difference in how you feel. When this happens, talk to someone who can help lift your spirits, and remind you that you can move through any rough patch. Bad times usually go away, and life and health often do get better. Think of your medicine as a friend. As with any friendship there are some bad times, but mostly good times. Finally: Keep track of how you are taking your medicines. When you have a perfect week do something nice for yourself. You deserve it! If you forget to take your medicine from time to time, it is not a good or bad issue. It is a fact of life and will happen. In fact, it may happen several times until you get the hang of it. If you forget a dose, don t give up. Try to figure out why you missed the dose of medicine so it doesn t happen again. The fact that you are trying is a good thing. You are the only person that can help your medicine work its best by taking it correctly. No one else can do that for you. 18
More Information and Resources Here are some medication-related websites to help you learn more about storing, managing, taking, disposing of and paying for your medications. Are you Taking Medication as Prescribed? U.S. Department of Health and Human Services Food and Drug Administration www.fda.gov/forconsumers/consumerupdates/ ucm164616.htm 1-888-INFO-FDA 6 Tips to Avoid Medication Mistakes www.fda.gov/forconsumers/consumerupdates/ ucm096403.htm Chronic Disease Fund www.cdfund.org Provides assistance with co-pay or free drug assistance. Must qualify for assistance. Chemocare www.chemocare.com Provides financial assistance programs for chemotherapy medications and treatment. Pfizer www.pfizer.com May provide free medications. Application must be submitted by the Primary Care Provider. Taking Medicines Safely www.nihseniorhealth.gov/takingmedicines/ takingmedicinessafely/01.html Prescription Drug Options for Older Adults www.n4a.org/files/programs/medication-mgmt-caretransitions/2013_bestdrugs_for_less.pdf The Importance of Taking Your Medication Correctly www.pfizer.com/health/senior_health/taking_medicines N.Y. Health Insurance Information, Counseling and Assistance Program (HIICAP) New York State Office of Aging New York State Office for the Aging www.aging.ny.gov/healthbenefits 2 Empire State Plaza Albany, NY 12223 1-(800) 342-9871 AIDS Drug Assistance Program (ADAP) Provides financial assistance for persons living with HIV/AIDS. www.health.ny.gov/diseases/aids/general/resources/ adap/formulary.htm 19
20 NOTES
PLEASE JOIN US. TOGETHER WE CAN MAKE ALL THE DIFFERENCE. Thanks to our generous donors, VNSNY is able to offer a vast range of direct patient services to the entire New York City metropolitan area, including those who otherwise could not afford care. For example: Providing urgent and long-term charitable health care to uninsured and underinsured New Yorkers as well as free health education and screenings to tens of thousands of New Yorkers. Caring for children with chronic illnesses and developmental delays and disabilities. Pairing first-time low-income mothers with nurses committed to improving their health, well-being and self-sufficiency. Purchasing life necessities, such as coats, medications, and transportation for our neediest patients, and offering free wigs to cancer patients. Improving health care quality and helping patients to manage chronic conditions and receive the most effective treatments possible in the comfort of their own homes thanks to vital research provided by VNSNY s preeminent Center for Home Care Policy and Research. Supporting Aging in Place allowing older New Yorkers to remain independent in their own homes, and with greater dignity and quality of life. Many of these programs are made possible only through the generosity of our donors. These contributions help to bridge the gap between what it costs us to provide our life-saving, life-altering, and life-enhancing philanthropic programs and the reimbursements we receive. Won t you join us in bringing this critical charitable care to our community s neediest? VNSNY is a not-for-profit organization and we count on the public our donors for support. Please mail your gift in the enclosed envelope or send it to: Visiting Nurse Service of New York Development Department 107 East 70th Street, 5th Floor New York, NY 10021 You can also make contributions easily online. Please visit our website at www.vnsny.org/donate, or call our donation hotline at 212-609-1525. Thank you! Together with your generous support, VNSNY will continue to provide the highest-quality, skilled and compassionate home health care in the New York metropolitan area. 21
A VNSNY SELF-CARE GUIDE to Taking your Medicine VISITING NURSE SERVICE OF NEW YORK 1250 Broadway, New York, NY 10001 www.vnsny.org 22 20-0613E (11/14)