Frequently Asked Questions (FAQs)



Q 1. Why a web site on Medication Safety?

A. According to recent data from the U.S. Centers for Disease Control and Prevention (CDC), patients in the United States made over 1.1 billion visits to physician offices and hospital outpatient and emergency departments in 2006. That’s an average of four visits per person per year. During that same year, seven out of 10 visits had at least one medication provided, prescribed, or continued. For physician office visits alone, four out of five Americans who visit the doctor leave with a prescription.

(Ref: “Americans Made Over 1 Billion Hospital and Doctor Visits in 2006,”CDC/NCHS Office of Communication, August 7, 2008, see http://www.cdc.gov/media/pressrel/2008/r080806.htm)

Unfortunately, nearly three out of every four American consumers report not always taking their prescription medicine as directed. A recent survey commissioned by the National Community Pharmacists Association (NCPA), also found a major disconnect between consumers’ beliefs and their behaviors when it comes to taking medicines correctly. Some of the findings of the survey include:

Almost half of those polled (49 percent) said they had forgotten to take a prescribed medicine;
Nearly one-third (31percent) had not filled a prescription they were given;
Nearly three out of 10 (29 percent) had stopped taking a medicine before the supply ran out;
Almost one-quarter (24 percent) had taken less than the recommended dosage.

While disturbing, these statistics only begin to demonstrate the magnitude and scope of poor adherence in the U.S. Lack of adherence affects Americans of all ages and both genders, but is of particular concern among those aged 65 and over who, because they have more long-term, chronic illnesses, now buy 30 percent of all prescription medicines and often combine multiple medications over the course of a day. Regardless of age and sex, poor medication adherence is also just as likely to involve higher-income, well-educated people as those at lower socioeconomic levels. As a result, poor medication adherence has been estimated to cost approximately $177 billion annually in total direct and indirect healthcare costs.

(Ref: “Enhancing Prescription Medicine Adherence: A National Action Plan,“ August 2007, National Council on Patient Information and Education; posted at www.talkaboutrx.org.


Q 2. Do all medicines have risks?

A. Yes. All medicines prescription and nonprescription, have RISKS as well as benefits. You need to weigh these risks and benefits carefully for every medicine you take. The benefits of medicines are the helpful effects you get when you use them, such as lowering blood pressure, curing infection or relieving pain. The risks of medicines arethe chances that something unwanted or unexpected could happen to you when you use them. Risks could be less serious things, such as an upset stomach, or more serious things, such as liver damage.

When a medicine’s benefits outweigh its known risks, the U.S. Food and Drug Administration (FDA) considers it safe enough to approve. But before using any medicine—as with many things that you do every day—you should think through the benefits and the risks in order to make the best choice for you.


Q 3. How can I lower the risks and obtain the full benefits from my medicine

A. There are several important steps that consumers can do to lower the risks from their medicine including:

1. Talking to your doctor, pharmacist, or other healthcare professionals;

2. Know your medicines—prescription and over-the-counter (OTC), including:

The brand and generic names.
What they look like.
How to store them properly
When, how, and how long to use them.
How and under what conditions you should stop using them.
What to do if you miss a dose.
What they are supposed to do and when to expect results.
Side effects and interactions.
Whether you need any tests or monitoring.
Always ask for written information to take with you.

3. Reading the label and following directions:

Make sure you understand the directions.
Ask if you have questions or concerns.
Always double check that you have the right medicine.
Keep medicines in their original labeled containers, whenever possible.
Never combine different medicines in the same bottle.

Read and follow the directions on the label and the directions from your doctor, pharmacist, or other healthcare professional.

If you stop the medicine or want to use the medicine differently than directed, consult with your healthcare professional.

4. Avoiding interactions.

Ask if there are interactions with any other medicines or dietary supplements (including vitamins or herbal supplements), beverages, or foods.
Use the same pharmacy for all of your medicine needs, whenever possible.
Before starting any new medicine or dietary supplement (including vitamins or herbal supplements), ask again if there are possible interactions with what you are currently using.

5. Monitoring the medicine’s effects.

Ask if there is anything you can do to minimize side effects, such as eating before you take a medicine to reduce stomach upset.
Pay attention to how you are feeling; note any changes. Write down the changes so that you can remember to tell your doctor, pharmacist, or other healthcare professional.
Know what to do if you experience side effects and when to notify your doctor.
Know when you should notice an improvement and when to report back.

Q 4. What can I do to help ensure that I get the information I need to use my medicines safely and appropriately?

A. Here are three things you can do:

1. Write your questions down ahead of time. Keep a list of questions you want to ask your healthcare team. Take the list with you to your appointment.
2. Take notes when you get information from your healthcare team.
3. Bring a friend or family member with you when you visit the doctor. Talking over what to do with someone you trust can help you make better decisions.
4. Keep a list of all the medicines, vitamins, and dietary supplements you take. Be sure to add new medicines to the list when you start taking something new or when you change your dose. Show the list to your doctor and pharmacist. Looking for a medicine list? See http://talkaboutrx.org/medsmart_makinglist.jsp#makingmedlist


Q 5. What are drug interactions?

A. Drug interactions occur when a drug interacts with another medicine, herbals, alcohol or even certain foods, and changes the way the drug acts in the body. The risk of serious interactions is higher for people taking multiple medications.

Some examples are:

Alcohol consumed with sleep medicines (for example, Ambien or Ambien CR) or anti-psychotics (for example, Seroquel)
Antibiotics decrease the effectiveness of birth control pills.
Selective Serontonin Re-uptake Inhibitor (SSRI) Antidepressants (for example, sertraline/Zoloft®) taken with St. Johns Wort increases the risk of drowsiness and not being able to think clearly.
Grapefruit juice can prevent the body from breaking down some medicines, which means the medicine may stay in your system longer.

Q 6. What are the 5 “Rights” When it Comes to Safe Medicine Use?

A. Double check each time. Medicines are approved in specific dosages to account for age and weight and to ensure the dose falls within the minimum amount needed to treat a condition and the maximum amount that might result in harm or unwanted side effects.

So, each time you pull a medicine from your cabinet or drawer, double-check to make sure you have:

1. The right medicine
2. For the right person
3. In the right amount
4. At the right time
5. In the right way (swallow, chew, apply to the skin, etc.)

Also pay attention to what different medicines looks like and how to store them properly.


Q 7. What is the right way to store medicine?

A. If you’re like most American families, they are safely in the bathroom medicine cabinet. Well, think again! The warmth and dampness from showers and baths can cause medicines to break down. As a result, they may not work as well as they should. You should store your medicines and vitamins:

So, each time you pull a medicine from your cabinet or drawer, double-check to make sure you have:

In a cool, dry place away from bright windows or rooms that are affected by outdoor weather. You might want to consider keeping medicines in a locked dresser drawer in your bedroom, or in a kitchen cabinet.
In their original containers. And if you get refills on certain medicines, don’t be tempted to combine the older pills with the new ones as you won’t be able to tell the difference or know the expiration date.
Out of children’s sight and reach. Also, if you have young children in your home or if they are just visiting, be sure your pharmacist dispenses prescriptions in child-proof bottles.
Away from other dangerous substances that could be taken by mistake. It’s probably a good idea to sort through your family’s medicines several times a year.

Q 8. What should I do with unused or expired medicines?

A. The U.S. Fish and Wildlife Service, the American Pharmacists Association (APhA) and the Pharmaceutical Research and Manufacturers of America (PhRMA) have signed a formal agreement to help protect the nation’s fish and aquatic resources from the improper disposal of medicines. The campaign, entitled, "SMARxT Disposal" is designed to inform consumers about how to safely dispose of medicines in the trash, and highlight the environmental threat posed from flushing medicines down the toilet. Consumers were once advised to flush their expired or unused medicines; however, recent environmental impact studies report that this could be having an adverse impact on the environment.


Q 9. What do I need to know about my medicines when I travel?

A. If you or your family is traveling, be sure to keep all medicines with you (in your carry-on bag for air travel and NOT in the glove compartment for travel by car) and in their original containers. Bring an up-to-date list of your family’s medicines just in case you lose a prescription or have questions while you’re away from home.


Q 10. What can I do to ensure a medicine-safe home for my children?

A. As a parent, it’s up to you to create a medicine-safe home by taking these simple steps:

Keep all medicine out of children’s sight and reach. If you have a toddler, don’t forget to install safety latches and locks on cabinets and dresser drawers, just in case there are ointments or other medicines or dangerous substances within reach.
Use child-resistant caps, and never leave containers open.
Set a good example for proper and safe medicine use. Kids learn by watching you, so treat medicines with care and take them only when necessary. If you have young children, avoid taking medicines in front of them so they don’t try to copy you.
Talk openly with your children. Teach them about the hidden dangers of taking medicines and encourage them to ask questions. If your child has a medical condition such as asthma or diabetes, encourage the pediatrician or nurse to talk directly to your child about medicines, so he or she starts to develop the skills and know-how to take them appropriately. This will help them take an active and responsible role in their self-care.
Know when to ask questions. Don’t try to guess your child’s symptoms and, in turn, what medicines he or she might need. Ask your doctor or pharmacist so you can be sure that you are giving the right drug and the correct dose. Remember, children are not “mini-adults” (their bodies respond differently and they breakdown medicines differently), so don’t try to calculate what the dose should be based on an adult dosage.
Dispose of medicines safely, so pets and kids can’t get to them.

Q 11. What are some medicine safety tips for older adults with memory problems?

A. Memory problems make it more difficult to manage medicines. Not being able to remember when and how to take multiple medicines can also cause problems. There are many different types of memory aids that can be used by older adults to help them remember to take their medicines. Helpful strategies may include:

Taking medicines at a set time each day (at breakfast or bedtime);
Setting a timer;
Placing pill bottles in an obvious location (although away from pets and grandchildren);
Using pill boxes for complicated regimens (especially for people who have difficulty opening pill bottles);
Posting a medicine checklist and schedule on the refrigerator.

Q 12. Why do kids abuse prescription medicines?

A. Did you know that teens as young as 12, as well as college students between ages 18 and 25, have among the highest rates of prescription drug abuse? Among the factors are a series of misconceptions, lack of information, and a care-free attitude toward the risks involved in using prescription medicines improperly.

They are seeking psychological or physical pleasure.
They want to fit in with groups of friends and are in search of acceptance and bonding.
They do not realize the risks of taking medicines that have not been prescribed specifically for them or the danger of not following a prescription’s directions.
It is easier to get prescription drugs than illegal drugs.

Believe it or not, teens believe in the following misconceptions:

Prescription medicines, even if not prescribed by a doctor, are much safer to use than illegal drugs.
Prescription pain relievers cannot be addictive.
Once in a while, there is nothing wrong with using prescription drugs without a doctor’s prescription.
As a parent, this is where you come in. You need to explain to your teen the dangers of prescription drug abuse.

Q 13. What is e-prescribing and why is it safer than a paper prescription?

A. Many physicians, nurse practitioners, and physician assistants are starting to make the switch from using the standard prescription pad and pen to electronic prescribing?

Instead of writing out your prescription on a piece of paper, they enter it directly into his or her computer. The prescription is then sent from the prescribers’ computer to the pharmacy’s computer, saving you the extra trip to the pharmacy to drop off the paper prescription.

By sending prescription requests directly to the pharmacy, you have a head start in getting your medicines filled. Your health team can also more easily monitor your medications and even select drugs that are covered by your family’s health plan. But even more important, e-prescribing can improve the safety and convenience of prescribing medicines.

Electronic prescribing, or e-prescribing, can help prevent some medication errors and gives pharmacists, doctors and nurses access to immediate, more complete information about your medical and medication history and can alert them to potential problems such as drug allergy. So, e-prescribing can lead to safer, more informed prescribing so that patients get the care that best fits their needs. This technology is especially helpful if you, your partner, parent or child have chronic illness or are recovering from surgery and take multiple medicines.


Q 14: Will my e-prescription be ready when I arrive at the pharmacy?

A. Because the prescription is sent electronically before you leave your doctor’s office, there’s a chance it might be ready when you arrive at the pharmacy, but this isn’t always the case. The time needed to prepare your prescription can be affected by several factors, including the number of prescriptions in the pharmacy’s computer, how quickly you arrive at the pharmacy after your doctor’s visit, and how many people are already waiting at the pharmacy. It’s a good rule of thumb to allow one to two hours before going to the pharmacy to pick up your prescription.


Q 15: Can my doctor send my e-prescription to any pharmacy I choose?

A. Yes. More than 70% of community pharmacies in the U.S. currently accept e-prescriptions, and more are doing so every day. If you do not want your prescription sent electronically, or your pharmacy does not yet accept e-prescriptions, your doctor will print your prescription for you.


Q 16: Are there laws governing the privacy of e-prescriptions?

A. The privacy of your personal health information contained in all your prescriptions, whether written or electronic, is protected by a federal law and state laws. The federal law is the Health Insurance Portability and Accountability Act (HIPAA). HIPAA requires that your personal health information be shared only for the purpose of providing you with clinical care. E-prescriptions meet this requirement.


Q 17: How can I find out if my doctor uses e-prescriptions?

A. Visit www.LearnAboutEprescriptions.com to see which physicians are e-prescribing in your community. Or just ask your doctor. Doctors who are not writing e-prescriptions and would like more information can visit www.GetRxConnected.com


Q 18: What problems can not taking medicines correctly cause or contribute to?

A. Not taking medicines correctly can spell trouble. If people with chronic conditions that require long-term therapy do not take their medicines as prescribed, this can lead to:

Unnecessary worsening of the disease;
Greater complications from the disease and increased resistance to needed therapies (for example, antibiotic resistance);
Reduced functional abilities;
Lower quality of life;
Premature death.

Q 19: What can I do about a possible side effect?

A. Since you will usually be the first person to notice any unusual symptoms or that you are “just not feeling right,” it is important to know what you should do about a possible side effect from the very start. Ask the following questions before you take your medicine home.

What are the common side effects this medicine might cause?
How can I manage mild side effects so I can keep taking the medicine?
Are there any serious side effects this medicine might cause? If so, what are the early warning signs so I can get immediate medical help?
When should I call the doctor?

Q 20: What else can I do about possible side effects?

A. Here are three important steps you can take:

Read about side effects in the information that you get at the pharmacy. Reread it every time you get the medicine refilled. The information may have changed or you might have new questions.
Keep a record of any side effects you might have had between doctor or pharmacy visits. Write down the date and the steps your healthcare provider told you to take.
Discuss it with your doctor during your next visit.
Seek medical advice if you don’t know if you are starting to develop a side effect.