The Quick Scoop: Medicines and Your Family

Your family may use medicines for a variety of reasons.

Medicines are used to help
Treat or prevent illness (for example, high cholesterol, diabetes, asthma and depression)
Provide symptom relief (for example, stomach upset, fever, headache)
Improve quality of life (especially for children and adults with chronic or life-threatening conTreat or prevent illness (for example, high cholesterol, diabetes, asthma and depression)

It’s important to talk openly with your family about the power of medicines and be knowledgeable about what you and your loved ones are taking.

Here’s the quick scoop on different types of medicines and tips to help your family use them safely.

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Types of Medicines

Believe it or not, there are now 10,000 prescription drugs and 300,000 over-the-counter medicines on the market, and that number continues to grow.

Over-the-counter (OTC) drugs are medicines you can buy at pharmacies, convenience and grocery stores without a prescription from your healthcare provider. These include aspirin and other pain relievers, antacids, laxatives, allergy and cough and cold medicines.

Many OTC medicines treat multiple symptoms. Antihistamines, for example, are active ingredients (or medicines) in many OTCs that treat allergy and cold symptoms including sneezing, runny nose and itchy, watery eyes.

Because you’re deciding on the best option and there are so many OTC products to choose from, it’s important to choose one that treats only the symptoms you or your loved one has. Just as you would follow your doctor’s advice when taking a prescription medicine, you need to know the facts about how to take OTC medicines safely.

Carefully read the Drug Facts label and talk with your pharmacist if you have any doubts about which OTC will best care for your family’s ailments.. Keep in mind, OTCs are meant to treat minor health problems, so if the symptoms you are treating do not improve in a few days, you should call your doctor.

What about your daily multivitamin? Although vitamins, herbals and other dietary supplements come in similar packaging and many are shaped just like pills, they are not considered OTCs. The Food and Drug Administration categorizes these products as food, so they do not have to follow the same strict rules that prescription drugs have to follow by law. Make sure to tell your healthcare providers if you use any. Mixing certain supplements or herbals with food or other medicines can be dangerous.

Prescription medicines can help clear an ear or sinus infection, lower elevated blood pressure or treat or manage a wide range of chronic and potentially life-threatening conditions, such as diabetes, asthma, heart disease and cancer. These medicines require a prescription from a doctor or other healthcare professional licensed to prescribe medicines, and should be taken exactly as directed and only by the family member for whom they are prescribed.
Carefully read the instructions that acompany every prescription medicine and ask your healthcare provider any questions before you begin taking the medicine. Click here for NCPIE’s Questions to Ask Your Health Team About Your Medicine.
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Generic vs. Brand: What’s the Difference?

In general, medicines can be referred to by three different names:

Brand (Bayer)
Generic (Aspirin)
Chemical (Acetylsalicylic acid)

A generic drug (often called by its chemical name) has the same active ingredient or medicine as the brand name, so it works the same way in your body. Generics are FDA-approved, bioequivalent versions that match brand name drugs in terms of dosage, safety, strength, how it is taken, quality, performance and intended use. However, they may look different in their shape and/or color, and you will not see them advertised on television.

The advantage of generic medicines is that they are less expensive and, therefore, more likely to be covered by your health plan for a lower co-payment. In fact, some insurance plans will only pay for the generic if one is available. If you prefer the brand name, ask your doctor to write "brand medically necessary" on your prescription.

In very rare circumstances, the generic drug may affect some people differently than the brand.

If you think that you cannot afford to pay for your medicines and no generic exists (this is true for new medicines), there are prescription assistance programs that provide financial assistance for hundreds of medicines (See the Resources). If you qualify for Medicare, but do not enroll in a Part D prescription drug plan, you may qualify for extra assistance that can greatly reduce the cost of getting the medicines you need.

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Play It Safe: Avoiding Medication Misuse

Although medicines can make you and your loved ones feel better, all medicines have risks as well as benefits.

Benefits are helpful effects from using a medicine (for example, lowering cholesterol, reducing a fever or curing an infection).

Risks of medicines are the chances that something unwanted or unexpected could happen to you or a loved one when using a medicines (for example, an upset stomach or dizziness). Risks of medicine use can result from:

1) a harmful interaction between the medicines and a food, drink, supplement or another medicine

2) the medicine not working as expected

3) the possibility that the medicine may cause anticipated or unanticipated side effects

Medicines can cause problems, even if used correctly.

Allergic Reactions occur when your body’s defense system reacts in a bad way to a medicine. Such reactions might include:

Hives, itching or a rash
Narrowing of the throat, difficulty breathing, shortness of breath

Side effects are undesired effects of a medicine that can occur even though the medicine is being taken correctly at the recommended dose. These might include:

Headache, dizziness, or an upset stomach, which are all common side effects
Liver failure, which is a very rare side effect
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Potential medicine use problems

Misuse of medicines can result in serious and even deadly consequences.

Potential problems that you or a family member might encounter may include:

Over use — taking more than prescribed or recommended by the healthcare provider or label. This can happen by accident -- maybe you forgot you took your blood pressure medicine this morning, so you take it again.
Under use — taking less than prescribed or recommended, missing or skipping doses, not filling an initial prescription or failing to get a refill.
Not following instructions
Taking medicines that are not prescribed for you.
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.

Get the Facts about Your Family’s Medicines

You wouldn’t drive your car without making sure your kids were buckled up before driving, so why would you not take the time to understand the medicines in your cabinet and adopt safe medication habits to protect your family? If you haven’t, you’re not alone. Most Americans fail to ask questions about their medicines, and half don’t use their medicines as prescribed. They may

Know what active ingredients are in your medicine. Combining pain relievers, prescriptions or multi-symptom medicines that have the same active pain relief ingredient could result in your taking too much of that ingredient, and too much of any one ingredient can lead to serious health problems.
Forget to take their medicine
Decide not to fill a prescription that was recommended
Stop the medicine before it was finished
Take less or more than the recommended dose
Unfortunately, not using medicines properly can spell trouble for you and your family:
Preventing your loved ones from getting well as fast as you’d like
Leading to longer sickness or unnecessary progression of disease
Reducing the body’s ability to respond certain therapies (for example, when taking antibiotics, it’s important to finish all of the medicine even if you start to feel better. If you don’t, the surviving bacteria can develop resistance to the medicine, which means it may not work the next time)
Negatively impacting your quality of life
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Tips for Protecting Your Family

Whether it’s for your family unit or as a caregiver for aging parents or other loved ones, know your medicines and how to best promote their safe use.

Here are some helpful hints to reduce the likelihood that you or your loved ones will experience troublesome side effects or other problems, such as unintended interactions with other medicines, herbal supplements or foods.

Carefully read the prescription drug medicine information sheets that come with your family’s medicine(s), and the over-the-counter (OTC) drug facts label.
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:

The right medicine
For the right person
In the right amount
At the right time
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.

Take medicines exactly as directed. This means following dosage recommendations and knowing how to measure your medicines correctly to get the right dose.

Always use the measuring spoon, cup or syringe that comes with the medicine. If you have children, give medicines based on their weights and ages. If a dose is not listed for your child’s weight or age, talk with your pharmacist or pediatrician.

Keep all medicines in their original bottle, box or tube.
Talk with your doctor, nurse or pharmacist if you have any questions or concerns about your medicines. Also consult him or her before starting any new prescription or non-prescription medicines.
Stick with the recommended treatment plan. If you think a change needs to be made to a medicine that you, your child or parent are taking, talk with the doctor first. Don’t try to adjust the dosage yourself or skip doses altogether to minimize side effects because you think the medicine isn’t working or to save money. For example, if you or your child is taking an antibiotic to fight an infection, it’s very important to take all of the medicine for as many days as your doctor prescribed, even if you feel better. If you or a loved one has high blood pressure, the doctor will likely prescribe multiple antihypertensive medicines to help control it.
Create a list of medicines used by each family member—be sure to list all OTCs, prescription medications, vitamins, herbals and other supplements as some medicines and supplements don’t mix well and can cause harm. Be sure to record information about why each medicine is being taken, dosages, how and when they are taken, and note any side effects or allergies.
Possible signs of allergic reaction include hives, itching, a rash or difficulty breathing
Possible side effects include headache, dizziness or an upset stomach; liver or kidney damage is rare, but possible with too much of a certain ingredient or drug-drug interactions

Share an up-to-date, written list of ALL the medicines you and your children use, including vitamins and herbals and dietary supplements, with each of your family healthcare providers. Encourage your partner and parents to do the same. Also tell your doctor if you or someone you are caring for smokes or drinks alcohol.

Use the same pharmacy for all of your family’s prescriptions to avoid confusion. It’s safer to have your family records in one place.
Talk with your family about why it’s important not to share prescription medicines or give any remaining supply to friends or others (for example, strong pain medications after getting their wisdom teeth pulled). Nor should they take anyone else’s medicine.
Keep a list of emergency numbers handy, including the toll-free nationwide poison control center number (1-800-222-1222), in the event of an accidental overdose or poisoning.
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Safely Storing and Disposing of Medicines

Making sure you and your family store your medicines safely is as important as taking them correctly.

So where do you keep your medicines? That’s an easy question. 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:

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. So what do you do with unused or expired medicines?

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. Just three small steps can make a big difference:

DO NOT FLUSH unused medications or POUR them down a sink or drain. While the rule of thumb is not to flush, the Food and Drug Administration (FDA) has determined that certain medications should be flushed due to their abuse potential. Read the instructions on your medication and talk to your pharmacist.

As of September 2008, the FDA advised that the following 13 drugs be flushed down the toilet instread of thrown in the trash:
  • Actiq (fentanyl citrate)
  • Daytrana transdermal patch (methylphenidate)
  • Duragesic trandermal system (fentanyl)
  • OxyContin tablets (oxycodone)
  • Avinza capsules (morprhine sulfate)
  • Baraclude tablets (entecavir)
  • Reyataz capsules (atazanavir sulfate)
  • Tequin tablets (gatifloxacin)
  • Zerit for oral solution (stavudine)
  • Meperidine HCl tablets
  • Percocet (oxycodone and Acetaminophen)
  • Xyrem (Sodium Oxybate)
  • Fentora (fentanyl buccal tablet)
Dispose of Unused Medicines in Household Trash. When discarding unused medicines, ensure you protect children and pets from potentially negative effects:
  Pour medicines in a sealable plastic bag. If medicines are in a solid form (pill, liquid  capsule, etc.), crush it oradd water to dissolve it.
  Add kitty litter, sawdust, coffee grounds (or any material that mixes with the medicine and makes it less appealing for pets or children to eat) to the plastic bag.
  Seal the plastic bag and put it in the trash.
  Remove and destroy ALL identifying personal information (prescription label) from the medication container.
Check for Approved State and Local Collection Programs.In certain states, you may be able to take your unused medicine to your community pharmacy.

Visit the SMARxT Disposal website at:  or click here to download NCPIE’s Tips on Safe Storage and Disposal.

Traveling? 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.

Remember, your community pharmacist is an important part of your family’s health team. He or she can give you expert advice on properly storing and disposing of medicines.