Take a Stake in Your Prescriptions

Pharmacist helping a man

Epilepsy News From:

Wednesday, March 25, 2015

Clearly, the mainstay of modern treatment of epilepsy is antiepileptic drugs (AEDs). Many, if not all, of these medications have unique properties. While all of the medicines currently marketed in the U.S. have been evaluated and approved by the U.S. Food and Drug Administration (FDA) and should therefore be considered generally safe and effective, we also know, just like the medicines, the people who ultimately take them are also unique.

There are many factors that can result in a particular medicine working well and causing no side effects in one person, to not completely controlling seizures or causing bothersome (or perhaps serious) side effects in another. To help ensure a good outcome with these different medications, health care providers have developed a number of tools over the years. One of the most important of these tools is knowledge.

Knowledge is power. It is also the responsibility of everyone on the health care team, including the patient. This only makes sense. Ultimately, most all decisions regarding changes in epilepsy treatment come from information shared by the patient to his or her health care provider. It is important, therefore, that people learn as much as they can about their medications. This is not always an easy task. So, the objective for this upcoming series of short articles is to help you, the patient, better use a valuable yet frequently underutilized information source every time you get your prescriptions.

Ask questions.

Every time you bring a new prescription to the pharmacy to be filled, there should always a list of questions you should ask - and expect to get answered!

What is this medicine for? This is one of the best ways to avoid errors. If you know your health care provider intended the new medicine to treat seizures, but are being told that this prescription is intended to treat something else, then it might be prudent for your pharmacist to double check.

What side effects should I expect? Make sure you understand what the most common side effects are likely to be, when you should expect them, and what you should do if they occur. You also want to know if there are any side effects that require immediate medical attention, and which ones are likely to lessen over time.

Is there any time of day, or way, that I should take this? For some AEDs, it might be more appropriate to take the tablet or capsule at bedtime. For others, it is really more a question of what is most convenient for you. Also, if you have difficulty swallowing pills, ask your pharmacist if the medicine can be crushed and mixed with food.

What should I do if I forget to take my medicine? There are different answers to this question, depending on the particular medicine and your individual situation. Ask your pharmacist in advance, so you can be prepared.

Am I receiving a generic product? If so, make sure your pharmacist provides you with the manufacturer name, and write this down on your medication list.

Will this new medicine interact with any of my other medicines? There are many potential drug-drug interactions with most of our AEDs. These possible interactions are not just limited to interactions with other AEDs, but may also occur with medicines you might be taking for other medical conditions, such as high blood pressure, high cholesterol, heart disease, or depression. Some of our AEDs can also interact with oral contraceptive pills. If your pharmacist notes any potential interactions, make sure you write this down. Also ask if your health care provider should be notified.

Ask more questions!

While most people ask questions of their health care provider when they are given a new prescription in the office or clinic, this may not be enough. Sometimes, side effects to certain drugs do not appear right away. They may get better or worse over time. They also may change or appear after dose adjustments. What might be interpreted as a side effect might actually be the result of an unrecognized drug-drug interaction. So, people should take the opportunity to ask their pharmacist these types of questions EVERY time they pick up a medication refill.

Ask your pharmacist to ask more questions as well!

Many people think that the only time it is important to ask about a medicine is when they get a new prescription. Not so. As mentioned above, things can sometimes change over time. Your pharmacist is trained to ask these sorts of questions. Make sure this happens every time you pick up your refill. Don’t be shy. It may require you to start the dialogue. Let you pharmacist know that you expect this interaction at every visit.

Keep a list.

It is important that your health care provider know exactly what medicines you are taking in addition to your AED. This is a good reason to only use one pharmacy for your prescriptions. Most every pharmacy maintains a computerized record of your medicines, both past and present. Ask your pharmacist to periodically print you off a list so you can keep it with you and bring it to your medical appointment. It is also important to remember that most of these medication lists, or profiles, will not contain information about non-prescription or over-the-counter (OTC) drugs and supplements you might also be taking. Talk with your pharmacist about keeping this information on file for you as well. Some of these OTC products can interact with your AEDs or other prescription medicines.

Taking medicines is also a team effort.

It is not at all uncommon for many of our commonly used AEDs to have rather complex dosing instructions. For you to get the most benefit from your AED, it is important that you are able to take it as prescribed. Now, this can be difficult sometimes, especially when medicines need to be taken multiple times per day or are hard to swallow. Sometimes people forget, or forget that they forgot, to take their medications. If this is the case, look back to point #1 in this article … Ask questions! Your pharmacist can likely help with strategies or assistance in helping take your medications as your health care provider intended.

Authored by: Barry Gidal PharmD on 3/2015

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The mission of the Epilepsy Foundation is to lead the fight to overcome the challenges of living with epilepsy and to accelerate therapies to stop seizures, find cures, and save lives.

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