Ask A Pharmacist

Make sure to read the drug information that comes with your medication. Certain medications are coated or come in a specific dosage form that is supposed to be swallowed whole, not broken, crushed or chewed. Some things you need to know:

• Drugs (often tablets) that have what's called an Enteric Coating get absorbed past your stomach, in the small intestine. The coating is there for a specific purpose:
1. to help absorption.
2. to reduce stomach upset that can be caused by Aspirin or other anti-inflammatory medications.
• Drugs that are called Controlled Release are designed to be introduced more slowly into the body to release the medication at a steady rate over a specific length of time sometimes over the whole day. This may mean you have to take less doses per day. Be aware:
1. Crushing a controlled release drug forces the body to absorb the medication all at once, sometimes too quickly.
2. The hazards of crushing a controlled release medication can be severe - even fatal.

A prescription is a legal document which requires specific information to be included and serves as a source of communication between your physician and pharmacist to ensure the correct medication is dispensed to you. It may include some clinical terminology or abbreviations but overall here's what it contains:

• Date written.
• Name of patient.
• Name and strength of the medication.
• Dosing instructions including how & when to take it.
• Quantity of medication to dispense.
• Number of refills allowed.
• Whether generic substitution is allowed.
• Physician name, office address, & required license numbers.

A manufacturer can spend billions of dollars to develop, produce, and perform clinical trials to bring a new drug to market. As a result, they own the patented rights to that brand name drug for 20 years. However, when the patent runs out, generic manufacturers can develop and sell an exact duplicate. The generic equivalent drug must contain identical amounts of the same active ingredient, in the same dosage form and must use the same route of administration. The U.S. and Canadian governments require that the brand and the generic have the same rate and extent of absorption as the brand drug when studied under similar experimental conditions, which means they must both act identically within your body. This is called bioequivalence.

There is an upside and a downside to many medications. While medications are intended to cure or reduce the effects of your illness, they can also come with some challenging side effects. You can discuss what to expect with your doctor or pharmacist before taking your medication. If you're taking multiple drugs, you can run the risk of experiencing drug to drug interactions. Take this simple "yes" or "no" quiz. The more "yes" answers you have, the greater your risk.

• Do you take 5 or more medications on a regular basis?
• Do you take 12 or more doses per day?
• Are you taking medications for 3 or more conditions?
• Are you taking any of the following medications?
Carbamazepine
Lithium
Phenytoin
Quinidine
Warfarin
Phenobarbitol
Procainamide
Theophylline

It is not recommended. All medications come with expiration dates. The U.S. and Canada mandate from the drug manufacturers that at the time of the expiration date the drug should be at least 90% of the original potency - if properly stored. It is not known, once beyond the expiration date, how quickly the drug continues to lose potency. Here are some things you should know:

• If you take a medication after the expiration date, it could be less potent and may not work as well.
• Do not increase the dose; since the potency is unknown, this could have serious consequences.
• The manufacturer may not support the drug if taken after the expiration date.
• Eye drops & ointments should not be used after 4 weeks of opening as there is potential these products can become contaminated with bacteria.

Most medications can be safely stored at room temperature. For those medications that have specific storage requirements like refrigeration, this should be indicated to you at the time of dispensing. Please make sure you carefully read your label and any other drug information that you are given when your prescription is filled. Unless otherwise directed, here are some tips on the safest way to store your medications:

• Follow the pharmacy recommendations for storing each drug.
• Not in the bathroom medicine cabinet! Moisture can cause medications - especially capsules - to degrade.
• Not in your car, temperatures can get extreme in the summer and winter.
• If there is not specific storage directions, keep your prescription in a cool, dry place out of the reach of children.
• Childproof caps are a must if you're storing medications in the refrigerator.
• A lock box stored in a cool dry place is another option.

Here are some tips on disposing of unused medications responsibly per U.S. Food and Drug Administration guidelines:

• Check the instructions or patient information provided when the prescription was filled. Often the manufacturer will provide guidance with the instructions.
• Do not flush prescription drugs down the toilet unless the information provided specifically instructs you to do so.
• If no instructions are given, you can throw the drugs in the household trash with the following suggestions;
• Remove from original container and mix them with an undesirable substance such as used coffee grounds or kitty litter.
• Place them in a sealable bag, empty can or other container to prevent leaking or breaking out of the garbage bag.
• Find out about community drug take-back programs which allow the public to bring in unused drugs to a central location for proper disposal, call your city or county government's household trash and recycling service.
• Some additional tips: before throwing away old pill bottles, scratch out any identifiable information on the drug label to protect your identity & privacy of personal health information.
• Do not give any unused medications to friends or family - these medications were specifically prescribed for you and your medical condition and they may not be right or may even be dangerous for someone else to take.
• For more information http://www.fda.gov/forconsumers/consumerupdates/ucm101653.htm.

You can call BioScrip 24/7 at (800) 677-4323 and ask to speak with a pharmacist. You can also visit www.drugs.com and click on Pill identifier for information that may be helpful in identifying unknown medications.