Is it safe to stop taking the medication whenever you want?


If your medication is intended to make your broken arm hurt less and you stop taking it, your arm will probably hurt more -- but probably nothing worse than that will happen. If your medication is an antibiotic intended to cure a bacterial infection and you stop taking it before you finish the full course, some bacteria will probably survive and multiply and may make you sick again. Plus you may be contributing to the rise of antibiotic resistance -- since the bacteria that did survive (and multiply) will be the ones most resistant to the antibiotic.

It may be even less wise to stop taking other medications abruptly on your own. If you suddenly stop taking a medication meant to lower your blood pressure, for example, your blood pressure could spike dangerously.

What side effects should you watch out for?

In addition to the effects you want your medications to have -- making your blood pressure go down or your energy level go up -- drugs may have effects you'd rather they didn't, such as making you fall asleep in a meeting with your boss. Some side effects are more common than others, and some are more serious. You need to know which are which, how you can avoid them (if possible) and what you can and should do about them if they occur. For example, the standard recommendation for medications that make you drowsy is to avoid driving or operating heavy machinery.

What interactions should you watch out for?

If you're already taking any over-the-counter medications, herbal remedies, dietary supplements or other prescription drugs, or if you drink alcohol, your new medication might act in undesirable ways. It could be ineffective. It could be dangerous. There are ways to avoid some bad interactions, such as scheduling your doses appropriately. And there are times when the medications themselves should be avoided.

How should you store the medication?

Proper storage will ensure that your medication is as effective as possible. Usually this means in a cool, dry, dark place. Sometimes it means in the refrigerator or freezer. But for the most part it means not in the medicine cabinet in your bathroom, where conditions are often warm and moist.

Is there a way to save money on your prescription?

Physicians tend to underestimate the price of expensive drugs and overestimate the price of inexpensive ones, according to a study published in the journal PLoS Medicine in 2007. So they may not always have a very good idea of how much the drugs they prescribe are going to cost their patients. Often pharmacists can suggest changes or substitutions for prescribed medications that will save patients money.

In California, if your physician prescribes a brand-name drug and you'd rather take a less expensive generic, your pharmacist can make the substitution without consulting the prescribing physician. To change to a different drug, however, pharmacists do need the physician's approval. Even with a hefty financial incentive, patients are sometimes reluctant to take their pharmacists' advice.

"They think what their physicians prescribed must be better or they wouldn't have prescribed it," says Kathy Besinque, an associate professor at the USC School of Pharmacy who also works part-time at Patton's Pharmacy in Santa Monica. "But really, physicians have many choices that would work."

"Some patients assume generic drugs are less effective than brand names," says Julie Donohue, associate professor in the graduate school of public health at the University of Pittsburgh. In fact, generics contain the same amounts of active ingredients as do the brand names they are meant to be substituted for.

"As a pharmacist myself, I would take generics," says Ken Thai, owner of El Monte Pharmacy in El Monte.

Cost issues can affect people's insurance coverage. "Sometimes insurance plans won't cover new medications," Besinque says. "They want patients to try old, less expensive ones first."

Besides recommending less expensive medications, pharmacists can help patients save money in other ways too. For example, a pill that's twice as strong as the one your physician prescribed usually doesn't cost twice as much, Besinque says. So if the double-strength pill can be split in half, you can get the same amount of medication for less. Similarly, for medication you take long-term, you can often save money by buying more pills at once -- e.g., 60 pills probably won't cost twice as much as 30.

Does your pharmacy provide any special services that will make your life easier?

Some pharmacies can package your medication in daily doses, making it easier to take the right amounts. CVS Pharmacies recently began a free program to make it easier to refill prescriptions you take for chronic conditions. If you sign up for the new service, the store will simply refill any such prescriptions automatically -- and then call you to let you know they're ready.

Remember: It's never too late, and it's never too dumb.

If you get home and start taking your new medication and only then think of a bunch of questions about it, not to worry. "You can call your pharmacist with any question about your prescription at any time," says Anne Burns, vice president for professional affairs for the American Pharmacists Assn. In fact, it's just natural to have more -- and possibly more important -- concerns after you've taken the medication for a while.

In any case, "there are no bad questions," Thai says. "The more communication people have with their physician and pharmacist, the better. When people don't say anything, that's when we run into problems."

health@latimes.com