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How to Be Drug Smart
By Russell Wild
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Get special discounts
A new program called Together Rx became available in June 2002. For Medicare enrollees with no drug coverage and incomes of up to $28,000 ($38,000 for couples), the program offers discounts on products from such leading drug companies as Abbott Laboratories, AstraZeneca, Aventis Pharmaceuticals, Inc., Bristol-Myers Squibb Company, GlaxoSmithKline, Janssen Pharmaceutica Products, L.P., Novartis, and Ortho-McNeil Phamaceutical, Inc. There is no cost to enroll. 800-865-7211; www.togetherrx.com. Pfizer has its own discount card, the Pfizer Share Card, for Medicare enrollees with no prescription drug coverage and incomes of less than $18,000 ($24,000 for couples). A 30-day supply of a Pfizer drug is $15. 800-717-6005; www.pfizerforliving.com. The same income and Medicare rules apply to the Lilly Answers Card. 877-795-4559; www.lillyanswers.com. A 30-day supply of a Lilly drug is $12. More than two dozen states have programs to help the needy cover drug costs. If you're enrolled in an AARP health insurance plan, you have free access to its Prescription Savings Service, which offers discounts on drugs through the mail or at 46,000 pharmacies. If you don't have an AARP-sponsored policy, you can buy an identical service called Member Choice. 800-439-4457; www.aarppharmacy.com.
Go generic
Generic drugs typically cost 50 percent or less than brand name drugs. But are generics just as good? Sometimes there are minor differences, such as the flavoring and color, but there are no differences in the active ingredients. The FDA sees to that. Ask your doctor if the generic version is a good idea for you.
Avoiding Drug Interactions
In the alchemy of medicine, one plus one does not always equal two
Drug-Herb Interactions
- Ginkgo may exaggerate the body's response to anticoagulants or antiplatelet agents.
- Ginseng can decrease the effectiveness of the anticoagulant warfarin.
- Saw palmetto doesn't mix well with estrogens; it can increase the hormone's effects.
- Valerian in conjunction with opiates or barbiturates can seriously sedate you.
Drug-Drug Interactions
- Acid reducers (H2 receptor antagonists) may slow the metabolism of theophylline (an asthma drug), any of the tricyclic antidepressants (amitriptyline, doxepin), and an anticoagulant.
- Verapamil, a blood pressure medication, can increase the risk of muscle soreness in people taking statin drugs for high cholesterol.
- Sedatives and antihistamines can combine to severely slow your reaction time, making driving or operating machinery dangerous.
- Warfarin (Coumadin), an anticoagulant used to treat blood vessel conditions, can interact with many other medications. A particularly bad mix is warfarin and any nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen, or naproxen. Serious bleeding may result.
- Viagra must never be used by anyone taking medicines that contain nitrates. This includes nitroglycerin, the heart drug. Your blood pressure could drop to an unsafe or life-threatening level.
Drug-Condition Interactions
- Sleeping pills can complicate a breathing problem such as emphysema or sleep apnea.
- Nasal decongestants and bronchodilators can be dangerous when taken by those with heart disease or high blood pressure, thyroid disease, or diabetes.
- Many antihistamines, decongestants, and antitussives for coughing are not recommended for those who have difficulty urinating due to an enlarged prostate.
Drug-Food Interactions
- Asparagus, spinach, and broccoli and similar foods can neutralize anticoagulants. These vegetables are high in vitamin K, which promotes blood clotting.
- Grapefruit or grapefruit juice interacts with most statin drugs prescribed for lowering cholesterol, increasing the risk of side effects. Orange juice may be a suitable alternative.
- When taken with food, the absorption rate of the osteoporosis medicines alendronate (Fosamax) and risedronate (Actonel) is cut in half.
10 Questions to Ask about a New Prescription
- 1. What's the name of the drug you're prescribing?
- 2. Is a less expensive generic version of this drug available?
- 3. How much will I be taking and how many times a day?
- 4. What time of day is best to take the medication? Should it be taken with food or without?
- 5. Does the medication need refrigeration?
- 6. What side effects, if any, might I experience? What should I do if they occur?
- 7. Is it safe to take this drug with other drugs or supplements? Can I drink alcohol while I am on this medication?
- 8. What do I do if I miss a dose?
- 9. How long will I be taking the drug?
- 10. Do I need to finish the entire dosage you're prescribing for me? What do I do if I feel better before that?
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