Advice on mixing meds to using pills smarter is as close as your local drugstore
Article Source: msnbc.com
from:msnbc.comAmbien and cold meds? Pharmacists share tips for preventing medicinal mayhem
Seeded on Tue Jan 11, 2011 8:56 AM EST (msnbc.com)
- msnbc.com sites & shows:
- TODAY
- Rock Center
- Nightly News
- Meet the Press
- Dateline
- Morning Joe
- Hardball
- Ed
- Maddow
- Last Word
- msnbc tv
Leave a Comment:
Asking your doctor to prescribe a double dose and cutting the pill in half is asking the doctor to lie. It is illegal as well.
I get some free samples from my doctor to save money. He will give me free samples and if he is out of them he will prescribe a generic. Just because I got the samples, in no way does it make me stay with that drug. He evaluates the different medications and what they sell for before making a recommendation.
It has never been illegal for a doctor to give you a tripple dose and instruct you to cut it in half, you have no idea what you're talking about.
If the doctor orders 100mg tabs and instructs the pt to cut them in half, it is not illegal. It IS fraud if a 30 tablet supply that lasts 60 days is billed to the insurance company as a 30 day supply.
If the patient has a set co-pay, cutting tabs in half won't help. If a patient is self-pay, yes it can. Some products come as capsules or gelcaps and cannot be split. Enteric coated and 'osmotic-pump' type time release tablets also cannot be split. Most patches cannot be cut into pieces, either, some can actually kill if they leak, which cutting would cause. ALWAYS ask your Pharmacist first!
How do I know? I AM a Registered Pharmacist.
Darthdon is spot on with his information and I should know because I too AM a Registered Pharmacist.
I would like to point out a couple of things I disagree with that appeared in the article:
Aleve (and ibuprofen) will not act as an anti-inflammatory unless you take them regularly for about 3 days and at doses generally higher than recommended for OTC use. If you take acetaminophen (Tylenol), take it with food to reduce the impact it has on your liver.
I am not a fan of "shotgun" cold remedies. Buy the store brands, get the Sudafed product you have to sign for (pseudoephedrine) & take only what your symptoms dictate:
1) A decongestant (Sudafed) during the day if you are congested or have a "tickle" at the back of your throat- that's usually caused by mucus drainage & a decongestant will help with that as well. Read the package or ask the pharmacist to be sure you can take any of the medicines I mention. People with diabetes & most people with high blood pressure can't take decongestants. People with certain types of glaucoma & men with prostate issues should avoid anti-histamines. Both can interact with some prescription drugs.
2) An anti-histamine (Benadryl) at night in place of the decongestant, if decongestants keep you awake. Zyrtec (citirizine) can be taken during the day by people that don't tolerate decongestants for what ever reason. I'm not a fan of Claritin (loratadine) and you should not take both the Benadryl & Zyrtec at the same time.
3) Water- either in a glass or as steam from a hot shower or a steaming cup of coffee or tea or from a vaporizer- is the best mucolytic (meaning something that will thin out that thick, viscous green junk in your head). Guaifenesin (Mucinex or plain Robitussin) will help this process a little & maybe keep the decongestant & especially the anti-histamine from over-drying. Neither of these things (H2O or guaifenesin) will effectively remove mucus from your lungs. If you are short of breath or have persistent tightness in your chest especially if accompanied by a fever of 100 degrees or more, see you doctor.
4) Take Tylenol or ibuprofen for the aches & pains the sometimes accompany a cold. If you have a runny nose the ibuprofen may make it worse. If you are running a fever, it's not a cold, and you need to find out what's causing it.
5) If you're nose is running buy some facial tissue (Kleenex). An anti-histamine like Zyrtec may help some (I'm not a fan of Claritin) without making you drowsy.
6) Cough suppressants like dextromethorphan generally don't work very well and I tend to avoid them. Your best bet is to control the drainage that's causing the cough with decongestants & supplement with cough drops when needed. If you do cough something up, it's most likely mucus from your sinuses that's draining down your throat. Again, if you're short of breath or have significant tightness in your chest, especially if accompanied by a fever, it's not a cold & you need medical attention.
If you shop around a little & avoid the brand names you can generally get enough decongestant & anti-histamine to handle about 3 or 4 regular colds for about the same money as a 3 days supply of the brand name combination products would cost. I hope this helps.
Viagara (aka Bonerific) works just fine when a 100mg tab is cut in half. Been doing that for a while now. No problems.
Why is this article slanted toward men ? I know women who have done this and worse than any man.
Well, do you think it's at all related to the fact that this is a MEN'S HEALTH magazine related article? Didn't notice the Men's Health logo right below the authors name, did ya?
Talk to your pharmacist? Their time is valuable and the issues are complex. If they can really help (and its obvious they can) then a paid consultation by appointment should be available and I should be willing to pay it (with copy of consult summary to MD on request).
Advice while standing in line just can't be as comprehensive. These pharmacists have a wealth of professional knowledge and we aren't even beginning to tap it.
One thing I'm disturbed that they didn't mention - not all pills can be cut up.
Never cut or split your pills unless your doctor or pharmacist says it's okay! Some medications are long-acting or extended-release, and cutting or splitting them can cause all the medication to release at once, which can cause a fatal overdose.
I'm really surprised that they neglected to mention that. Very irresponsible reporting.
You mean you cant crush oxy up and snort it? I think people are aware and if they aren't Darwins rules apply..
Watch intervention or addicted there is always someone crushing oxy and snorting it, some even cut it up and smoke it.
Megidoloan- You are exactly right. There are many pills that should never be split or crushed and you should always ask your doctor or pharmacist if it's OK before you do. Good job in catching that oversight.
This is an exceptionally well written and meaningful commentary, side bars included. This should not be a male/female issue, it is for everyone bombarded by commercials pushing one miracle drug over another.
It is urgent for all of us to take some responsibility for our medication decisions. The expectorant/suppressant, and anti-hystamine/decongestant comments should be a slap on the forehead gesture, if you used any of these.
Seniors seem to be more aware of splitting a stronger dose for economy.
Pay attention.
A good article to reinforce the fact that a pharmacist knows far more than any doctor or lay person about a particular drug. I'm not a pharmacist, so I'm not tooting my own horn. No question is ever a dumb question to your pharmacist. Whether I go to the pharmacy to pick up a prescription or just to buy some cough drops I never hesitate to ask the pharmacist questions about it. Many people probably think to ask the pharm about side effects of a prescription. What people may NOT realize is that not only do the pharms know about all of the OTC meds, they know all of the individual active ingredients and how they work together to produce different effects and side effects with each med.
One obvious concern is the mis-information about the max daily dose of ibuprofen listed in this article. In this article it is listed as 1200mg, which is true of the package labeling of OTC ibuprofen, which states not to use more than 6 tablets in 24 hours. That being said however, we have many patients who use 600mg four times daily, and 800mg three times daily for acute pain management, who might be mislead by this article into thinking that they are at risk of inducing renal toxicity by using nearly three times the recommended amount according the the information given in this article. The actual maximum daily dosage limit is 3200mg of ibuprofen. As it turns out, this is one of the more common medications we dispense by prescription. Many people who don't have insurance, but who have received a prescription for higher dose ibuprofen will often opt to purchase it over the counter, and use 3 to 4 tablets, or 600 to 800mg as their prescription indicates, as a way to save money. Higher doses of ibuprofen should of course be given only under the recommendation/prescription/supervision of an appropriate prescriber.
Talk to your Dr. or phys. assistant. I was taking a pricey drug when she asked me why I was spending the money, "I said that was the prescription that I was given". She explained that the two ingredients in the pricey medication were common and could be taken as two separate pills. My blood pressure medication went from over fifty dollars a month to twenty dollars every three months. Tell the physician that you are on a limited income or just plain broke and he or she can be your best buddy when it comes to saving money.
it is not illegal. the MD prescribes half a tablet! DUH
I am on Seroquel, and went to the pharmacy to pick up my meds and fopund out now that Kroger took it off formulary I have a deductible of $130 per month. The script now costs me $163.00 instead of $30.00. And I tried to get it transferred to another pharmacy where it is cheaper and Kroger insurance wont pay anything when its not filled at a Kroger/Smiths Pharmacy. (My hubby works for Smiths). So back to the Dr. to get samples. Anyone else have these issues with their insurance?
Almost all insurance companies now have a formulary, I'm afraid. There are other drugs in the same general class as Seroquel that are off patent & available as generics (risperidone and clozapine and I believe Zyprexa (olanzapine) is due to come off patent soon). You might discuss these options with your doctor.
Doctors quite often prescribe larger amounts of generic drugs of those that are able to be cut with a pill cutter. Doctors around where I live are big on prescribing generics.
I read this article becuase it mentioned a medication that I take in the title...Ambien...but Ambien is NOT mentioned in the Article...that makes me think the writer is an idiot...
If you we're wondering: the Ambien immediate-release comes in a 5 & 10 mg strength & either can be broken in half. It also comes in a generic version & that can be split as well.
The AmbienCR (controlled-release) version is not available as a generic & cannot be split.
As of the last month, both Ambien CR 6.25 and 12.5 mg are available as generics. Even better, the generic form is actually manufactured by Sanofi-Aventis, so the tablet is identical.
Many websites also offer free discount cards to help with the cost of medication. There is never a reason to pay retail prices in pharmacy as some medication is marked up 1000% from the actual purchase price. Check out DrugDiscountNow.com for a free discount card to use at most any pharmacy in the country.
Feel free to direct all of your pharmacy related questions to them as well...
The biggest problem, as I see it, is allowing the drug companies to advertise PRESCRIPTION drugs on TV etc. This not only encourages people to think they need the "latest thing" when an older drug, often generic, works just as well, but it encourages them to think they have a problem when they may very well not. The second biggest problem is allowing insurance companies to decide which drugs they "prefer." All drugs within a category are not created equal. This is particularly true of antidepressants. And allowing insurance companies to decide a patient's drugs, just like allowing them to decide how long a patient can stay in the hospital, is allowing them to practice medicine without a license. (The hospital stay thing, by the way, was successfully prosecuted many years ago in New Mexico)
I knew most of this information years ago. It's a good thing to go by. Especially the cough and cold medicine section. Pay close attention to that. It really irks me how drug companies mess with people by putting the same drugs in different packages and saying that they are for slightly different things.
I've loaded your site in Three totally different internet browsers and I must say this website loads a great deal quicker then most. Would you intellect emailing me the company name of your respective website hosting provider? I'll even sign up as a result of your own affiliate link if you'd like. Thank you