Health Tips

Communicating with your health care provider

Communication between you and your health care professional is central to good medical care. Your health care professional needs to know about you, your medical history, and your current problems. In turn, you need to understand the recommendations he or she is making and what you will need to do to follow the treatment. You will have to ask questions — and answer some too. Communication is a two-way process.

Giving information
Your health care professional needs to know some details about your past and present medical history. In discussing these details, you should always be completely open and honest. Your health professional's diagnosis and treatment will be based in part on the information that you provide. A complete list of the details that should be included in a full medical history is provided below.

A "medical history" checklist covers the following information:

• All the serious illnesses you have ever had and the approximate dates.
• Your current symptoms, if any.
• All the medicines and dietary supplements you are taking or have taken in the recent past. This includes prescription and nonprescription medicines (such as pain relievers, antacids, laxatives, and cold medicines, etc.) and herbal medicines and home remedies. This is especially important if you are seeing more than one health care professional; if you are having surgery, including dental or emergency treatment; or if you get your medicines from more than one source.
• Any allergies or sensitivities to medicines, foods, or other substances.
• Your smoking, drinking, and exercise habits.
• Any recent changes in your lifestyle or personal habits. New job? Retired? Change of residence? Death in family? Married? Divorced? Other?
• Any special diet you are on — low-sugar, low-sodium, low-fat, or a diet to lose or gain weight.
• If you are pregnant, plan to become pregnant, or if you are breast-feeding.
• All the vaccinations and vaccination boosters you have had, with dates if possible.
• Any operations you have had, including dental and those performed on an outpatient basis, and any accidents that have required hospitalization.
• Illnesses or conditions that run in your family.
• Cause of death of closest relatives.

Remember, be sure to tell your health care professional at each visit if there have been any changes since your last visit.

Medical history forms
Many health care professionals have a standard "medical history" form they will ask you to fill out when they see you for the first time. Some may ask the questions and write down the answers for you. If you will be visiting a health care professional for the first time, prepare yourself before you go by thinking about the questions that might be asked and jotting down the answers — including dates — so that you will not forget an important detail. Once your "medical history" is in the files, subsequent visits will take less time.

You will have to supply each health care provider you see — every time you see one — with complete information about what happened since your last visit. It is important that your records are updated so he or she can make sound recommendations for your continued treatment, or treatment of any new problems.

Medical history file
It will simplify things if you develop a "medical history" file at home for yourself and each family member for whom you are responsible. Setting up the file will take time. However, once it is established, you need only to keep it up-to-date and remember to take it with you when you see a health care professional. This will be easier than having to repeat the information each time and running the risk of confusing or forgetting details.

It is also a good idea to carry in your wallet a card that summarizes your chronic medical conditions, the medicines you are taking, and your allergies and drug sensitivities. You should keep this card as up-to-date as possible. Many pharmacists provide these cards as a service.

Getting information
In order to benefit from your health care professional's advice you must understand completely everything that he or she tells you. Do not be embarrassed to ask questions, or to ask him or her to explain again any instruction or detail that you do not understand. Then it is up to you to carry out those instructions precisely. If there is a failure in any part of this system, you will pay an even higher price — physically and financially — for your health care.

Your health care professional may provide instructions to you in written form. If he or she does not, you may want to write them down or ask the health care professional to write them down for you. If you do not have time to jot down everything while you are still with your health care professional, sit down in the waiting room before you leave and write down the information while it is still fresh in your mind and you can still ask questions. If you have been given a prescription, ask for written information about the drug and how to take it. Your pharmacist can also answer questions when you have your prescription filled.

What you need to know about your medicines
There are a number of things that you should know about each medicine you are taking. These include:

• The medicine's generic and brand name.
• How the medicine will help you and the expected results. How it makes you feel. How long it takes to begin working.
• How much to take at one time.
• How often to take the medicine.
• How long it will be necessary to take the medicine.
• When to take it. Before, during, after meals? At bedtime? At any other special times?
• How to take it. With water? With fruit juice? With food?
• What to do if you forget to take it (miss a dose).
• Foods, drinks, or other medicines that you should not take while taking the medicine.
• Restrictions on activities while taking the medicine, such as driving a car or operating other motor vehicles.
• Possible side effects. What to do if they appear. How to minimize the side effects. How soon they will go away.
• When to seek help if there are problems.
• How long to wait before reporting no change in your symptoms.
• How to store the medicine.
• The expiration date.
• The cost of the medicine.
• How to have your prescription refilled, if necessary.

Other information
Following are some other issues and information that you may want to consider:

• Ask your health care professional about the ingredients in the medicines — both prescription and over-the counter (OTC) — you are taking and whether there may be a conflict with other medicines. Your health care professional can help you avoid dangerous combinations or drug products that contain ingredients to which you are allergic or sensitive.
• Ask your health care professional for help in developing a system for taking your medicines properly, particularly if you are taking a number of them on a daily basis. When you are a patient in a hospital, ask for instructions before you are discharged. Do not hesitate or be embarrassed to ask questions or ask for help.
• If you are over 60 years of age, ask your health care professional if the dose of the medicine is right for you. Some medicines should be given in lower doses to certain older individuals.
• If you are taking several different medicines, ask your health care professional if all of them are necessary for you. You should take only those medicines that you need.
• Medicines should be kept in the container they came in. If this is not possible when you are at work or away from home, ask your pharmacist to provide or recommend a container to transport your medicines safely. The use of "pill boxes" can also cause some problems, such as broken or chipped tablets, mistaking one medicine for another, and even interactions between the medicine and the metal of these boxes.
• Some people have trouble taking tablets or capsules. Your health care professional will know if another dosage form is available, and if tablet or capsule contents can be taken in a liquid. If this is an ongoing problem, ask your prescriber to write the prescription for the dosage form you can take most comfortably.
• To protect children from accidental poisoning, child-resistant caps are required by law on most oral prescription medicines. These containers are designed so children will have difficulty opening them. Since many adults also find these containers hard to open, the law allows consumers to request traditional, easy-to-open packaging for their drugs. If you do not use child-resistant packaging, make sure that your medicines are stored where small children cannot see or reach them. If you use child-resistant containers, ask your pharmacist to show you how to open them.

Consumer education is one of your health care professional's most important responsibilities. To supplement what you learn during your visit, ask if there is any written information about your medicines that you can take home with you. Your health care professional may also have available various reference books or computerized drug information that you can consult for details about precautions, side effects, and proper use of your medicines.

Your health care team

Your health care team will be made up of several different health care professionals. Each of these individuals will play an important part in the overall provision of your health care. It is important that you understand the roles of each of these providers and what you should be able to expect from each of them.

Your dentist
In addition to providing care and maintenance of your mouth, teeth, and gums, your dentist is also an essential member of your overall health care team since your oral health and general health often affect one another.

In providing dental treatment, your dentist should base his or her decisions upon an extensive knowledge of your current condition and past medical and dental history. Because the dentist is a prescriber of medications, it is very important that he or she is aware of your full medical and dental history. A complete medical and dental history should include the information that is listed in the "Medical history checklist" section above. Even if you do not consider this information important, you should inform your dentist as fully as possible.

In the treatment of any dental/oral problem your dentist should make every effort to inform you as fully as possible about the nature of the problem. He or she should explain why this problem has occurred, the advantages and disadvantages of available treatments (including no treatment), and what types of preventive measures can be employed to avoid future problems. These measures may include periodic visits to the dentist, and a general awareness of the manner in which dental and overall health may affect one another. In any type of treatment, your dentist should always allow you to ask questions, and should be willing to answer them to your satisfaction.

In selecting a dentist, it is important to keep in mind the role of the dentist as a member of the health care team, and the extent of the information that he or she should be asking for and providing. There are also several practical issues that you should consider, such as:

• Is the dentist a specialist or general practitioner?
• What are the office hours?
• Is the dentist or his/her associates available after office hours by phone? In emergencies, will you be able to contact a dentist?
• What is the office policy on cancellations?
• What types of payment are accepted at the office?
• What is the office policy on x-ray procedures?
• Is the dentist willing to work with other medical and/or dental specialists that you may be seeing?

Your dentist should be an integral part of your health care team. In treating problems and providing general maintenance of your oral health, your dentist should base decisions upon a full dental and medical history. He or she should also be willing to answer any questions that you have regarding your oral health, any medications prescribed, and preventive measures to avoid future problems.

Your nurse
Depending upon the setting, type of therapy being administered, and state regulations, the role of the nurse in your health care team may vary. Registered nurses practice in diverse health care settings, such as hospitals, outpatient clinics or physicians' offices, schools, workplaces, homes, and long-term care facilities like nursing homes and retirement centers. Some nurses, including certified nurse practitioners and midwives, hold a master's degree in nursing and may assume the role of primary health care professional, either in practice by themselves or in joint practices with physicians. In most states, nurse practitioners may prescribe selected medications. Clinical nurse specialists also have a master's degree in nursing and specialize in a particular area of health care. In some hospitals, long-term care facilities, and out-patient care settings, licensed practical nurses (LPNs) have certain responsibilities in administering medication to patients. LPNs usually work under the supervision of a RN or physician. Nursing aides assist RNs and LPNs with different kinds of patient care activities. In most places where people receive health care, RNs may be the primary source of information for drug therapies and other medical treatments. It is important that you be aware of the roles and responsibilities of the nurses participating in your health care.

Professional nurses participate with other health professionals to ensure that your medication therapy is safe and effective and to monitor any effects (both desired and negative) from the medication. You may be admitted to the hospital so that nurses can administer medications and monitor your response to therapy. In hospitals or long-term care facilities, nurses are responsible for administering your medications in their proper dosage form and dose, and at correct time intervals, as well as monitoring your response to these medications. At home or in outpatient settings, nurses should ensure that you have the proper information and support of others, if needed, to get the medication and take it as prescribed. When nurses administer medication, they should explain why you are receiving this medication, how it works, any possible side effects, special precautions or actions that you must take while using the medication, and any potential interactions with other medications.

If you experience any side effects or symptoms from a medication, you should always tell your health care provider. It is important that these reactions be detected before they become serious or permanent. You can seek advice about possible ways to minimize these side effects from your nurse. Your health care professional should also be made aware of any additional medical problems or conditions (such as pregnancy) that you may have, since these can also affect the safety and effectiveness of a medication.

The professional nurse is someone who can help to clarify drug information. In most health care settings, nurses are accessible and can answer your questions or direct you to others who can assist you. Professional nurses are skilled in the process of patient teaching. To make sure that patients learn important information about their health problem and its treatment, RNs often use a combination of teaching methods, such as verbal instruction, written materials, demonstration, and audio-visual instructions. Above all, professional nurses should teach at a pace and level that are appropriate for you. RNs can also help you design a medication schedule that fits your lifestyle and may be less likely to cause unwanted side effects.

Your pharmacist
Your pharmacist is an important member of your health care team. In addition to performing traditional services, such as dispensing medications, your pharmacist can help you understand your medications and how to take them safely and effectively. By keeping accurate and up-to-date records and monitoring your use of medications, your pharmacist can help to protect you from improper medication therapy, unwanted side effects, and dangerous drug interactions. Because your pharmacist can play a vital role in protecting and improving your health, you should seek a pharmacist who will provide these services.

To provide you with the best possible care, your pharmacist should be informed about your current condition and medication history. Your personal medication history should include the information that is listed in the "Medical history checklist" section above. Your pharmacist should also be aware of any special packaging needs that you may have (such as child-resistant or easy-to-open containers). Your pharmacist should keep accurate and up-to-date records that contain this information. If you visit a new pharmacy that does not have access to your medication records, it is important that you inform that pharmacist as fully as possible about your medical history or provide him or her with a copy of your medication records from your previous pharmacy. In general, in order to get the most out of your pharmacy services, it is best to get all of your medications (including OTCs) from the same pharmacy.

Your pharmacist should be a knowledgeable and approachable source of information about your medications. Some of the information that your pharmacist should explain is listed in the "What you need to know about your medicines" section above. Ideally, this information should also be provided in written form, so that you may refer to it later if you have any questions or problems. The pharmacist should always be willing to answer any questions that you have regarding your medications, and should also be willing to contact your physician or other health care professionals (dentist, nurses, etc.) on your behalf if necessary.

Your pharmacist can also help you with information on the costs of your medicines. Many medicines are available from more than one company. They may have equal effects but different costs. Your insurance company, HMO, or other third-party payment group may reimburse you for only some of these medications or only for part of their costs. Your pharmacist will be able to tell you which of these medications are covered by your payment plan or which cost less.

In selecting a pharmacist, it is important that you understand the role of the pharmacist as a member of your health care team and the extent of information that he or she should be asking for and providing. Because pharmacies can offer different types of services and have different policies regarding patient information, some of the issues that you should consider in selecting a pharmacist also relate to the pharmacy where that person practices. There are several issues regarding the pharmacist and pharmacy that you should consider, such as:

• Does the pharmacy offer written information that you can take home? Home delivery?
• Are you able to talk to your pharmacist without other people hearing you?
• Can the pharmacist be reached easily by phone? In an emergency, is a pharmacist available twenty four hours (including weekends and holidays) by phone?
• What types of payment are accepted in the pharmacy?
• Does the pharmacy accept your HMO or third-party payment plan?
• Does the pharmacy offer any specialized services, such as diabetes education?

You should select your pharmacist and pharmacy as carefully as you select your physician, and stay with the same pharmacy so that all of your medication records are in the same place. This will help to ensure that your records are accurate and up-to-date and will allow you to develop a beneficial relationship with your pharmacist.

Your physician
One of the most important health care decisions that you will make is your choice of a personal physician. The physician is central to your health care team, and is responsible for helping you maintain your overall health. In addition to detecting and treating ailments or adverse conditions, your physician and his or her coworkers should also serve as primary sources of health care information. Because the physician plays such an important role in your overall health care, it is important that you understand the full range of the physician's role as health care and information provider.

In providing any type of treatment or counseling, your physician should base his or her decisions upon an extensive knowledge of your current condition and past medical history. A complete medical history should include the information that is listed in the "Medical history checklist" section above. Your physician should keep accurate and comprehensive medical records containing this information. Because your treatment (and your health) is dependent upon a full disclosure of your medical history, as well as any factors that may currently be affecting your health (i.e., stress, smoking, drug use, etc.), it is important that you inform your physician as fully as possible, even if you might not consider this information important.

It is important that you inform your personal physician of any other physicians (such as specialists or subspecialists), dentists, or other health care professionals that you are seeing. You should also inform your physician of the pharmacy that you use or intend to use, so that he or she can contact the pharmacist if necessary.

In treating any health problem, your physician should make every effort to help you understand completely the nature of the problem and its treatment. He or she should take the time to explain the problem, why it may have occurred, and what preventive measures (if any) can be taken to avoid it in the future. Your physician should explain fully the reasons for any prescribed treatment. He or she should also be willing to discuss alternative therapies, especially if you are uncomfortable with the one that has been prescribed. Your physician should always be willing to answer all of your questions to your satisfaction.

In selecting a physician, you should look for one who will provide a full range of services. You may also want to consider your physician's medical credentials. Your local medical society should be able to provide specific facts about your physician's training, experience, and membership in professional societies.

Cost and payment are two of the most important issues in contemporary health care. Your physician should be sensitive to the costs of your treatment and the manner in which you intend to pay for this and related medications. If you belong to an HMO or third-party payment plan, be sure that your physician is aware of your involvement in the plan. You should also be aware of the different types of payment that are accepted at the physician's office.

In prescribing medications, your physician should take into account the manner in which you intend to pay for your drugs, and should be aware of any specific concerns regarding the costs of your treatment and medication. He or she should also explain why brand or generic medication may be preferable in certain situations.

In selecting a physician, there are also several practical issues and matters of convenience that you should consider, such as:

• Is the office convenient to your home or work?
• What are the office hours?
• Is your physician or his/her associates or partners available (twenty-four hours) by phone? In emergencies, will you be able to contact a physician?
• Are you able to arrange appointments to fit your schedule? What is the office policy on cancellations?
• Is the physician well regarded in the community? Does he or she have a reputation for listening to patients and answering questions?
• Does the physician have admitting privileges at a hospital of your preference?
• Does he/she participate in your health plan?

In addition to the considerations already mentioned, your physician should be sensitive to the special concerns of treating the elderly. Older patients can present disease processes differently from younger adults, can react differently to certain drugs and dosages, and may have preexisting conditions that require special treatments to be prescribed.

There are also several special issues to consider in your selection of a pediatrician or family physician. If your child is not old enough to understand all instructions and information, it is important that your child's physician explain to you any information about a problem and all instructions for treatment. When your child is of school age, the physician should speak directly to the child as well, asking and answering questions, and providing information about cause and prevention of medical problems and the use of medications. He or she should choose a dosage form and dose that is appropriate for your child's age and explain what to do if the child has certain symptoms, such as fever, vomiting, etc. (including the amount and type of medicine to give, if any, and when to call him or her for advice).

Your physician should be a primary source of information about your health and any medications that you are taking. In providing treatment for medical problems or conditions, the physician should base decisions on a full medical history and be willing to answer any questions that you have regarding your health, treatment, and medications.

Managing your medicines

To get the full benefit and reduce risks in taking your medicines, it is important to follow instructions exactly. This means taking the right medicine and dose, at correct time intervals, for the length of time prescribed. Bad effects can result from taking too much or too little of a medicine, or taking it too often or not often enough.

Establishing a system
Whether you are taking one or several medicines, you should develop a system for taking them. It can be just as difficult to remember whether you took your once-a-day medicine as it can be to keep track of a number of medicines that need to be taken several times a day. Many medicines also have special instructions that can further complicate proper use.

Establish a way of knowing whether you took your medicines properly, then make that a part of your daily routine. If you take one or two medicines a day, you may only need to take them at the same time that you perform some other regular task, such as brushing your teeth or getting dressed.

For most people, a check-off record can also be a handy way of managing multiple medicines. Keep your medicine record in a handy, visible place next to where you take your medicines. Check off each dose as you take it. If you miss a dose, make a note about what happened and what you did on the back of the record or the bottom of the sheet.

Be sure to note any unwanted effects or anything unusual that you think may be connected with your medicines. Also note if a medicine does not do what you expect, but remember that some medicines take a while before having a noticeable effect.

If you keep a check-off record faithfully, you will know for sure whether or not you took your medicine. You will also have a complete record for your health care professionals to review when you visit them again. This information can help them determine if the medicine is working properly or causing unwanted side effects, or whether adjustments should be made in your medicines and/or doses.

If your medicines or the instructions for taking them are changed, correct your record or make a new one. Keep the old record until you are sure this information is no longer needed.

You might want to color code your medicine containers to help tell them apart. If you are having trouble reading labels or if you are color-blind, codes that can be recognized by touch (rubber bands, a cotton ball, or a piece of emery board, for instance) can be attached to the container. If you code your medicines, be sure these identifications are included on any medicine record you use. If necessary, ask your pharmacist to type medicine labels in large letters for easier reading.

A check-off list is not the only method for recording medicine use. If this system does not work for you, ask your health care professional for help in developing an alternative. Be sure he or she knows all the medicines prescribed for you and any nonprescription medicines you take regularly, the hours you usually eat your meals, and any special diet you are following.

Informed management
Your medicines have been prescribed for you and your condition. Ask your health care professional what benefits to expect, what side effects may occur, and when to report any side effects. If your symptoms go away, do not decide you are well and stop taking your medicine. If you stop too soon, the symptoms may come back. Finish all of the medicine if you have been told to do so. However, if you develop diarrhea or other unpleasant side effects, do not continue with the medicine; call your health care professional and report these effects. A change in dose or in the kind of medicine you are taking may be necessary.

When you are given a prescription for a medicine, ask the person who wrote it to explain it to you. For example, does "four times a day" mean one in the morning, one at noon, one in the evening, and one at bedtime; or does it mean every six hours around the clock? When a prescription says "take as needed," ask how close together the doses can be taken and what the maximum number of doses you can take in one day should be. Does "take with liquids" mean with water, milk, or something else? Are there some liquids that should be avoided? What does "take with food" mean? At every mealtime (some people must eat six meals a day), or with a snack? Do not trust your memory — have the instructions written down. You must understand exactly what the prescriber wants you to do in order to "take as directed."

When the pharmacist dispenses your medicine, you have another opportunity to clarify information or to ask other questions. Before you leave, check the label on your medicine to be sure it matches the prescription and your understanding of what you are to do. If it does not, ask more questions.

The key to getting the most from your prescribed treatments is following instructions accurately and intelligently. If you have questions or doubts about the prescribed treatment, do not decide to stop taking the medicine or fail to follow the prescribed regimen. Discuss your questions and doubts with your health care professional.

The time and effort put into setting up a system to manage your medicines and establishing a routine for taking them will pay off by relieving anxiety and helping you get the most from your prescribed treatment.

Taking your medicine

To take medicines safely and get the greatest benefit from them, it is important to establish regular habits so you are less likely to make mistakes.

Before taking any medicine, read the label and any accompanying information. You can also consult books to learn more about the medicine. If you have unanswered questions, check with your health care professional.

The label on the container of a prescription medicine should bear your first and last name; the name of the prescriber; the pharmacy address and telephone number; the prescription number; the date of dispensing; and directions for use. Some states or provinces may have additional requirements. If the name of the drug product is not on the label, ask the pharmacist to include the brand (if any) and generic names. An expiration date may also appear. All of this information is important in identifying your medicines and using them properly. The labels on containers should never be removed and all medicines should be kept in their original containers.

Some tips for taking medicines safely and accurately include the following:

• Read the label of each medicine container three times: (1) before you remove it from its storage place, (2) before you take the lid off the container to remove the dose, and (3) before you replace the container in its storage place.
• Never take medicines in the dark, even if you think you know exactly where to find them.
• Use standard measuring devices to take your medicines (household teaspoons, cups, or glasses vary widely in the amount they hold). Ask your pharmacist for help with measuring.
• Set bottles and boxes of medicines on a clear area, well back from the edge of the surface to prevent containers and/or caps from being knocked to the floor.
• When pouring liquid medicines, pick up the container with the label against the palm of your hand to protect it from being stained by dripping medicine.
• Wipe off the top and neck of bottles of liquid medicines to keep labels from being obscured, and to make it less likely that the lid will stick.
• Shake all liquid suspensions of drug products before pouring so that ingredients are mixed thoroughly.
• If you are taking medicine with water, use a full, 8 ounce glassful, not just enough to get it down. Too little liquid with some medicines can prevent the medicine from working properly, and can cause throat irritation if the medicine does not get completely to the stomach.
• To avoid accidental confusion of lids, labels, and medicines, replace the lid on one container before opening another.
• When you are interrupted while taking your medicine, take the container with you or put the medicine out of the reach of small children. It only takes a second for them to take an overdose. When you return, check the label of the medicine to be sure you have the right one.
• Crush tablets or open capsules to take with food or beverages if your health care professional has told you that this will not affect the way the medicine works. If you have difficulty swallowing a tablet or capsule, check with your health care professional about the availability of a different dosage form.
• Follow any diet instructions or other treatment measures prescribed by your health care professional.
• If at any point you realize you have taken the wrong medicine or the wrong amount, call your health care professional immediately. In an emergency, call your local emergency number.

When you have finished taking your medicines, mark it down immediately on your medication calendar to avoid "double dosing." Also make note of any unusual changes in your body, including change in weight, color or amount of urine, perspiration, or coughed-up matter; as well as your pulse, temperature, or any other items you may have been instructed to observe for your condition or your medicine.

Try to take your medicines on time, but a half-hour early or late will usually not upset your schedule. If you are more than several hours late and are getting close to your next scheduled dose, check any instructions that were given to you by your health care professional. If you did not receive instructions about missed doses, check with your health care professional.

When your medicines are being managed by someone else (for example, when you are a patient in a hospital or nursing home), question what is happening to you and communicate what you know about your previous drug therapy or any other treatments. If you know you always take one, not two, of a certain tablet, say so and ask that your record be checked before you take the medicine. If you think you are receiving the wrong treatment or medication, do not hesitate to say so. You should always remain involved in your own therapy.

Many hospitals and nursing homes now offer counseling in medicine management as part of their discharge planning for patients. If you or a family member are getting ready to come home, ask your health care professional if you can be part of such instruction.

The 'expiration date' on medicine labels

To assure that a drug product meets applicable standards of identity, strength, quality, and purity at the time of use, an "expiration date" is added by the manufacturer to the label of most prescription and nonprescription drug products.

The expiration date on a drug product is valid only as long as the product is stored in the original, unopened container under the storage conditions specified by the manufacturer. Among other things, humidity, temperature, light, and even air can affect drugs. A medicine taken after the expiration date may have changed in potency or may have formed harmful material as it deteriorates. Contamination with germs can also occur. The safest rule is not to use any medicine beyond the expiration date.

Preventing deterioration
A drug begins to deteriorate the minute it is made. The manufacturer in calculating the expiration date factors in this rate of deterioration. Keeping the drug product in the container supplied by the pharmacist helps slow down deterioration. Storing the drug in a proper manner — for example, in a light-resistant container or in a cool, dry place (not the bathroom medicine cabinet) — also helps. The need for medicines to be kept in their containers and stored properly cannot be overstressed.

Patients sometimes ask their health care professionals to prescribe a large quantity of a particular medicine in order to "economize." Although this may be all right in some cases, this practice may backfire. If you have a large supply of your medicine and it deteriorates before you can use it all, or if your doctor changes your medicine, you may lose out.

Sometimes deterioration can be recognized by physical changes in the drug, such as a change in odor or appearance. For example, aspirin tablets develop a vinegar odor when they break down. These changes are not true of all drugs, however, and the absence of physical changes should not be assumed to mean that no deterioration has occurred.

Some liquid medicines mixed at the pharmacy will have a "beyond use" date on the label. This is an expiration date that is calculated from the date of preparation in the pharmacy. This is a definite date, after which you should throw away any remaining medicine.

If your prescription medicines do not bear an "expiration" or "beyond use" date, your dispensing pharmacist is the best person to advise you about how long they can be safely used.