Understanding Your Medications
Kathryn Tortorice, Pharm D, BCPS -- VA Pharmacy Benefits Management Services
Do you look at your prescription bottles and wonder - how did I get to this point? What are all these medications costing me, not only in dollars but in my quality of life? You aren’t alone with these questions. Many people take medications for chronic diseases like MS, often as many as 20 different medications a day.
Knowing Your Medications
It is important to keep a record of what medications you are currently taking. Be sure to include the name, dose, and directions for each prescription. Remember to include any over-the-counter (OTC) medications like acetaminophen (Tylenol®), herbal supplements, and vitamins that you take on a regular basis. Many of these medications and supplements can interact with your prescription medications, which might cause side effects or make your medications less effective. When purchasing OTC medications, be sure to look at the list of active ingredients. Many of these products contain more than one ingredient, especially products for the cold, flu, or allergies. Some of these ingredients may cause undesired reactions when mixed with your prescription medications or with the health conditions for which you are being treated.
Be sure to check before beginning any new products. You may be considering obtaining prescription medications or supplements from other countries which are not available in the US. These medications may pose a health risk. Some imported medicines may have been made using unsafe procedures or may not have been checked for safety or effectiveness. Vendors may make claims or suggest uses for imported medicines that the US Food and Drug Administration (FDA) has not approved. Some products may have been made using addictive, dangerous, or impure ingredients which might not be listed on the label.
VA Prescribed Medications
Veterans may hear that the VA will only cover medications on the formulary. What does formulary mean in the VA? The VA National Formulary (VANF) is a comprehensive list of medications approved by a group of physicians and pharmacists from VA facilities throughout the nation. Formularies promote rational, clinically appropriate, safe, and cost-effective drug therapy. This list is carefully developed to include a full range of medications necessary to treat medical conditions.
When a medication is called non-formulary, your provider will need to request this non-formulary medication by completing a special request form. This form is then reviewed to ensure that the non-formulary drug requested is being used appropriately and for an FDA approved use. This process may take a few days. If the request is denied, there is an appeal process that would allow the request to be reconsidered. You or your provider can get more information on the appeal process from your local VA pharmacy.
Many MS medications are injectables: self-administered syringes and auto-injectors that are prefilled, easy to use syringes. Your provider can teach you how to safely self-administer medications using a syringe and how to use the auto-injector, which is a spring-loaded syringe. Auto-injectors can improve the safety of injections and make it a little easier to take your medication. They should be replaced yearly and when new models are available. The auto-injectors can be accessed through your provider.
Disposing of Prescription Medications
You might have questions about the best way to dispose of medications you no longer take. It is not safe to flush drugs down drains. Drugs flushed down drains can harm the water supply that we and the wildlife drink. The first step is to check the label of the drug container to see if guidance has been provided regarding its disposal. If there are no instructions on the label, the information can sometimes be found on the internet or by calling the manufacturer of the drug. If this step is not successful, contact your local VA pharmacy to find out if they can dispose of your medication. Another option is to take advantage of community drug disposal programs. These programs allow the public to bring in their unused or expired medication for proper disposal. Check with your local government to see if this service is offered in your area.
Many drugs can be thrown out with the trash, but precautions should be taken before doing this. Medications can be left in their original bottle, but you should remove names and prescription numbers on labels for safety. Add some water or soda to pills to start dissolving them. Mix pills or liquid drugs with something that you cannot eat, like cat litter, saw dust, or dirt. Close the bottle lid and secure with duct or packing tape. Place the bottle(s) inside a non-see through container like a coffee can or detergent bottle. Tape that container closed and hide the container in the trash. Do not put the container in the recycle bin.
Many people with MS have questions about disposing of needles which are used for medications. The laws that guide safe disposal of needles vary from state to state. To find out how to dispose of needles in your area go to www.safeneedledisposal.org and search by your state. Many communities offer a drop off site that you can use, and you can also check with your local VAMC for information on disposal.
A reminder… make sure that you bring a list of all of your over the counter and prescription medications to each clinic visit. Ask your provider about possible medication interactions and be informed about how and when to take your medications, as well as how to dispose of them properly.
