Understand How to Take Your Medicines Properly!
A consumer who did not understand how to take a diabetes medication has shared a report with ISMP Canada
through the SafeMedicationUse website. The consumer was prescribed metformin, to be taken three times daily*.
This consumer was meant to take the metformin at three different times during the day, with meals (for example,
with breakfast, lunch and supper). However, this was not clear to the consumer from the directions on the label.
The consumer took three tablets each day, but sometimes took two at the same time. As a result, the consumer
was sometimes taking too much medicine and at other times was not taking enough. Fortunately, the problem was
discovered by a family member and corrected.
This consumer is not alone. In a study published in the Annals of Internal Medicine1, patients were asked to
explain the directions on five different prescription labels. The study found that 46 percent of the patients
misunderstood at least one of the labels. Half of the mistakes reflected an error in dosage (how much medicine to
take), and almost one third involved an error in frequency (when and how often to take the medicine). The study
also found that most patients ignored, or did not understand, additional warning labels that provided extra
information on how to take the medicine properly. For example, "Take with food" or "Do not crush or chew,
Medicines can play an important part in your healthcare, but it is important to take them properly. Sometimes, the
correct way to take your medications may not be obvious. Here are some examples: If the label of your
prescription says "Take three tablets daily", should you take all three tablets once a day, or one tablet three times a
day? If you are prescribed one tablet four times a day, should you take one tablet every six hours around the clock
or can you just space out the doses during the hours that you are awake? Should you take your medicine with
food, or on an empty stomach? The answers depend on the medicines you are taking. If a medicine is not taken
properly, it may not work as well as it should or could cause you harm.
So how can you as a consumer avoid mistakes and make sure you and your family members take medicines
properly? ISMP Canada has the following suggestions:
- When you receive a prescription, ask your doctor (or the person who has prescribed the medication for
you) to explain the proper way to take it. Also, ask for other important information such as the name of
the medicine, the dosage and what it is for. If it helps, write down the information and instructions.
- Have your pharmacist go through the instructions on the prescription label with you. Make sure you know
how much of the medicine to take, when you should take it, and for how long. This information should
match what your doctor has told you; if it does not, tell your pharmacist.
- Look for additional warning labels on the prescription container, and ask your pharmacist to explain what
these labels mean.
- Be sure you know whether the medicine should or should not be taken with food.
- When you receive information or instructions about a medication, describe your understanding of the
information back to the health professional (doctor, nurse or pharmacist) to be sure there is no confusion.
- If you are still unsure, or become unsure, about how to take the medicine correctly, ask your pharmacist to
clarify the instructions.
- Read the information that comes with your medicine from the pharmacy. If you have any questions or
concerns, ask your pharmacist.
- Be sure you know whether there are any medications or products (including non-prescription and natural
products) that should not be taken with your medicine. Before taking any new medicine, check with your
pharmacist to be sure that it does not interact with a medicine you are already taking.
- Whether you take one or several different medicines, it can sometimes be difficult to keep track. Ask your
pharmacist to prepare a schedule that shows when to take your medicine(s). A medication “organizer”,
available from most pharmacies, can also help you remember when to take your medicines.
Remember, learning about your medicines, and taking them properly, will help you get the best effect from each
medicine you take!
1. Literacy and misunderstanding prescription drug labels.
Ann Int Med 2006; 145:887-94
* Please note that the dose and schedule for metformin can be different for other patients, depending on individual needs.