Harvard Health Letter

Ask these questions when you get a new prescription

For the best results and for your safety, learn what those new pills do and how you should use them.

Medications play a crucial role in helping us get better or manage chronic disease. But don’t sit silently when your doctor prescribes something new. Ask questions about the drug and bring unanswered questions to your pharmacist. “The doctor may not have the time to explain everything that’s important, like whether to take a medicine on an empty stomach,” says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

The next time your doctor suggests that you take a new pill, jot down answers to the following questions.

Why do I need this medication, and how does it work?

Ask about the goal of treatment and how the drug will do its job. For instance, “you may need medication to control high blood pressure and keep it from leading to a heart attack, stroke, or kidney damage,” says Doyle Petrongolo. Indeed, many medicines treat several chronic illnesses simultaneously.

What are the risks and benefits?

Some effective prescriptions pose significant risks. For example, some newer blood thinners, such as apixaban (Eliquis) and rivaroxaban (Xarelto), don’t require frequent lab monitoring like the older blood thinner warfarin (Coumadin). But apixaban and rivaroxaban do not yet have an approved treatment to reverse bleeding, which can lead to uncontrolled bleeding in some circumstances (such as surgery or accidents).

Are there side effects?

Find out about common side effects and serious (if rare) side effects, when to expect them, and when to report them to your doctor. “Many side effects, such as nausea, vomiting, or diarrhea, can be uncomfortable. Others are more serious, like difficulty breathing. If you experience a more serious side effect, call your doctor’s office right away,” says Doyle Petrongolo.

How do I take this medication?

Ask when and how often you should take the drug and if you should take it with food. “Some medications work better at different times of the day. For example, cholesterol medications work better at bedtime, because the body produces cholesterol when you sleep,” Doyle Petrongolo says. Some pills, such as levothyroxine (Levoxyl) for an underactive thyroid, are best taken on empty stomach for better absorption. Certain antibiotics are best taken with food to prevent stomach upset.

Do I need to avoid anything while taking this new medication?

Some drugs can interfere with others. “They may block the effectiveness of other medications or intensify the effect,” Doyle Petrongolo says. Some foods and drinks may also interfere with medications. For example, large amounts of grapefruit juice can intensify the effect of cholesterol-lowering statins, the blood pressure drugs called calcium-channel blockers, and anti-anxiety drugs. Too much or too little vitamin K (from multivitamins or from green, leafy vegetables such as kale and Brussels sprouts) may interfere with warfarin.

What about generics?

It’s smart to ask if a medication is the most cost-effective choice. If it’s a brand-name drug, ask if a generic version is available. And be sure you know which is which. “Sometimes people will actually have two prescriptions for the same medication and take both of them,” warns geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School.

How soon will the medication work, and how long will I be taking it?

Ask how long it will be before you can expect results. Will it be days or weeks before symptoms clear up? Find out how long you’ll have to take the medication, too. Some pills, like antibiotics or sleep aids, should be taken for an allotted amount of time; others, like drugs for Parkinson’s disease, may need to be taken indefinitely; and others, such as proton-pump inhibitors for heartburn, need to be re-evaluated from time to time.

When will you review how well this is working for me?

Your doctor should check periodically to see if a prescription is still the right fit. Find out when that will happen. “You should also ask if there will be an opportunity to increase or decrease the dosage if necessary,” suggests Dr. Randall Zusman, a cardiologist with Harvard-affiliated Massachusetts General Hospital.

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