Your Roadmap to Starting a New Medication

Starting a new medication is often a daunting and overwhelming experience.  “What should I ask my doctor?  What should I do when I receive the medicine?  What do I do if something goes wrong?”

After starting and stopping numerous medications since high school, I have an unofficial path sketched out in my mind that I follow throughout the process.  An occasional detour is sometimes required.  But at least, what follows is like a recipe from your grandmother — it has worked well for her and others, though not everyone; and maybe it will work well for you too.

What to Ask Your Doctor

1. Current Conditions:  The first thing to do is ensure you have told your doctor about all of your current ailments, especially things like allergies.  They need to know what you are already dealing with before they can help you with this next issue.
2. Current Medications: One of the most important things to talk to your doctor about is what medicines you are already taking.  Medication interactions are a serious deal, so it is important you tell them everything you take regularly, as needed, or even just frequently.  This should include vitamins and supplements too.
3. Generic and Brand Names:  Ensure you know both the generic name(s) and some of the more common brand names of the drug, even if you’re only taking the generic.  Not everyone knows the generic names of every drug, so being familiar with anything your medication might be called will be helpful down the road.
4. Dosage Practice:  Know exactly how much and when you are supposed to be taking the medicine.  Some medications work best when taken at a certain time of day.  Other medicines have side effects that may influence your wakefulness or sleepiness.  Be sure to get clarification on how strict that timing is too.  Do you have to take it at the same exact time every single day, or can it generally be taken within the same three hour period each day?  Some medicines are really picky about that, while others are more lax.
5. Food Requirements:  Sometimes you have to have a meal or at least a full glass of water with a dosage.  And yet other medications only work on an empty stomach.  Be sure you know if you need to be taking this medicine with food or not, and how much food too.
6. Food & Activity Limitations:  Those of us who have been living off antidepressants know that we are supposed to limit our grapefruit consumption, due to the reactions the medication will have with the fruit. There are even medications that require you to limit your time in the sun!  So be sure to ask your doctor if there are any foods or drinks you should not be taking or anything else you should not be doing.
7. Arrival of Results:  Our culture glorifies instant gratification.  Medications, however, do not always work that way.  Ensure you know the time frame of when you can expect results to start arriving.  Pain medications, for instance, will work within minutes or hours.  Antidepressants, meanwhile, can sometimes take multiple months.  Get from your doctor the time frame of when to expect to notice a change in your issue.
8. Side Effects:  Everyone’s least favourite thing about medications (well, maybe other than the costs).  It is imperative you talk to your prescriber about what the side effects of a given medication are.  Sometimes side effects are small enough that they can be ignored.  Other times, a small side effect may be the precursor to a larger problem, something that might require hospitalization down the road if you do not tend to the issue immediately.  Know which side effects are common, which are less common, and which are actively dangerous.  This includes alcohol.  If you drink, even just casually, please discuss it with your doctor.  Alcohol can have wildly negative effects on both your medication and yourself.
9. Insurance & Costs:  So those costs…  In most cases, your doctor and your insurance will not communicate to one another about what the former wants to the prescribe and if the latter will cover it.  It is your responsibility to take the medication recommendations from your doctor and to ask your insurance if and how much of it will be covered.  Some insurances will be able to provide you with a list of alternatives that you can present to your doctor.  Sometimes this whole process involves a lot of back-and-forth conversation for you; other times, it is a breeze.  It just depends on the efficiency of your doctor’s office and your insurance.
10. Operating Heavy Machinery:  Even if you do not work in the world of factories, construction, or such environment, knowing if you can operate heavy machinery while taking your medication is very important.  Another way to ask your doctor about this is, “Can I drive while on these meds?”  Because a vehicle constitutes “heavy machinery.”  Simple tools like hammers sometimes fall under this category as well.  So be sure to stay safe.
11. Missing a Dosage:  You were busy, you left it at home, an emergency came up, you simply forgot — there are countless reasons why we might miss a dosage of our medication; so make sure you know from your doctor what to do if that happens.  Do you skip it, take it immediately, take it at a lower dose, et cetera?  It may also depend on how far you are from your missed and next dosages as to what you should do.  Get your prescriber to inform you of how to respond in each situation.  And remember that you are not the professional in the situation.  If you are doubting your current doctor’s advice or feel they are not listening to you, seek out a second opinion before making a decision based solely on your own judgement.

What to Do Before Taking Your First Dosage

1. Don’t Google It:  WedMD is not your best friend.  It can be a great tool when used correctly, yes.  But it should be used in support of everything you have already discussed with your doctor.  Do not make your online readings the foundation of your approach to your medication.  Remember: doctor first, internet last.
2. Keep the Leaflet:  Do not just throw away with the paper bag the booklets that came with your prescriptions.  These leaflets go by different names: Patient Package Inserts (PPI), Medication Guides (MG), and Instructions for Use (IFU).  Instead of immediately disposing of them, store them for safety’s sake.  In fact, if you think you can understand them well enough, you really should look through these before going to WebMD or another medical website.  These leaflets are directly from the manufacturers so as to meet various requirements of the FDA.
3. Medication’s Website:  If you are like me and absolutely must do some research, be smart about your sources.  Instead of random medical websites or blogs, go to the medication’s official website.  Many of these sites have a patients’ section that will break down the medical terms into more easily consumable everyday speech.  Others have their commonplace conversations on the front page or have links to FAQs.  So if you must do some additional digging, do it via a certified source like the manufacturer’s direct website.
4. Secondary Meds on Hand:  First, confirm with your doctor before making plans to take any additional medications, even if they are of the over-the-counter variety.  Then, ensure that you already have on hand any additional or backup medications that you may need.  This may be what you would take if you have to suddenly stop taking the original medication in question (as determined by your doctor).  Or it might be medicines used to counteract potential side effects.  
5. Start on the Weekend:  If you have a normal 9-to-5 weekday job, your best bet is to start your medication on Friday night or Saturday morning.  This gives you the most amount of time to adjust and work through any side effects you may have.  Then, come Monday morning when you are getting ready for work, you should already know a little bit about what you are in for throughout the day.
6. Have Things Already Wrapped Up:  Errands, big projects, social commitments, et cetera — try to have all of these completed prior to taking that first dosage.  Many medications can upset your stomach, zap your energy, or otherwise just knock you out for the count.  By making sure as many of your obligations are met before starting the medicine, you can better focus on dealing with side effects and on the healing aspect of your issue, instead of running around all over town or attending a ton of social events while your brain or body are not functioning at full capacity.
7. Support Person:  It really helps to have a friend or family member around who will be able to help you out should things go sour.  A support person may be needed to run errands for you, help with lifting heavy objects, making meals, and other simple tasks that your medication may prevent you from being able to do.  Keep in mind, however, you should really only rely on these people when necessary.  It is best to keep your life and routine as consistent as possible, which includes your own self-reliance.

What to Do While on the Medication

1. Start Low, Go Slow:  Although this is not the best approach for all medicines, this is a great general rule of thumb for starting traditional medications that are treating non-life-threatening conditions.  The idea is to start at the lowest advised dosage and increase very gradually.  This allows the body some time to adjust to the new chemicals in its system.  However, be sure to always follow your doctor’s orders, as they know your situation best.
2. Keep a Journal:  When you go to your doctor and they ask how things are going, it is imperative you can tell them everything in as much detail as possible.  To avoid forgetting something, and to better identify patterns that may exist, keep a daily journal.  The following are advised things to log:
   1. The date and time of day
   2. The amount and the time of the dosage taken
   3. Location (to note if you are engaging in an activity that might upset your condition or the consumption of the medication, such as swimming does sometimes)
   4. Any symptoms experienced
   5. Any additional management of the symptoms in question (over-the-counter painkillers are popular here)
   6. Any side effects experienced (create a checklist from the side effects you got from the doctor in item 7)
   7. Any management of the side effects mentioned
   8. Note any changes in diet, routine, or other medications
   9. If there are changes in your other medicines, be sure to contact the prescriber of your current medication in question
3. Extra Dosages:  If you can manage it, have an extra dosage on hand at work or in your purse.  Too often have I rushed out the door and arrived at my destination only to realise I did not take my morning medicine.  By having a backup dosage on hand, I save myself from truly missing any doses.  However, it is imperative that you make sure a copy of your prescription paperwork is included with the medicine, in case officials have questions. 
4. Set Alarms or Reminder:  If you are a forgetful or even just a busy person, you might want to set alarms or reminders for your medications, especially those that are on more strict timetables.  It doesn’t have to be a loud one; even just a vibrate-only alarm on your phone or a silent alarm on your smartwatch can help remind you to take your medicine on time and thus limit missed doses.  Many people also incorporate into an already-established routine.  Coffee-drinkers may take their morning medication with their drink, for example; so they keep their bottle next to the coffee machine as a reminder.
5. Take Exactly as Prescribed:  If your doctor says to have a meal with each dosage, have that meal.  Medications are composed of very complex chemicals, and breaking even just one rule from your doctor can undo a lot of the good your medicine was supposed to do in the first place.  If you are not sure about something, do not just guess.  Call either the pharmacy where you filled it or your doctor’s office and ask for more information or some clarification.  Your health and life are not worth disobeying what your doctor or pharmacist tells you.
6. Be Patient:  If you are still in the window of time your doctor told you the medicine may take to work (item 6), be patient.  If you are outside of that window, then it may be appropriate to call and check in with them.  But otherwise, just hold steady and wait it out.  Results will come soon enough.
7. Don’t Stop Early:  Do not stop taking your medication prior to your doctor telling you to.  No matter if you think the medicine is taking too long to start working, or even if you are already feeling much better.  You were prescribed this medication for a set time or quantity for a reason, so you need to stay diligent and follow through.  Again, your health and your life are not worth stopping early.

Beginning a new medication can sometimes be an easy task.  But more often than not, it is an entire ordeal that infiltrates your life and can cause massive adjustments.  By completing at least a few of the suggested steps above, you are likely to increase the chances of ensuring the whole process runs a little more smoothly.  And if you ever feel yourself wanting to cut corners, take some shortcuts, or break some rules, just ask yourself — are my health and my life worth the risk?