Changing the brand of the medicine

Your doctor may recommend an antibiotic marketed by one company. The brand is expensive; so, at the drugstore, you purchase the same antibiotic but one which is marketed by another company. Your behaviour may be justified because doctors sometimes forget the patient's purse when they prescribe. But, medicines marketed by some companies can be inferior in quality and, when changing brands, you may buy pills that do not work. So, if you have concerns about cost, express these tactfully to your doctor and ask for an inexpensive but trustworthy brand. On a separate note, patients stabilised on long-term treatment, especially those with conditions such as epilepsy, should not change brands because the bioavailability of different brands may differ.

Taking the medicine at the wrong time

Medicines are best taken at the times advised. For example, some medicines should be taken in the morning so that they act across the course of the day; others, at night, so that the adverse effects are dissipated during sleep. Some medicines should be taken on an empty stomach so that food does not interfere with their absorption; others, with food so that food blunts their adverse effects. Some medicines should be take at the same time of day every day to ensure uniform blood levels. Ask your doctor for guidance on how to take your medicines, and what flexibility you have in case it is not possible for you to follow the instruction to the letter.

Taking lower doses than advised

People do this to cut down on costs or to reduce adverse effects, or because they think that they are getting better and therefore do not need such high doses. This is often a mistake because some medicines may not work at all if the dose is below a certain threshold.

Accidentally missing doses

Missing doses once in a while may not affect outcomes with most medicines and in most illnesses. However, there are certain illnesses, such as epilepsy, where even a single missed dose can result in disastrous consequences.

Deliberately missing doses

Some patients deliberately skip doses for any of a variety of reasons. A question that they must ask themselves is, who are they cheating? And who will suffer the consequences?

Taking an extra dose to make up for a missed dose

This is sometimes permissible, but more often than not should be avoided. The reason is that taking two doses together may raise blood levels of the drug beyond safe limits. Particularly if you are on long-term therapy, check with your doctor what you should do if you realise that you have missed a dose.

Missing follow-up appointments

Sometimes, the prescription may need to be changed on a time-bound basis in accordance with a treatment plan. If you miss a follow-up appointment, you may be taking the wrong doses, or even the wrong medicines.

Switching doctors because the medicines aren't working

Medicines don't come with a guarantee card. Doctors know this. So, they have a plan of management for what to do if the first medicine does not work. If you switch doctors midway because the medicines aren't working, and if the second doctor follows a different treatment plan, you've lost all the efforts of the first doctor and have to start from scratch with the second doctor. Switch doctors only if you have good reason to be dissatisfied with your first doctor. And not arbitrarily.

Stopping medicines because of improvement

This can be disastrous for many disorders because medicines may be necessary to effect improvement as well as to keep you well after you recover. So, always check with your doctor for how long you need to take the medicines, and why. And remember that people who wear spectacles usually need spectacles lifelong; so, if your illness needs lifelong treatment, accept it. Think of your medicine as a food that your body requires.

Stopping medicines in favour of religious interventions

People have been praying for millennia, but life expectancy has risen only during the last 50 years or so, thanks to advances in medicine. So, pray by all means, but take your medicines. The world needs physicians as well as priests.

Accepting advice from unqualified persons

Friends or relatives may tell us, "Don't take that medicine" because the medicine is too strong; or because some home remedy is better. Even worse, such well-meaning persons may recommend a prescription medicine because it worked for them, their friends, or their friend's friends. Do a quick mental check: do these persons have a medical qualification? No? Then consult somebody who does. You've got only one body; don't allow well-meaning but medically-ignorant persons to experiment with it. In this context, keep in mind that the internet, like an encyclopedia, is only a source of information. It cannot replace your doctor.

Taking chances with medical supplies

Don't wait until your medicines are over before you visit your doctor for a follow-up, or before you buy fresh supplies. Sometimes, you may not be able to get the supplies immediately, and there could be an interruption of a day or longer in your treatment. This could be a serious matter in certain illnesses. Always ensure that you have at least a week's supply of medicines in hand; and it is usually a good idea to keep a day's supply on your person in case your are unexpectedly unable to return home.

The author is a professor in psychopharmacology, Nimhans, Bangalore and can be contacted at                andradec@gmail.com