Multiplying the risk

Having diabetes means you’re at greater risk for other conditions. These include high blood pressure, heart disease, kidney problems, and depression. Along with your diabetes medicine, you may take other medicines to keep these conditions under control. If you have health conditions not related to diabetes, such as arthritis or asthma, you may also need to use medicines to treat them. You could end up taking many types of medicine every day. The more medicines you take, the greater the risk for a medicine mistake.

A medicine interaction happens when 2 or more medicines react with each other to cause an unexpected or harmful effect. Taking several medicines increases the risks of a harmful interaction. And when you’re trying to keep track of several pills, it’s all too easy to make a mistake. You might forget a dose or confuse one pill for another. Or you could take pills at the wrong time.

A dose of caution

By working with your healthcare provider and your pharmacist, you can reduce the risk of such problems. These tips can help:

• Be informed. Know what each of your medicines is for. Also know how each should be used and when you should take it. Ask in advance about what to do if problems occur. Call your pharmacist if you have questions.

• Tell each of your healthcare providers about all the medicines you’re taking. Include nonprescription medicines and any vitamins, supplements, and herbal products. These can all cause unexpected side effects. Make a list of all your medicines. Include each medicine’s name, purpose, strength, dosage, and directions for use.

• Carry an up-to-date copy of your medicines. Keep this in your wallet, purse, or on your smartphone. In case of an emergency, make sure your spouse, partner, or close friend also has an up-to-date list of medicines.

• Find some helpful apps. If you enjoy using technology, check out smartphone apps for reliable medicine management apps and medicine reminder alerts. Ask your healthcare providers for recommendations.

• Try to use the same pharmacy or pharmacy benefit manager. They can keep track of your medicines with you and alert you to possible drug interactions and side effects.

• Know how all your medicines should be taken. Find out which medicines need to be taken by themselves because they block absorption of other medicines (such as iron-blocking thyroid hormone). Also find out which need to be taken on an empty stomach or with food.

• Understand how to manage taking metformin and vitamin B-12. Metformin is a commonly prescribed medicine for diabetes. It may decrease the absorption of vitamin B-12 from the intestines. If you are taking metformin, have your vitamin B-12 levels checked from time to time. Take supplements if needed.

• Review your list of medicines from time to time with your healthcare provider. Ask if you can stop taking some medicines. Or if you can replace them with more effective choices.

• Know the side effects of your medicines. Let your healthcare provider know if you develop any of these. Also tell your provider or pharmacist if you’re having trouble following your medicine schedule. They may be able to offer schedule management ideas.

• Talk with your healthcare provider before stopping any prescribed medicine. And before starting any new prescription medicine, nonprescription medicine, or supplement. Ask if it's safe to combine the product with your current prescription or nonprescription medicines.

• Keep your medicines organized. Make a checklist to mark down each dose of medicine as you take it. Or use a pillbox with sections that organize your pills by day and time. Pay particular attention to medicines that are only taken once a week instead of daily.

• If you develop problems swallowing a medicine, talk with your healthcare provider or pharmacist. You may be able to take the medicine in liquid form instead. Don’t crush or cut your pills without first talking with your pharmacist or provider. Some medicines don’t work as they should when they are cut or crushed.

• Once a year, schedule a “brown bag checkup” with your healthcare provider or pharmacist. Put all of your current medicines, vitamins, supplements, and over-the-counter products you’re using in a bag. Take them to your provider or pharmacist so they can review them and find any possible problems. While you're there, ask about safe ways of disposing of these if your healthcare provider says you do not need to take them anymore.

To help guide your diabetes management, your healthcare team will use clinical standards that include medicine use. It's important to work closely with your healthcare team. With a little planning and your provider's help, you’ll have a prescription for safer medicine use.