Understanding a prescription

April 9, 2012 By

DEAR DR. GOTT: Why would two doctors write a “no refill” prescription that was the same except for the number of days the prescription was to last?

The first prescription (written in hospital by a resident) was for 30 tablets with a dosage of one to two tablets every four to six hours, as needed for pain. It was written for four days. The prescription could not be refilled before the four days were up even though the two highest dosages would use up the tablets in fewer than four days.

The second prescription (written after discharge by a private practice physician) had the same number of tablets and the same dosage but was written for two days and, therefore, could be refilled before the prescription ran out no matter which dosage to be used.
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November 13, 2008 By

DEAR DR. GOTT:
In a recent article published in your column, you stated that “outdated medications can be discarded easily by flushing them down the toilet”.

We in Niagara County, NY, are currently working on a Pharmaceutical Waste Collection Program because, in part, an Associated Press article in the spring of 2008 reported on a five month inquiry into the drinking water of 62 metropolitan areas and 51 smaller cities. They found that the drinking water of at least 24 American cities contains trace amounts of a wide array of pharmaceuticals and their by-products. These include antibiotics, heart medications, psychiatric drugs, hormones such as those in birth control pills, and others.

Municipal drinking water supplies are extensively regulated by the US Environmental Protection Agency (EPA), [Read more...]

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October 6, 2008 By

DEAR DR. GOTT:
I am a registered pharmacist in New Jersey. I read your column almost every day out of professional interest. Recently you had an article that centered on the allergy medication, Allegra-D. The writer was concerned because she found the pills in her stool and her husband found many in the septic tank.

Your conclusion that it was not working was incorrect. Finding the pill in the stool is perfectly normal. Allegra-D is an extended-release product. It works like a little pump as it passes through the GI tract, slowly releasing the medications contained therein over a certain time period. The spent carcass of the dosage form is expelled upon defecation which is why the tablet must be swallowed whole, not crushed or chewed. Many controlled-release/extended-release/time-release tablets and [Read more...]

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July 29, 2008 By

DEAR DR. GOTT:
You recently responded to a reader who wanted to know how to dispose of outdated medication. I feel your answer directing the population to further contaminate our water supplies by flushing them down the toilet is completely inappropriate. This is totally against all and any safety regulations. Why are you so driven to destroy our environment? If perchance you correct your article, you will have already done insurmountable damage by the time your response appears in print.

DEAR READER:
Since my article appeared in late May, I have received several letters on the subject. While some were not as strong as yours, I have chosen to address the subject again with the hope I can redeem myself.

Unused over-the-counter and prescription medications can be found in almost every household, nursing home and hospital in the country. [Read more...]

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May 29, 2008 By

DEAR DR. GOTT:
What is the safest way to dispose of old prescription bottles and out-dated medication? I am afraid to just throw the bottles away because of all the information on the labels. I am also afraid to throw the pills in the garbage because I live in a rural area and regularly have wild animals get into my trash cans (despite my attempts to keep them out).

DEAR READER:
A short time ago I responded to a reader who indicated she was reluctant to dispose of empty prescription bottles in the garbage because of all the personal information contained on the label. I suggested she use a magic marker to cover the information, or soak the bottles in warm to hot water for ease of removal of the label. Since that article appeared, I have received several letters from readers with varying thoughts I will share with you.

A blow dryer applied to labels for a few seconds will provide instant removal of the label.

Place the empty bottle in a container of water and heat it in the microwave for one or two minutes for removal of the label.

Use a single-edge razor blade to scrape labels off, taking extra care to make sure your hand doesn’t slip and cause any cut fingers.

Ask your local pharmacy staff if they have a means of shredding and disposing of old prescription bottles. Many have the capability, and they will dispose of unused medications, too. This suggestion sounds great to me as it guarantees your privacy and helps with recycling at the same time.

Out-dated medications can easily be discarded by flushing down the toilet. Birth control pills are also excellent plant fertilizers (one pill every two or four weeks).
Readers, thank you for your ideas.

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March 13, 2008 By

DEAR DR. GOTT:
I would like your opinion on generic drugs versus brand name drugs. Is one more effective than the other? What are the differences other than cost?

DEAR READER:
For millions of people, generic drugs are as effective as brand-name versions. But not always.

In general, the difference between generic and name brand medications is very minimal. They have the same amounts of active ingredients and usually have similar inactive ingredients. However, for a few individuals, these minute alterations can make the difference between an effective treatment and an ineffective one. Many times the more costly name brand version can be avoided by simply taking a slightly higher dose of the generic.

If your generic product is not doing the job despite fine tuning, talk to your doctor about a trial with the name brand product.

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