I’m an MD, but as a patient, I’ve left my doctor’s office with just as many questions as when I arrived. There’s a lot to cover in so little time, and I often forget some of the things I planned to ask. We’ve all gotten derailed during important health conversations – for example, when starting a new medication.
One problem is that there’s no standard way that healthcare providers talk with patients about medications. Unlike the informed consent process for medical procedures (your doctor must explain your risks, benefits, and alternatives before proceeding), there’s no checklist or order of topics to cover when prescribing a medication. So it’s easy for things to get left out, even with the best of intentions. One study reported that doctors spent an average of 12 seconds talking about a new medication’s side effects, and in another, fewer than 50% covered side effects at all.
Luckily, doctors love to answer questions. If you ask good ones, you’ll get better information, participate in your health decision, and leave the office with confidence instead of confusion.
Before you walk out the door with that new prescription:
1. What's the name of the medication?
I can't tell you how many times I've talked to patients or friends who don't know the name of a drug they're taking. It's important, especially if you're taken to the hospital in an emergency and your doctors need to be careful of serious drug-drug interactions.
2. What does it do?
Find out what conditions the medication treats and how it works. You can try a deep-dive on Wikipedia, but even just the basics of a drug's mechanism of action can help you understand certain side effects, too. For example, a nasal decongestant tightens blood vessels, which prevents the leakiness that leads to a stuffy nose, but it can also cause your blood pressure to increase.
3. What are the potential benefits?
For example: Does it just lower your cholesterol, or has it actually been shown to prevent strokes, heart attacks, or deaths? For anyone with low cardiovascular risk, statin cholesterol medications may change your lab results without significantly altering your health risks, but it's still possible to experience harmful side effects. How many people taking the drug does it actually help? Drugs have varying rates of response – for example, 50% for many depression meds. You want to take a medication that's more likely to benefit you than harm you.
4. What are the potential harms?
Find out how many people taking the drug have side effects. Which side effects are common? Are they temporary, or will they stick around as long as you keep taking the medicine? Are there any rare but severe side effects? What side effects should you call your doctor about if you have them? Sometimes we use side effects strategically. For example, if you're depressed and you've been having trouble sleeping, your doctor might try something like sertraline (Zoloft) because it's known to cause drowsiness.
5. Are there alternatives?
Find out if there are other types or classes of medications that treat your condition because each class will have a different profile of benefits and side effects. Always ask about drug-free alternatives, too. Exercise is more effective than drugs at reducing your risk of death from certain causes and will make you feel better, healthier, and less anxious.
6. How do I take it?
Many medications come in different forms so that you can get whatever's easiest for you to take, whether it's a pill, a liquid, or a tablet that dissolves under your tongue.
7. Does it interact with any of my current health conditions, medications, supplements, foods, or alcohol?
Certain drugs, such as opioid pain medications, can multiply the effects of alcohol and put you at serious risk for respiratory depression - in other words, you could stop breathing. In other cases, a medication or food (like grapefruit or milk) can cancel out another drug's effects in your body or make it harder to absorb its active ingredients. Aways make sure you doctor knows what else is going on with your body before you start a new medication.
8. How long does it take to start working? Can I stop taking it if I feel better?
Some medications start working as soon as they get into your bloodstream, while others take a while to reach the right concentration in your body to reach their maximal effect. For example, most antidepressants start working in a week or two, but it usually takes six to eight weeks to feel their full effects on your mood. If you don't know what to expect, you might give up on a medication before has a chance to really help you.
9. What if I miss a dose?
For some medications, missing a dose isn't a big deal, and a pharmacist will tell you to just take your next dose on time. For others, like combination birth control pills, you'll want to take a missed dose as soon as you remember it again, double up the next day, or else use a backup method of birth control. Always pay close attention to your pharmacist's instructions on this one.
10. Is any monitoring required?
Some medications, such as blood pressure drugs, can affect major organs - most commonly your liver and kidneys because they do the heavy-lifting to process chemicals in your body. Other times, your doctor may want to see if a drug is successfully doing its job. In these cases, you may need regular lab tests to monitor for the effects of your medication. If you're not into the idea of regular needle sticks, ask your provider if there are other types of medications for your condition that don't require monitoring.
11. How much does it cost? Is there a generic version available?
Don't be a sucker. Always take generic drugs unless the medication you really need isn't off patent yet. With very rare exceptions (such as with certain thyroid medications), generic medications work just as well as the brand version.
A version of this article was originally published on Iodine.com.