Take the tablet on time
Most of us don’t finish all the tablets of a course of
antibiotics. Why? Because we are lazy; we are getting better; or we lose the
box. Research tells us most people won’t take their tablets at the right
time, let alone take all of them. The real question is: Does it matter?
The answer is both yes and no. Before medication is licensed
for sale in Australia, it needs to be approved by the Therapeutic Goods
Authority. A drug needs to be safe, reliable and predictable. Every detail
– how it is made, its exact weight, how it gets into the body and is
excreted, all its side effects and what to do if someone takes too much –
needs to be sorted out.
Then, it may get a licence for use in Australia. So
complicated is this process that the development of new drugs becomes too
expensive for a lot of companies. The cost is estimated to be up to $3 billion
dollars to prove the safety of a new drug. Some people say that, if aspirin
were discovered today, it would never get a licence to be used because it has
so many effects and side effects.
The advantage of all this study is that we know so much about
how drugs are absorbed and how to get the best use out of them. That is why you
will see things like: “Take tablet half an hour before food”,
“...with food”, or “...after food”. Some times the food
will protect the stomach lining from medication such as aspirin, and that is
why the food is important. Sometimes the food slows down the release of the
tablet.
Sometimes the food will “neutralize” the tablet by
interacting with the medication in the stomach and so make it ineffective.
There is also the situation in which food makes no difference
whatsoever, or so little difference that it does not matter. The best idea is
to check with the doctor prescribing the medication, or to ask the chemist
about the interactions and the importance of any labels on the bottle. Even if
a reaction with food occurs, it is still good to check because the interaction
might be so small that it does not really matter in the situation in which you
are using it.
The most obvious problem for most of us is actually taking the
medication at all. Most studies of compliance suggest that more 80 per cent of
people won’t complete a course of antibiotics properly and that up to 70
per cent of people on long-term medication either fail to take their tablets or
do not take them properly. It is one of the reasons why the Government –
which subsidizes the medication – spends a lot of money and time trying to
get compliance.
The pressure is on you and your doctor to check if you really
need medication in the first place and not to get a prescription if no real
need exists. Treatment for cholesterol by medication costing about $80 per
month is a good point. The government will subsidize medication if you have
high cholesterol, but it wants to know if you are taking it properly to justify
the $60-plus subsidy a month. That is why politicians argue that you should pay
more so that you invest in the treatment yourself.
Some treatments for osteoporosis are now made available once a
week because it is more likely to be remembered. But some people forget because
it is so long between taking the tablets that they don’t have a daily
routine to help them. Others argue that taking a tablet once a day is better,
and most studies show it is more likely to be remembered if once a day.
If you miss taking a once-a-day tablet, it increases the time
that you don’t have that medication in your system. These days, there is a
lot of time spent altering tablets so that they are released slowly into the
circulation and, often, the tablets will have initials like CD (controlled
delivery) or SR (sustained release) to show that they have been specially put
together to get over some of these compliance issues. That is also a reason to
check if the tablets can be crushed or broken in half because there may be an
effect on the delivery system.
Because of all these issues, you should check on your need to
take medication and check if the way you take it is going to affect the benefit
you get from it.
Some of the interactions are theoretical while others can so
dramatically affect your treatment that you might as well not have the
prescription. Doctors and chemists spend a lot of their training understanding
all these effects and should be able to tell you if this is important for your
situation.
The company that invented the medication would have spent
millions of dollars testing all these interactions and will have spent time and
money convincing government and health authorities that there is value for
money in using these treatments.
You are the person who should benefit from taking the
tablets. All these checks and balances in the systems make most treatments safe
and, to get best use from the money we spend on medication, you should check
with doctor or chemist if you have any questions. Then take the treatment
knowing it is the safest and most effective way to do so.
