Members of the Arthritis Patient Advisory Board know how hard it can be to keep track of all these medications, prescription renewals, side effects and drug interactions, and that taking medication can be costly and inconvenient. But, we also know how important they are for our health, and that following a few simple tricks can make it a whole lot easier.

Once a day, twice a day, morning, night, with food, without food… How am I supposed to keep track?

• Organize your pills into daily doses using a plastic pill organizer. If possible, find one that has separate removable boxes that you can take with you each day.
• Ask your pharmacist to make personalized blister packs that organize your meds into daily doses (your pharmacist may charge a small fee for this service).
• Download an app or set an alarm on your phone or digital device to remind you to take your medication. Alternatively, use a spreadsheet to keep track.
• Think about your daily routine and make meds convenient. As an example, put your daily vitamins by your toothbrush to remind you to take them in the morning.

How can I make sure I always have my prescriptions when I need them?

• Use a calendar, a day planner, or your smartphone to keep track of when your prescriptions are going to run out. Set a reminder for a few weeks before the prescription runs out so that you have time to book a doctor’s appointment. Try to synchronize your medications so that they can all be renewed at once.
• Before a medical visit, check the labels on your medications to find out how many repeats you have left and which meds need to be renewed. Alternatively, you can call your pharmacy and ask them to look it up. Many pharmacies have automated phone systems that will allow you to check if you have a renewal available just by typing in the prescription number written on the label.
• When you have your annual check-up and IF your condition is stable, ask for one year’s worth of all of your meds (three months at a time, so three months and three repeats).
• If your doctor recommends regular follow-ups, never miss these appointments just because you have not yet run out of your meds or you still have a renewal or two available. These checkups are intended to review your condition and make sure your meds and dosages are still right for you. Don’t sacrifice your care just for the sake of being efficient.
• Don’t pour new prescriptions into an old bottle or you will get renewal information mixed up. It’s better to put OLD prescriptions of the same dose in to a NEW bottle.

My medications are so expensive! How can I save some money?

• Fill your prescriptions in three-month increments. This will reduce the extra dispensing fees of filling prescriptions monthly. Note that insurance companies usually won’t cover more than three months at a time (this minimizes waste in case a medication is discontinued or the dose is changed).
• Some extended benefits plans will cover vitamins or supplements if they are prescribed by your doctor. If they are agreeable, ask your doctor for annual written prescriptions for the ones he or she recommends you take (e.g. Vitamin D)
• Choose your pharmacy carefully. Different pharmacies charge different fees, and some are more expensive than others. Be Sure to check different pharmacy chains and don’t forget about big box stores. As an example, Costco doesn’t require a membership to access the pharmacy.
• To avoid the huge one-time fee, opt for paying your Pharmacare deductible over twelve months.
• If you are covered under your spouse’s extended health package and you get a divorce, you will no longer be covered. Some companies’ human resource departments will offer a reasonable plan even if you are no longer married. It is worthwhile to approach them.

How can I make injections and infusions more bearable?

• Allow medications that have been stored in the fridge to come to room temperature before injecting. This makes it more comfortable.
• Use a diary or calendar to keep track of which arm/leg/side of abdomen you last injected so that you can switch sides for the next dose
• Pick the day you take your meds carefully. Keep short and long term side effects in mind if you want to avoid having them during big meetings or you need to be ready for the weekend.
• Take a teaspoon of cough syrup the day before and the day after you take methotrexate and it may take away the nausea. Make sure to consult your physician regarding high sugar content for diabetics and potential drowsiness and impact on activities.
• Keep yourself hydrated the night before an infusion to lessen side effects of fatigue, headache, and so on. Drink a minimum of one litre of fluid the night before and the day of the infusion.
• Lift some tin cans the day before your infusion so that the intravenous (IV) goes in a little smoother. Good general muscle tone makes veins easier to find for IVs.
• Acupressure can be useful in combatting nausea, and this could be done in consultation with a Traditional Chinese Medicine practitioner. Press on and off the vein in your arm to prevent nausea. The point is called P6 and travel bracelets are available for purchase that have pressure points built into them. Wear them on both arms.
• If travelling, always check for an in-suite fridge for your meds that need refrigeration.

My meds make my eyes and mouth dry. What do I do?

• If eye drops (e.g. Restasis) burn upon application, keep the product in the refrigerator, then ten minutes before applying use one or two drops of your favourite moisturizing tears to help reduce and prevent the burn.
• If your eyes are chronically dry and you’re purchasing over the counter ocular products, make sure they are preservative free. Over time, preservatives may irritate dry eyes.
• If a dry throat makes it tough to swallow pills, see if the medication comes in liquid form. If not, ask the pharmacist if it would interfere with meds if you take a little Vitamin E oil, aloe vera gel or olive oil beforehand to help the pill slide down more easily. Many meds should not be crushed or cut, but if your doctor or pharmacist says it’s okay, try taking it in smaller portions between sips of water.

What can I do about the pain from my Osteoarthritis?

• If you need to take a pain reliever for your osteoarthritis, Tylenol Arthritis extended release lasts for up to eight hours and you don’t have to worry about it wearing off suddenly or having to take it again four hours later.
• Take pain medications regularly because it is easier to keep pain at bay than to try to control it after it becomes worse.
• If you will be doing an activity which you know could be aggravating, such as walking for several hours, take pain medications before the activity to keep the pain under control.
• If you’re going travelling and know you’ll be doing more vigorous activity, increase your dose of non-steroidal anti-inflammatory drugs (NSAIDs) about three days prior, as they take that amount of time to work.

Can I travel while I’m on all these medications?

• When travelling, bring copies of labels, prescriptions or receipts. If you get searched at customs or security, you’ll need proof that the medications belong to you. To be extra safe, bring your medication list, signed and dated by your doctor.
• If you need to carry needles and vials when you travel, always carry a letter from your rheumatologist explaining why. Make extra copies that you keep in a different place, in case the original gets lost of confiscated. Update it every year at your annual visit.
• Before travelling, ask the hotel where you’ll be staying if they have diabetic needle containers. If not, do an online search for the closest pharmacy so you know where to drop off your used needles. There may even be a medical supply site that sells travel containers directly to patients.
• If you will be away from home for an extended period of time, remember to ask your rheumatologist for a six month prescription so that you don’t run out while you’re away.

How can I avoid having my medications react negatively with each other?

• Every once in a while, gather up all your prescription and non-prescription drugs (even herbal teas) and take them to your pharmacist to make sure there are no contraindications between the things you’re taking.
• Be careful with non-pharmacological or alternative treatments as they can still have active ingredients that can do harm or interact with your other drugs.
• To save costs of retail and dispensing, pharmaceutical companies in some countries (coming soon in Canada) will offer mail order prescriptions. Do not order your medications online unless you know they are coming from a reputable company.
• Carry your medication/dosage list in your wallet at all times. This is critical in case of an emergency. Make sure it’s up to date by crossing off any medications you’re no longer taking and noting any changes in dosage. Show this to your doctors; they will be impressed. Keep it somewhere accessible so that anyone could easily find it in an emergency.