“My Symptoms Are Getting Worse” How Do You Take Your Drugs?

Over the years, we have heard individuals complained about the ineffectiveness of drugs prescribed. The various statements include; “This drug is just not working for me, my symptoms are still there.” Some may even say, “I think this drug isn’t strong enough for my typhoid fever, I need a different brand of drug.” These are a few of the numerous complaints often heard at the doctor’s office, especially on out-patient visits. Considering the statements above, you would notice a common denominator—the drug regimen. After all, it is easier to project our flaw than take responsibility for the outcome of our actions. For the most part, issues around drug efficacy has always been attributed to the drug of choice or the Physician’s error. However, that isn’t the case 9 out of 10. Do you agree?

Now, let’s consider a few factors that often affect drug efficacy among the majority:

Drug Interactions

In a simple term, drug interaction refers to the negative effect of a drug regimen when used concurrently with another drug, irrespective of the drug class; it may also include a reaction between a drug and certain foods, beverage, or herbal supplements. This is one common reason for drug inefficacy. Before you combine medications, certain kinds of food, or herbal supplements, it is very important you discuss the s same with your health provider, for drug reconciliation, so as to avoid serious adverse effects. For example, frusemide and aminoglycosides enhance ototoxicity; diuretics cause hypokalemia and increase digitalis toxicity; licorice enhances hypokalemia in patients on diuretics; St. John’s Wort interacts with numerous medications, including anticoagulants (warfarin); patients on Monoamine Oxidase Inhibitors (MAOIs) should avoid tyramine-containing food such as, avocados, banana, red wine, tofu, grapefruit, and aged cheese.

The reason why your antibiotics or anti-malaria isn’t working may be as a result of the concomitant use of antacids and/or orange fruit juice or vitamin C, respectively. For example, orange fruit juice or vitamin C should be avoided while taking anti-malaria; it alters the mechanism of action of this drug. Conversely, you shouldn’t take antacids (tabs or liquid form) at the same time with other medications. If necessary, you may take antacids at least 2 hours before or after any other drug regimen. Make it a routine to always check in with your provider about the safety of ingesting different drugs at the same time.

Compliance

This is simply the degree to which patients adhere to the treatment regimen; from drugs prescribed, to dosage and time of administration. Do you take your drug as prescribed by your provider? How do you take your drugs daily? For example, a ‘b.d’ drug should be taken twice daily, 12 hours apart. In the same vein, a ‘t.d.s’ drug should be taken three times daily, 8 hours apart. Whereas, some drugs are best taken before mealtime. E.g., sucralfate, omeprazole, etc. In addition, do not crush enteric-coated, sustained and extended (SR/ER) release drugs before ingesting them, as they can irritate your gut before absorption. When you don’t take the right drug for the right disease condition, at the right dosage and time, you shouldn’t expect a positive therapeutic result. It’s a no-brainer.  You don’t take anti-malaria for a headache or migraine. Neither can you catch the bacteria or virus unawares by taking a couple of extra doses or way before the prescribed time? Furthermore, drugs are not candy, you don’t pop them to save cost either.

And for those who still believe that a particular trade/brand name of the drug is more effective than a different generic name, as a result of the high cost of purchase, I have ‘bad’ news for you; branded and generic drugs are the same and would work likewise if the various factors enumerated so far are carefully put into consideration. As long as the active ingredients are retained in the generic drugs, you shouldn’t worry about the trade name, so infinitesimal.

Note: Before you complain about a drug not working in the future, ensure you must have checked the boxes of the various factors highlighted above that might pose a threat to the drug’s efficacy.