How do I take medicines correctly, and what if I miss a dose?

Most medicine problems at home are not dramatic. They are a dose missed and then doubled, two products taken together that contain the same drug, a course stopped early because the symptoms went, or a leaflet never opened. All four are avoidable.

Safety

Step by step

1. Read the leaflet once, properly.The patient information leaflet in the box tells you what the medicine is for, how to take it, what to do about a missed dose, what not to take with it, and which side effects mean stopping and getting advice. It is written for you, not for a clinician.
2. Understand what the timing instruction means.Three times a day usually means spread across waking hours, not with meals specifically. Every eight hours means what it says and matters more for some drugs than others. If you are unsure which yours is, ask the pharmacist when you collect it.
3. Follow the food instruction.With food, before food, or on an empty stomach are not decoration. Some medicines irritate the stomach without food, and some are poorly absorbed with it. The leaflet says which.
4. Handle a missed dose the way the leaflet says.The general pattern is to take it when you remember unless it is nearly time for the next one, in which case skip it — but this genuinely differs between medicines, and some have specific instructions. Never double up to catch up unless told to.
5. Watch for duplicate ingredients.Paracetamol is in a great many cold and flu remedies as well as in painkillers, and taking two products containing it is the classic accidental overdose. Read the ingredients on anything you buy, and tell the pharmacist what you already take.
6. Ask about interactions before adding anything.This includes supplements and herbal products — St John's wort in particular interacts with a long list of prescription medicines. Grapefruit juice affects several. A pharmacist will check in a couple of minutes.
7. Finish a course of antibiotics as prescribed.Unless a clinician tells you to stop. Feeling better is not the end of the treatment, and stopping early is one of the drivers of resistance.
8. Store them properly and check dates.Out of reach and sight of children, in the original packaging so the batch and expiry are readable, and not in a steamy bathroom. Return anything out of date or unwanted to a pharmacy, which disposes of it safely.
9. Keep one list of everything you take.Prescriptions, over-the-counter items and supplements, with doses. It is what you will be asked for at every appointment and in every emergency, and it is the single most useful health document a household can keep.

Tips

• A pill organiser makes missed doses far less likely, but fill it from the original packs and keep the boxes so the information and the expiry dates are still available.
• Set a phone alarm for a medicine you keep forgetting. It works better than intending to remember.
• Ask for a New Medicine Service consultation at the pharmacy when you start a long-term medicine in England. It is free and it is designed for exactly the questions people think of a fortnight later.

Common mistakes

• Doubling up after a missed dose — For some medicines it is genuinely dangerous, and for most it is unnecessary. The leaflet tells you what to do for that specific one.
• Taking a cold remedy alongside paracetamol — Most cold and flu remedies already contain paracetamol. Combining them is the most common accidental paracetamol overdose there is, and paracetamol overdose does its damage quietly.
• Stopping a medicine because you feel fine — For blood pressure, thyroid, epilepsy and many other conditions, feeling fine is the medicine working. Some also cause problems if stopped abruptly.
• Keeping medicines in the bathroom cabinet — Heat and humidity degrade them. A cool, dry, high cupboard away from children is the right place, and out of the kitchen too if it gets steamy.

If it doesn't work

Questions people ask