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strategies and tools for taking medication

If you have difficulties with taking your medication the following strategies and tools might help you.

I sometimes forget to take my medication. What might help me?

It is not uncommon for people to forget to take medication or accidentally miss a dose. This might be forgetting altogether or forgetting at a particular time of day. Some people with epilepsy have memory problems related to their epilepsy which can make remembering to take medication difficult. Some may also take too much medication if they forget that they have taken a dose.

For most people, missing one dose on a rare occasion is unlikely to cause a seizure. If you miss a dose, or take too much medication, the patient information leaflet may tell you what to do. In general if a dose is missed and the AED is usually taken:

  • once a day – take the forgotten dose as soon as you remember it; or

  • twice a day – take the forgotten dose if you remember within six hours after it was due, otherwise don’t take the forgotten dose and just take the next dose at the due time.

It is important that if you miss a dose you do not take twice as much at the next dose time. Taking a larger dose than normal could cause side effects.

I had forgotten to take the odd one now and again and nothing ever happened but I guess I was just lucky.  Now I have an alarm set twice a day to remind me!

If you find that you regularly forget your medication there are several things that might help. These things may also help to ensure you don’t take too much medication.

Reminders

It might help to set an alarm or reminder for taking your medication. Our free smartphone app has a function to help you set up reminders for taking your medication. You can also use the alarm function on a mobile phone, watch or clock.

Routines

Having a routine for taking your medication, and linking this to something that you do every day, might help. For example, taking it in the morning and evening when you have a meal.

I find now it is part of my daily routines like brushing my teeth or having a wash.

‘If – then’ plans

'If-then' plans involve creating a plan to do something and using an action to ‘implement’ it (to do it). This relies on your intention to do something (take your medication). This technique is sometimes called an 'implementation intention intervention’.

To create an ‘if – then’ plan, decide on what you want to do and link this to something meaningful that will remind you to do it. So, rather than thinking ‘I will remember to take my medication’, you set up a plan that if (something happens) then you will do something. For example, the plan might be: ‘if it is 7.30am and I have just brushed my teeth then I will take my medication.’

To use this technique try the following.

  • Decide on an activity for you to link taking your medication to. It needs to be something you do every day as part of a routine. If you take medication more than once a day you could have a different plan for each time in the day you take it.

  • Write down your plan in the form of ‘if this happens then I will take my medication’.

  • Say your ‘if – then’ plan out loud and keep repeating it until you can say it without reading it. This will help you to store this information in your memory.

The theory behind this technique is that you make one positive decision to do something (I will take my medication) and link this to an action. Repeatedly saying your plan out loud helps you to store the information in your memory and means that you don’t have to make a decision to take your medication every day.

It makes me feel sooo stupid. As if fits weren’t embarrassing enough. Then I can’t get the damned things out of the packets. Sigh.

Medication charts

If you take medication, a medication chart can help you to record which anti-epileptic drugs (AEDs) you take and when you take them. A chart can also help if you are changing your AED dose, or starting or coming off an AED. You may also want to store your medication in a pill box to help remind you to take it.

Medication charts may help you to record which anti-epileptic drugs (AEDs) you take each day for your epilepsy. It can be useful to remember the names of your AEDs, how often you take them, and what dose you take. You could also include any other medication you take for other reasons.

 

Medication change charts may help you to record what doses of your anti-epileptic drugs (AEDs) to take and when, if you are starting a new AED, you are changing the dose of an AED or you are withdrawing (coming off) an AED.

 

I can’t get the tablets out of the packet. What might help me?

pill popperMedication comes in packaging such as bottles, sachets and blister packs (plastic strips where you ‘pop’ the pill through foil on the back of the strip). ‘Pill poppers’ are plastic tools that help you to pop pills out of blister packs. The pills often collect in the handle of the popper so that you don’t lose them. You can find these online or at some supermarkets and chemists.

I find it difficult to take my AEDs. Are different forms are available?

Some AEDs come in different forms including tablets and capsules, liquids and syrups, sprinkles and granules (which can be added to food), and suppositories. Some AEDs are available as ‘slow release’ forms which release their active ingredient more slowly in your body than non-slow release forms. Slow release forms are usually taken once or twice a day.

pill crusherSome tablets can be crushed into a powder which might make them easier to take if sprinkled onto food or in a drink, and it may be worth asking your pharmacist if this is possible with your medication. You can buy tablet or pill crushers from some chemists and online or from ‘independent living’ shops.

I could not swallow the tablet, it was too big. I now have it in granules and it is much better.

For babies, medication that can be dissolved in water can be given in a feeding bottle or with a special oral syringe. Giving it this way, rather than mixed in with food, means you can check that they have taken all of it even if they don’t eat all of their food. You can ask your pharmacist about how medication can be taken.

If you have difficulties in taking a particular form of AED you can talk to your specialist or pharmacist about whether there are alternative forms for your AED.

I find it difficult to get to the pharmacy to collect my medication, or to my GP for a repeat prescription. What might help me?

Some surgeries and pharmacies offer services that might help.

  • Repeat prescriptions is where a pharmacist orders prescriptions from the GP and you collect it from the pharmacist.

  • Repeat dispensing is where a pharmacist gets a six month prescription for medication from the GP and they dispense it to you each month.

  • Some pharmacies offer home deliveries for medication.

  • You can talk to your pharmacist about what to do if you forget to order your prescription and you need an urgent supply.

Can’t take [my two drugs together] – as get very dizzy. So I take them separately, say one early evening and one before bed and this has worked.

I have picked up my prescription but it looks different from normal. What should I do?

If your medication looks different – either the packaging or the medication itself – you may have been given a different version. This sometimes happens if your prescription has only the generic name of the drug. If this happens you can ask your pharmacist whether they are able to replace it with your usual version. For this reason it is a good idea to check your medication before leaving the pharmacy so that you can talk to the pharmacist if you think your medication looks different from usual. A pharmacist may not be able to change your medication if you have left the pharmacy and then try and return it.

We have produced a letter about being prescribed the same version of your medication (unless a change is advised for medical reasons). You can give this letter to your GP or specialist.

I have taken my medication but I have been sick. Should I take another dose?

If you have been sick or have diarrhoea this can affect how well your medication will work and this could affect your seizures. Whether you should take the dose of medication again depends on how soon after taking your medication you were sick.

General guidelines are:

  • if you are sick within one hour of taking medication take another dose; or

  • if you are sick more than one hour after taking medication wait until your next dose is due before taking it.

The patient information leaflet (PIL) for your medication may have more information or you could talk to your pharmacist about what to do.

I am very concerned about the switching [of my medication] I have taken action by getting a letter from my neurologist and this is now specified on my prescription.

 

Ideas to help you manage your epilepsy if you have just been diagnosed.

Tips on how to take anti-epileptic drugs to get the best from your medication.