Puzzled by Pills? Tips for Medication Management


With the range of medications people with cancer often need to take daily as part of their treatment or to manage side effects, it’s easy to forget a dose or confuse one pill with another.

Taking all of your medications as prescribed is important, however, and the consequences of a mix-up can potentially be serious, explains Memorial Sloan Kettering clinical pharmacist Manpreet Boparai.

“Sometimes when a drug doesn’t appear to be having a therapeutic benefit, we find the real problem is that the patient isn’t taking it correctly,” she says.

Here, Dr. Boparai offers some tips for keeping everything straight.

Have a List.

Probably the most important step in using medications correctly is to have a complete list of everything you take, including not only prescription medications and over-the-counter drugs but also vitamins and other dietary or herbal supplements.

Your list should include medicines you take on a regular schedule as well as those you might take only when you have symptoms, like Tylenol. If you’re an MSK patient, your medical team likely already provided you with a table showing all your medications and when and how to take them. (If not, ask for one at your next appointment.) Other patients who have not been provided with a medication list should make their own.

Be sure to include the following information for each medicine or supplement you take:

  • How much of the medication you take (the dosage)
  • When you take it
  • How many times a day you take it
  • How you take it — for example, on an empty stomach or with food
  • What you’re taking it for (what medical condition or symptom)
  • The date you started taking it
  • The date you stopped taking it, if you’ve stopped
  • Any potential drug interactions with foods, beverages, or other drugs

Between appointments with your doctor, write down any questions or problems that come up. Note any side effects you’re experiencing, even if you don’t know which medication may be causing them.

If you start, stop, or change a medication, update your table, and also notify your doctor and pharmacist — which leads to Dr. Boparai’s next tip.

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Update your doctor and pharmacist.

Go over your entire list of medications with your medical team at least once a year so they can help make sure you’re following directions and also that you’re not taking anything you don’t need.

Dr. Boparai explains that as people age, the way their bodies handle drugs changes. At a certain point, a drug that was safe and effective for many years may become harmful if an aging person can no longer metabolize, or process, it the way someone younger does.

Particularly if you’ve been taking a medication for many years, Dr. Boparai recommends asking if you need to keep taking it, if you’re on the right dose, and if there are any long-term side effects you should be aware of.

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Use caution with supplements.

It’s always important to let your doctor and pharmacist know about any herbal products or other dietary supplements you use. If you’re scheduled for chemotherapy, don’t be surprised if you’re advised to stop taking such products at least temporarily.

Dr. Boparai says some dietary and herbal supplements can counteract the effects of chemotherapy. And for many botanical products, it’s simply not known whether they interact with chemotherapy drugs. It’s safer, therefore, to stop taking them while receiving chemotherapy. However, there are a few vitamins that are essential to take with some chemotherapy drugs to prevent toxicity — your medical care team will let you know what those are.

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Try a pillbox.

Once you and your healthcare providers have agreed on a drug regimen, you need to develop a system that you can easily follow. Using a pillbox can make remembering your medications a lot easier, and they’re generally inexpensive and available at any pharmacy.

Some pillboxes have one compartment for each day of the week; some have three for each day, so that pills can be divided into morning, lunchtime, and evening doses; and others have different divisions.

If you have trouble filling your pillbox yourself, your pharmacist may be able to do it for you on a weekly or monthly basis.

Some pharmacies can also provide special packaging (usually called a bubble pack) that groups pills taken together and marks them with the dates and times they should be consumed.

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Jog your memory.

Another way to increase the chances you’ll remember to take your medications is to use some simple memory devices.

  • Place your pillbox in a visible place where you’re sure to see it. It often helps to put it next to an item you’ll be using at about the same time — for example, a coffeemaker if you take your pills first thing in the morning.
  • Write reminder notes to yourself and put them where you won’t miss them, such on as the bathroom mirror, refrigerator door, or computer screen.
  • Program your computer, cell phone, watch, or other device to sound an alarm or deliver a message when you need to take your medication.
  • For medications you take less frequently than once a day, use a calendar to mark when you need to take them.

Over time, you may start to ignore the cues you’ve put in place. If you do, change things up and try a different way of reminding yourself.

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Commenting is disabled for this blog post.

I use a pill box. Its a life saver. Makes the day so much easier.

For those unfortunate enough to have to take pills to survive, it seems like a pill box would be very helpful in many cases.

I remember back when I was younger my grandmother had a pill box. I always was so confused as to what it was. Took me a long time to figure out it's purpose.

I have also discovered tiny ziplock bags that are really helpful for carrying extra meds with me when the pill box would be too bulky. They are available at drugstores like CVs and Walgreens.

I have a slew of morning meds, and I set them up a week in advance, so that all I have to do is pour that day's pills into a bowl and take them. (BP, Cholesterol, specific required supplements (vit. D and fish oil, per MD) plus a few others. Setting up means that if interrupted during my morning routine, I never have to remember which pills I've taken. I use the stackable weekly pill case from CVS. (Off to set it up for next week!)