Question

"My father does some 'creative' things with his medication to save money. He is a WWII veteran who grew up during the Depression. He takes one of his prescriptions for blood pressure every other day, he uses his eye drops for glaucoma only when he feels like it, and the list goes on and on. I have told him to take his medications as ordered, but he insists that he has had no problems with taking them as he likes. Do I push this a little bit harder or let him be?" - READER

Answer

Your father is playing with fire when he does not take his medications as directed. He may be alright with less medication for some conditions but not for others. An incredibly large amount of knowledge and experience is required to properly assign or alter the dosage of many medications. It is the reason why a difference between prescriptions and over-the-counter medications exists in the first place.

Glaucoma eye drops are an important medication because they decrease the pressure in his eyes. This pressure, if left untreated, will eventually cause blindness. No, it will not happen instantly or even over a month, though it will happen gradually. Without the eye drops, he will go blind. Therefore, randomly or sporadically using the eye drops to control the pressure in his eyes is a very poor idea. If your father is doing this for financial reasons, he must consider that in the long run, he would spend far more money trying to live without sight than he would spend on his eye drops.

Now let’s move on to his blood pressure medication. Hypertension, high blood pressure, is another silent killer. When your blood pressure is elevated, you do not always have symptoms. It is possible that he takes the medication on days he is going to see the doctor and his blood pressure is fine. The real question here is “What is his blood pressure like the rest of the time?” The damage is being done when it is elevated. Therefore, if he is going to adjust his medication for blood pressure, he needs to be monitoring it several times a day with the agreement of his physician. 

Most medications are ordered at certain intervals for a reason. Laypersons rarely understand all of the nuances about why drugs are ordered at specific intervals. Doubling up on medications, skipping them, crushing enteric-coated drugs, taking old antibiotics, or using someone else’s pills are some of the ill-informed strategies people come up with that simply do not solve the problems they are trying to fix. Most often this behavior comes from ignorance or misperception. 

Unless your father is a physician, and even if he is, he should have an honest conversation with his doctor about his beliefs surrounding his medication and share his creative administration schedule. This will give his doctor an opportunity to explain which drugs are okay to take off-cycle and which are not. There is another danger to your father that he may not have thought about. If your father's physician is unaware that he takes his medication off-schedule, the physician may increase the dosage with the false understanding that the current dose is not working. The bottom line here is that your father's doctor needs to know how frequently or infrequently he is taking his medication. 

One last thing - If your father cannot afford his medications, take a look at his insurance. Medicare now has a drug benefit, Medicare Part D. You can actually go to the Medicare web site and enter his medications to see if this insurance will save him some money. Figure out what he is paying for medication and help him seek solutions.

I wish you success on your journey with Dad. This is an important one.