While medication labels look simple, there are many issues with following them. You may not know if twice daily means once in the morning and once in the evening. You may not know if 5 mL is a kitchen teaspoon. And you may not know if using two different cold medicines at the same time is allowed. If you guess at these answers, you may take the wrong dose or take too much of the medicine.
To prevent medication errors, you do not have to be able to define a lot of medical terms. However, you do need to be able to define a system for interpreting instructions and determining answers to your questions. This may include asking an expert for help. These steps work for prescription medicines. They also work for products sold without a prescription and for many vitamins or supplements used at home.
Start with six basic checks
Before anyone takes a medicine you should confirm six important details.
- The correct person Check the full name on the label. This is especially important when several people in the home take medicine.
- The correct medicine Read the medicine name and active ingredient.
- The correct amount Look for the number of tablets or the amount in milligrams or milliliters.
- The correct method Check whether the medicine goes in the mouth or on the skin. Some products are made for the eyes or ears. Other medicines may use another route.
- Time and Dosage Take note of the time and dosage. Some medicines are taken with meals while others are taken on an empty stomach.
- Duration of Treatment Some medicines are taken for a limited number of days. For others, treatment is taken until the prescribing healthcare worker (HCW) decides to stop or changes the treatment.
Ask the pharmacist or the HCW who prescribed the medicine to clarify any part that you do not understand.
Know which type of label you are reading
Prescription labels and nonprescription labels present information in different ways.
A prescription bottle usually shows the patient name and medicine name. It should also show the strength and directions. Other details may include the quantity and prescriber. The label may show pharmacy information and refill details as well. Warning stickers can add useful reminders. They do not replace the full information sheet supplied by the pharmacy.
A product sold without a prescription normally uses a Drug Facts label. Read each part before using the product.
- Active ingredient This is the substance that creates the intended effect.
- Purpose This tells you the type of medicine. It may describe the product as a pain reliever or antihistamine.
- Uses This section lists the symptoms or conditions the product is intended to treat.
- Warnings This section explains when the product should not be used. It may also describe interactions and situations that need medical advice.
- Directions This section gives the dose and timing. This section lists age restrictions, limits, and the maximum allowable quantity.
- Inactive Ingredients
These ingredients are important to a consumer who has a sensitivity or allergy to a particular ingredient.
Do not judge products based on brand names or product claims on the front of the packaging. The active ingredient and directions for use allow for an accurate comparison of the product.
Separate medicine strength from the dose
Strength and dose are related, but different, concepts. The strength describes the amount of active ingredient in a dosage form. The dose is the amount prescribed or recommended for a particular patient. The same dosage form may have different strengths, and the same strength dosage form may have different doses prescribed for various patients.
An example of a liquid label stating 250 mg active ingredient per 5 mL does not mean a dose of 5 mL is prescribed. The prescribed dose may be less than 5 mL.
If a product is refilled or a new lot is purchased, it may contain different concentrations. New product packaging may contain the same dosage form, but each dose may contain a different amount. The patient should check the strength of the new product and the amount prescribed to determine the new dose. It is always assumed that the same dose contains the same number of units.
Turn timing instructions into a clear schedule
Medication timing should be clear enough that every caregiver would follow the same plan. Several common phrases need careful attention.
- Once daily This means one dose each day. Use a consistent time unless the instructions say something different.
- Twice daily This often creates a morning and evening routine. It does not always mean exactly every 12 hours. Ask how the doses should be spaced for that medicine.
- Every 8 hours This describes the time between doses. It does not simply mean breakfast and lunch and dinner. Confirm whether the schedule continues during the night.
- With food Food may reduce stomach discomfort or improve absorption. The reason depends on the medicine.
- On an empty stomach This requires a clear period away from meals. Ask the pharmacist for exact timing if the instructions do not explain it.
- As needed This does not mean without limits. The directions should explain the reason for use. They should also show how often the dose may be repeated and the maximum amount allowed.
Medical orders sometimes use shortened terms instead of complete instructions. This guide explains how ACHS is used in medication and glucose check orders. ACHS usually refers to before meals and at bedtime. It describes timing only. It does not identify the medicine or action. It also does not provide the route or dose. Follow the individual care plan when meals are skipped or bedtime changes. Never calculate an insulin dose from the letters alone.
Measure liquid medicine with the correct device
Kitchen spoons are not reliable measuring tools. One household spoon may hold a different amount from another. This can make a dose too small or too large.
Use the oral syringe or dosing cup supplied with the medicine. A proper measuring spoon may also be suitable when it comes with the product. Ask a pharmacist for the correct device if the package does not include one. The device markings should use the same unit shown in the directions.
Milliliters are written as mL. They are the clearest standard for liquid medicine. Check the marking at eye level. Make sure you have not confused 0.5 mL with 5 mL. Do not use a dosing device from another medicine. Its size or markings may not match the current product.
Read the bottle for any instruction to shake well. Some liquids settle while they stand. Failing to shake them can affect how much active ingredient is given.
Use extra care when giving medicine to a child
Children are not simply smaller adults. The right medicine and dose may depend on age and weight. Health conditions and product concentration can also affect the decision.
Do not estimate a child dose from an adult dose. Do not give a child a product made only for adults. You should also avoid giving medicine below the age stated on the label unless a healthcare professional provides clear instructions.
Write down every dose when more than one adult cares for the child. Record the medicine and amount. Add the exact time as well. This simple record can prevent another caregiver from repeating the dose.
Vitamins and gummies should also appear on the child medicine list. Their sweet taste can make them seem like candy. A child may take too many when the container is within reach. This guide explains safe use of chewable vitamins for children. It covers product labels and suitable amounts. It also discusses choosing an age appropriate product and storing it safely. A child resistant cap may slow access but it is not childproof.
Check for repeated active ingredients
Two products with different brand names can contain the same active ingredient. This often happens with products for cold symptoms and flu symptoms. It can also happen with allergy products and sleep aids. Pain medicines may appear in combination products as well.
A person may use one product for a headache and another for cold symptoms. Both products could contain the same pain reliever. This may result in more medicine than intended.
Compare the active ingredient section on every nonprescription label. Review prescription medicines and supplements as well. Ask a pharmacist before combining products if you are unsure about repeated ingredients or interactions.
The same rule applies when changing between a generic product and a brand product. A different package or name does not always mean a different medicine.
Keep one complete medicine list
A useful medicine list includes more than prescription tablets used every day. Add each type of health product used by the person.
- Prescription medicines
- Pain and allergy products sold without a prescription
- Cold and sleep products
- Stomach medicines
- Vitamins and minerals
- Herbal supplements
- Inhalers and injections
- Creams and patches
- Eye drops and ear drops
- Medicines used only on certain days
- Known medicine allergies or past serious reactions
Record the name and strength of every product. Add the dose and purpose. Include the usual schedule. Update the list after any change and take it to medical appointments. Bring it to urgent care visits and the pharmacy as well.
Using the same pharmacy for prescriptions can help the pharmacist see a more complete record of the medicines being dispensed. You should still provide an updated list because the pharmacy may not know about products bought elsewhere.
Replace risky habits with safer actions
Guessing an abbreviation
Ask the pharmacist or prescriber to explain the full direction in plain language.
Using a kitchen spoon
Use the oral syringe or measuring device supplied with the product.
Identifying a pill only by its appearance
Check the original label and ask a pharmacist. Color and shape alone are not enough for safe identification.
Choosing products by brand name
Compare the active ingredients before using two products together.
Doubling a dose after forgetting one
Follow the instructions for that specific medicine. Ask a pharmacist when the missed dose advice is unclear.
Sharing prescription medicine
Use a prescription only for the person named on the label.
Moving medicine into an unmarked container
Keep it in the original labeled container. This protects important directions and reduces mixups.
Relying on memory
Record every dose at the time it is given. This is especially important when several people provide care.
Follow specific advice after a missed dose
There is no single missed dose rule for every medicine. Some medicines can be taken when remembered. Other medicines should be avoided around the time of a scheduled dose.
Two doses of a medicine should not be taken together unless specifically directed. It is acceptable to contact the pharmacist about an ambiguous situation.
It is not always necessary to replace a full dose of medicine if a child spits out or vomits the medicine. Contact the child’s pharmacist or healthcare professional if unsure.
Explain when the dose was given and how much may have come back up.
Act quickly after a medicine mistake
Do not wait for symptoms after a possible extra dose or accidental swallowing. Unless you are told by a poisonous substance specialist to induce vomiting, do not do so.
People in the U.S. may call Poison Control at (800) 222-1222. People who live outside of the U.S. should call either their country’s Poison Center, or an Urgent Medical Care Facility.
Call for immediate emergency service assistance if the individual loses consciousness, experiences a seizure, is experiencing difficulty breathing, or cannot be aroused.
Please keep your package with you as you request assistance.
Be ready to provide the product name and strength. You may also need to explain the amount taken and the time of the event. The specialist may ask for the age and weight of the person.
Store medicine in a secure place
Follow the storage directions for each product. Many medicines need a dry place away from heat and direct light. Some products require refrigeration. Do not refrigerate or freeze a medicine unless its instructions say to do so.
Keep medicine in the original labeled container. Store it in a locked place or another location that children and pets cannot see or reach.
Do not leave medicine in a handbag or on a counter. A bedside table can also be easy for a child to reach. Keep products for different family members in separate areas to reduce mixups.
Dispose of unwanted medicine safely
A pharmacy or community medicine collection program is usually the best option for expired or unwanted medicine. Follow the disposal instructions supplied with the product.
Do not flush medicine unless the label or official disposal guidance specifically allows it. Remove or cover personal information on an empty prescription container before throwing it away.
Speak with the pharmacist before leaving
A short conversation at the pharmacy can prevent confusion at home. Confirm each important detail before using a new medicine.
- Ask what the medicine is used for.
- Confirm the exact amount for one dose.
- Ask what times the medicine should be used.
- Verify the correct interval between doses.
- Determine if food is required when dosing.
- Learn about the consequences of a missed dose.
- Learn about the next steps if the medicine is vomited.
- Review possible expected/common adverse effects.
- Review the consequences of using the medicine with other drugs.
- Learn about the correct method for measuring doses and the storage method.
Review the instructions and then repeat the instructions in your own words to the pharmacist. You could say I will give 5 mL orally at 8 a.m. and 8 p.m. each day for the next week. Explain to the pharmacist that you need to understand the consequences of giving the medicine before they explain potential adverse effects of the medicine.
Clear instructions create a safer routine
Safe medicine use does not depend on perfect memory. It depends on a reliable routine. Read the complete label and separate the strength from the dose. Turn timing words into a clear schedule. Measure liquids with the correct device and record every dose when several caregivers are involved.
Keep one current medicine list. Ask for help whenever an abbreviation or interval is unclear. Take every warning seriously. A few minutes spent checking the instructions can prevent a small misunderstanding from becoming a serious medication error.
Medical Disclaimer: The information me, a generalized article focuses on general education only and is not have to blame from a physician pharmacist or another qualified health advisor. Follow the directions for each patient and product.
