More than 80% of patients occasionally miss a dose of their medication. Health practitioners ought to plan with their patients what to do if a dose is missed. The PIL will include the manufacturer's advice about what to do if you miss a dose. Ask your pharmacist for a PIL if you haven't been given one with your. If you miss a dose of your Levaquin, take it as soon as you remember. If you remember relatively close to the time you take your next dose then you sh.
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Reprinted from Australian Prescriber ;25 1: Health practitioners ought to plan with their patients what to do if a dose is missed. Patients believe that this plan should be a required part of the information received when a medication is prescribed and dispensed.
Consumer Medicine Information sheets, which are available for most commonly prescribed medications, contain a section on what to do if a dose is missed. The routine use of these sheets or similar advice may help patients to know what to do when they miss a dose. Why don't consumers know what to do when they miss a dose of their medication? As health professionals we know that the vast majority of patients occasionally miss a dose of their medication. This unintentional non-compliance, and request for advice after the event, is very common in practice.
Given our understanding of the difficulties around compliance with medication regimens, it must be our expectation that many patients will miss doses. Informing them about what to do about a missed dose at the time of prescribing, dispensing and administration would seem to be a logical step towards improved compliance.
Missed doses could be viewed within the framework of patient non-compliance, however the problems which arise often result because health professionals do not give enough information to allow the patient to safely use the medication. Teaching a patient what to do if a dose is missed and providing strategies to minimise the number of missed doses appears a sensible approach. In practice, giving information on what to do if a dose is missed should not be too onerous a task for medical practitioners or pharmacists.
Giving patients a CMI sheet the first time they receive a medication, and using this material in discussion with patients at the time of prescribing and dispensing would prepare them for this eventuality.
The severity of the patient's condition, whether clinically significant breakthrough effects are likely to be observed, and the characteristics of the medication should be considered when deciding the most appropriate strategy following a missed dose. Vulnerable patients are easily recognisable in any practice and include those on medications of low therapeutic index, b or suffering from conditions which require constant maintenance of therapeutic concentrations for example epilepsy and thromboembolic diseases requiring anticoagulation.
On the other hand, for most people with hypertension or hypercholesterolaemia a single missed dose will be of little consequence. The patients should be informed at the time of prescribing and dispensing, of strategies to minimise missed doses and to redeem the situation when a dose is missed.
Highlighting the strategy as it appears on the CMI or writing out an action plan as a reminder to the patient may prove very useful. While a pre-emptive approach is ideal it is recognised that requests for information about missed doses are common.
Knowledge of a drug's half-life, a major determinant of the fluctuation in interdose concentrations at steady state, is useful for making recommendations on what to do if a dose is missed. Upon cessation of therapy, it takes four to five half-lives for the drug to be completely eliminated. In general, medications, or their active metabolites, with a long half-life tend to create less problems when a dose is missed than medications with a short half-life. However, the clinical effect of some drugs is not related to the half-life.
This usually occurs when the drug is acting via an irreversible mechanism for example aspirin's effect on platelets , via an indirect mechanism for example the effect of warfarin on blood coagulation , when the drug is a pro-drug in which case it is the half-life of the active species that is important or when the drug is converted to an active metabolite which has a long half-life.
Missing several consecutive doses raises additional problems. For example, for drugs with long half-lives it can take a significant time to re-establish therapeutic concentrations when regular dosing resumes unless loading doses are given for example digoxin.
Drugs with short half-lives will lose therapeutic effect rapidly. Further, drugs with first-dose effects, for example an ACE inhibitor in combination with diuretics, may also present clinical problems when normal dosing is resumed.
Overall, surprisingly few studies have examined the clinical significance of a missed dose. You should always finish a course of antibiotics, even if you start to feel better.
If you don't finish the course or miss several doses, the infection may return. Skip to main content. Home Common health questions Medicines Back to Medicines.
What should I do if I miss a dose of antibiotics? Page contents One missed dose Several missed doses Remembering to take your antibiotics Always finish a course of antibiotics.
Several missed doses Contact your GP for advice if you've missed several doses of antibiotics or more than one day's worth of treatment. Remembering to take your antibiotics If you find it difficult to remember to take your antibiotics, you may find some of these ideas useful: Always finish a course of antibiotics You should always finish a course of antibiotics, even if you start to feel better.
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If you miss a dose of Flomax, take the missed dose as soon as possible. However , if you are close to the time of your next dose, you should skip the m. because missing a dose may make the medicine less effective, but taking If in any doubt about what to do, patients should seek further advice. If you miss a dose, you should take it as soon as you remember, unless the time for your What happens if I stop taking Cymbalta as treatment for fibromyalgia?.