So your doctor has identified your health problem and it’s one a prescription can help fix. 

Off you go to fill it and start taking as prescribed. After all, the sooner you begin, the sooner you’ll begin to feel better.

But wait! Before you can start taking your medicine, there are some things you should know. One of the most important is possible drug contraindications. 

Not all drugs work well together. Not all drugs go well with certain foods or beverages either. Let’s take a look. 

What exactly is a contraindication?

Medline defines “contraindication” as “a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person.”

Most of us are familiar with pregnancy as a contraindication for many prescriptions. That’s because some drugs can harm the developing baby when they cross the placenta. But contraindications can be a little less obvious, too! For instance, you might need to avoid eating dairy products, drop otherwise healthy foods out of your diet, stop taking common over-the-counter medications, or even limit your exposure to the sun.

Get informed about your contraindications!

Before your doctor prescribes a medication for you, he or she may review your medical history, your current prescriptions if you have an ongoing medical issue, and anything else which may interfere with your taking the medication properly and safely. If your doctor doesn’t volunteer this information, there’s no harm in asking!

For example, some medications cannot be taken together. If you are on blood thinners, like warfarin for example, you should not take aspirin as that is also a blood thinner.

Your pharmacist can review any other issues with potential for contraindications. For example, your medication may come with guidelines to avoid certain foods while taking your medicine. And again, you can always ask. Watching out for contraindications, and answering your questions about them, are a key part of a pharmacist’s job.

You should also let your doctor and your pharmacist know if you’re taking any over-the-counter medications or supplements (vitamins, herbal medicines and so forth) as these may also interfere with the effectiveness of your medication or even cause additional health complications. 

Here are some common contraindications you might encounter.

Contraindications are most common for people with chronic diseases such as heart disease, high blood pressure, diabetes, thyroid disease and depression, as well as people who have had or are at risk of having a stroke.  

This list gives you a baker’s dozen of frequent contraindications you may encounter! 

1. Grapefruit or pomegranates can alter the effectiveness of statin-based cholesterol medications.
2. Decongestants should be avoided if you have high blood pressure.
3. Leafy greens like kale or spinach can increase levels of vitamin K, which can be a risk for people taking blood thinners for stroke prevention. 
4. Vitamin supplements can disrupt the chemical balance needed in your body for certain dosages of medicines to work their best.
5. Antibiotics and common pain relievers should be avoided if you’re taking blood thinners.
6. Cold and allergy medications can intensify the effects of different medications.
7. Alcohol can change the liver’s ability to filter medication from the body, and if you drink while taking certain antibiotics, the combination can make you sick.
8. Salt can increase the amount of liquid kept in your body and this can affect the way your body will process your medication. 
9. Chocolate and peanut butter can affect how blood pressure medications and some anti-depressants will work for you. 
10. Licorice can reduce the benefits of certain medications used for congestive heart failure and abnormal heart rhythms and alter the effectiveness of blood pressure drugs and diuretics (water pills). 
11. St. John’s Wort is a popular supplement that can reduce the concentration of your medication in your blood. It is contraindicated in people who wish to use Viagara. 
12. Ginseng can interfere with bleeding effects of Coumadin, Heparin, aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve) and ketoprofen (Orudis). Combining ginseng with antidepressants can cause headaches, sleep issues, nervousness and hyperactivity. 
13. Antihistamines can cause your blood pressure to increase and may also speed up your heart rate if you’re taking medication to lower it.

Prevention is the best way to avoid problems with contraindications. 

• Become informed about how the drug will work for you. Ask your doctor or pharmacist about possible contraindications and what you should look for. 
• Make them aware of your medication history. Keep a record of everything you take, including prescription drugs, OTC drugs, and dietary supplements (including herbal medicines). 
• Ask about food, beverages, dietary supplements and other drugs with the new drug you have been given.
• Read all the labels for prescribed drugs and over-the-counter medications. 
• Develop a relationship with your pharmacist (or pharmacists) and make sure to inform everyone you work with about all the prescriptions you take.  

Follow these basic guidelines and you’re well on your way to having a trouble-free experience with your medication!

To prevent pregnancy, estrogen and progestins work together to regulate monthly bleeding and result whether an individual conceives or not. Natural sex hormones, estrogen and progesterone play a vital role in regulating bodily function, and the use o birth control changes the level of these hormones which can also result in affecting other body organ functionalities and cause side-effects.

Common side effects associated with birth control include changes to the menstrual period, resulting in heavier or lighter monthly bleeding, spotting or no bleeding at all. Headaches, breast tenderness/pain and nausea are common side-effects associated with birth control whereas some side-effects are more specific to the form of birth control taken. Birth control taken in the form of a skin patch can cause skin irritation and itchiness depending on where the patch is applied, whereas for vaginal rings may cause vaginal irritation/discomfort and cause in vaginal discharge. And as for IUDs, they can cause discomfort and pain in the lower abdominal area.

Less known birth control side-effects are changes in vaginal discharge, with vaginal secretions being thicker making it difficult for sperm to move, or change in colour. Hair loss, dry eyes, changes in sex drive, and changes in mood are also side-effects that may result due to the intake of birth control. Some of the long-term risks are linked to birth control, but low risks are breast cancer or the rise in risk of developing blood clots.

Individuals that are more prone to experiencing risks associated with birth control include individuals with PCOS (polycystic ovary syndrome) experiencing hair loss, and dry eyes for those who have diabetes, thyroid problems or certain autoimmune conditions. To lower side-effects of dry eyes, over-the-counter artificial tears can be taken along with drinking lots of water. For vaginal dryness, over-the-counter vaginal moisturizers and lubricants may be used to relieve the dryness associated with birth control intake.

Although there is nothing in particular to lower the risks of these side-effects mentioned, there are plenty of ways to help relieve these symptoms, and trying out different birth control to see which best suits your body can help lessen the side effects, along with the consultation of your healthcare provider.

“Eeeewww! Gross! I don’t wanna!” If you’re a parent or caretaker of a small child, you’re probably familiar with this reaction to medication. Often too young to know how to swallow tablets or capsules, most toddlers and young children strongly resist taking their medicine –and parents or caretakers may end up wearing the rejected medicine.

Why is taking medicine such an issue for little kids? Small children don’t usually tolerate strong tastes well, and most medicine isn’t tasty. Some young children may become afraid of taking medicine because of unpleasant or scary associations; or they may sense a parent’s concern, which can contribute to increased tension and anxiety. While older children can (sometimes) be reasoned with, younger children may simply not understand what is happening and why they need to take the medicine. Unfortunately, kids’ poor experiences early on can colour all their future encounters with medicine.

So what can you do to help the medicine go down? Julie Andrews may have sung about using a spoonful of sugar, but we know that’s not a wise approach. Most kids already ingest too many sugary drinks and treats. It may be tempting to tell your child the medicine tastes good—when it doesn’t—just to get it down the hatch, but this can create confusion and distrust. However, there are quite a number of things you can do to help make the situation easier for you and your child.

1. Shift your attitude. Children pick up on a parent’s vibes very quickly. If you’re anxious about giving them their medicine, your children will become anxious too. It may be hard to put on a happy face, since no parent likes to see their child sick, but a positive attitude will help. Routines like bath time, clean-up time, or story time create familiarity and foster a sense of comfort. You may find “medicine time” allows you to create a space in the day where taking their medicine is the focus for your child.
2. Empower your children. Give children age-appropriate information they can process. Help them understand why medicine will help them get better. Use role play to get them used to the idea of taking medicine when they’re ill. Give them a choice in how they take their medicine (a spoon, a dropper or a cup), when they take it (before or after daycare or school), and where (in the kitchen or while watching their favourite program).
3. Ask for help. These days, pharmacists are able to access a variety of compounds and forms of medication. Your doctor and pharmacist can help you navigate the available choices. For instance, perhaps the medicine your child needs can be given in a single dose daily instead of two or four times each day, to minimize occasions for conflict.
4. Improve the taste. If the medicine children must take comes in different flavours, let them pick out what they like most. Most pharmacists can use specially formulated products to increase the range of flavour options available to your child. Just be careful not to describe the medicine as candy or a treat so as to avoid creating confusion for your child about what they’re taking.

1. Numb the tongue. Eating a popsicle, sucking on ice chips, or nibbling on some frozen fruit before taking the medicine can help chill the taste buds sufficiently so strong flavours are muted. Offering a stronger-flavoured food item or a preferred treat after can help wash away unpleasant tastes. You may also find keeping some medicines chilled in the refrigerator can soften their bitterness.
2. Bypass the tongue. Rather than using a spoon to deliver the medicine, try using an eyedropper or a needle-less syringe. Keep your child upright and slowly squirt the medicine along the sides of your child’s mouth avoiding their tongue entirely. It may also help to gently stroke your child underneath their chin to get them to swallow.
3. Redirect their attention. Some parents find playing a game like peek-a-boo helps distract the child. Singing a song that includes actions can deflect your child’s attention.
4. Reward positive behaviour. Older children often respond well to incentives like stickers or tokens they can collect to trade up for a special item like a new storybook or small toy. You can use the stickers to count down the days as well so your child can anticipate when they will finish their medication.
5. Teach kids to swallow pills. If your child is eating whole foods well on their own, you can teach them to swallow pills. Offer your child the pill in a spoonful of yogurt or applesauce. The slippery texture of the food will help the pill go down more easily.

Watch out for these four pill-taking pitfalls. Some techniques might seem helpful, but can come with hidden dangers. Or they may simply not be as effective as you would hope. Here are a few cautions to keep in mind when giving your child medicine.

1. If you hide medicine in food, choose a small amount of food to make sure the child eats all of it. Otherwise you run the risk that they may only get a partial or incomplete dose, thus reducing the effectiveness of the medicine.
2. If your child spits out or vomits up the medicine despite your best technique, check with your pharmacist or doctor before repeating the dose. Some medicines can be given again without harm, while others may require you to wait a while to avoid giving your child too strong a dose.
3. If you want to use your child’s favourite spoon, that might work well to help them take their medicine, but you should always use the dosing tool provided (syringe, cup or special spoon) to measure the dose accurately first. Do not use regular dinnerware spoons to measure with, as size may vary and you could give your child too much or too little medicine.
4. If you’re tempted to crush or split a pill to make it smaller or easier for your little one to swallow, check with your pharmacist first. With some medications this is fine, but with others it can affect the way the medication is absorbed. For instance, the pill may feature a protective coating for a timed release or to prevent the stomach’s acids from reducing the medication’s effectiveness. If you expose the inside of the pill in a way it’s not designed to be, it may not work as well. Also, while crushing or splitting can make the pill smaller, it may increase the bad taste or leave sharp or rough edges that are difficult to swallow, so the trade-off may not be worth it in the end.

With a little trial and error, you can find the medication method that works best for your child.
There’s no one perfect way to get a child to take their medicine, but we hope that if you follow these basic tips and ideas, you’ll find something that works for your little one! Being sick is no fun, but when you find an approach to medication that works for your child, you can set the stage for a lifetime of good healthcare.

Flu season is in full swing in most parts of the world. Immunization is the leading factor in preventing the flu, reducing its impact, and minimizing complications from the flu.

Health care providers—doctors, nurse practitioners and pharmacists—have a role to play in supporting widespread immunization. As part of your health care team, ADV-Care strongly recommends that you get immunized!

Recent research shows immunization rates increased modestly when pharmacists were allowed to give flu shots. While ADV-Care, as an online pharmacy, can’t provide flu shots for you, we firmly believe in the individual and public health benefits of flu shots. So we’re absolutely encouraging you to get immunized, whether that means visiting a brick-and-mortar pharmacy, seeing your doctor or making a walk-in clinic appointment.

Why you should get the flu shot?

Partly, it’s for your own health. Getting the flu shot makes you more resistant to the flu, so you’re much less likely to get sick. It’s a straightforward benefit to you!

Partly, it’s about the people you care about—your friends and family, your work colleagues and so on.

It’s also about people you don’t even know—random strangers on the bus or in the shopping mall. Perhaps most importantly, this also includes people whose age or medical situations prevent them from getting the shot themselves, and who rely on herd immunity to stay safe from a flu that could have devastating effects on them. Some people cannot get immunized because they are undergoing cancer treatment, or their immune systems are compromised, or they’re too young to be immunized. Getting the flu shot even when you’re not a member of a high-risk group helps promote herd immunity and protect those who can’t get the shot.

Immunization is critical in reducing the spread of disease.

Here’s how the flu shot works.

Every year, World Health Organization (WHO) researchers look at data and predict which flu strains are most likely to spread. The flu vaccine is then produced to protect against the most likely strains. Because this a prediction based on probability several months to a year before the flu season the vaccine is designed to protect against, the flu vaccine is not 100% effective. Flu strains can also mutate or die out and new unanticipated strains can emerge.

Recent studies suggest that flu vaccination usually reduces the risk of influenza illness by 40% to 60%. So, while getting a flu shot is not a guarantee that you won’t get sick, it’s definitely much better protection than not getting the shot!

When you get your flu shot, your body prepares itself by generating antibodies. Sometimes this can make people feel like they have the flu coming on, but it doesn’t actually make you sick. Sometimes, you may get your flu shot but then you get the flu quite soon after. In that case, you were likely already exposed to the flu virus and your body could not generate the antibodies in time.

If you do get the flu, you can reduce its impact.

First, make sure what you have is the flu and not a severe cold. People with the flu experience muscle aches, fever, chills, sore throat, headache and severe fatigue. You may also have a runny nose and a dry hacking cough.

For most people, the flu will pass within a week. Your doctor may prescribe Tamiflu and rest.

Some other things you can try to minimize the negative effects of the flu include:

• Wash your hands often with soap and water. Here’s a hint: sing happy birthday to yourself—that’s how long you should wash your hands!
• Do the “vampire sneeze” into your arm or sleeve—like a vampire sweeping his cape up to cover his fangs. Sneezing spreads tiny droplets of liquid containing flu germs. Containing your sneeze in your sleeve reduces the spread of infection!
• Reduce your contact with others: stay home if you are sick. Avoid crowded spaces such as shopping malls, grocery stores, places of worship, concert halls and movie theatres. Take a sick day or work from home if you possibly can—your colleagues will thank you, and so should your boss. After all, overall productivity will be higher if fewer people get sick!
• Clean all surfaces with disinfectant wipes or cleaners. Did you know flu viruses can live for 24 to 48 hours on hard surfaces? That means you need to wipe down counters, laptops, phones and door handles!

Still, flu complications can arise, and some people are at higher risk.

WebMD lists several possible complications from the flu, such as viral or bacterial pneumonia, dehydration, and sinus and ear infections. Other issues that could develop include muscle inflammation and heart-related inflammation (myocarditis and pericarditis). Some people are especially vulnerable to such complications:

• Children under the age of five, and especially those under 12 months
• Adults older than age 65
• Residents of nursing homes and other long-term care facilities
• Pregnant women and women up to two weeks postpartum
• People with weakened immune systems
• People who have chronic illnesses, such as asthma, heart disease, kidney disease, liver disease and diabetes
• People who are very obese, with a body mass index (BMI) of 40 or higher.

Influenza can also make chronic illnesses worse, so people with congestive heart failure, asthma or diabetes need to keep a close eye on symptoms. In short, if you’re in a risk group and you get the flu, take it very seriously and seek medical attention quickly as needed.

Nothing can fully eradicate the flu, but if you get it, the above tips can help you recover quickly and avoid spreading it to others. Still, getting vaccinated remains your best shot—and collectively, the population’s best shot—at staying well and healthy this winter. It’s not too late to get your flu shot!

Medication adherence refers to the extent to which a person’s medication-taking behavior corresponds with recommendations from a healthcare provider. The world Health Organization reports that adherence to medications averages 50% among patients with chronic diseases, although it can vary substantially by patient population, age and location.

As expected, nonadherence to medications leads to significant detrimental clinical outcomes. Hospitalizations and death. Medication nonadherence can arise from taking more or less of medication, dosing at the wrong times, discontinuing prematurely or not filling a prescription. It can be an intentional decision or passive unintentional process.

Intentional nonadherence arises when a patient actively decides to not adhere to medication regimen.  Commonly cited reasons include adverse effects, lack of expected benefit or stigma, unresolved concerns about diagnosis, lack of symptoms or the time it takes to observe or experience an effect from medication.

Unintentional nonadherence results from factors such as forgetfulness. Elderly patients are particularly vulnerable to unintentional nonadherence resulting from physical and/or cognitive limitations in their capacity to manage medications, as well as polypharmacy and complex medication regimens.

Given the impact of nonadherence on hospitalization, morality and healthcare costs, extensive interest lies in developing technological solutions to address unintentional nonadherence, especially in older adults. Smart electronic medication reminders and AI monitoring using mobile devices serves as a convenient economic solution to improve drug nonadherence in older patients.

Pharmacists are in enviable position of being able to identify patients who may be non-adherent to medications, guide the choice and use of appropriate adherence technology, guide the choice and use of appropriate adherence technology, and provide real-time monitoring of adherence. Once unintentional nonadherence has been detected in an older adult, pharmacist can be an excellent resource for patients and their care-giver.

Flu season is around the corner, and many of you may be wondering, “Is it possible to get the flu and to have COVID-19 at the same time?” The answer is YES, it is possible to be infected with COVID-19 and the flu at once.

COVID-19 and the flu spreads through respiratory droplets that are produced by sneezing, coughing, or by simply talking. Although the two cause similar illnesses, the flu is caused by an influenza virus, while COVID-19 is caused by a new coronavirus called SARS-CoV-2 (also known as severe acute respiratory syndrome coronavirus 2).

At this time, it appears to be rare for someone to get both viruses at the same time, but there have been a few reports. Some studies have shown the outbreak of different respiratory viruses don’t spread at the same time, which means that one virus may not overlap with another virus. With flu season approaching, healthcare providers may start testing for both COVID-19 and the flu. The FDA is beginning to authorize additional combination diagnostic tests for COVID-19 and the flu.

So what happens if someone gets COVID-19 and the flu? People who get the flu or COVID-19 have mild symptoms and may not require any medical care, while individuals at higher-risk, like individuals that are 65 years of age or older with certain medical conditions like hypertension, or diabetes, may develop more serious symptoms and require to be hospitalized.

How can you prevent catching COVID-19, the flu, or both?

• Clean your hands often with soap and water, or alcohol-based hand rub
• Avoid contact with individuals who are not feeling well or are around those that are ill
• Try to avoid touching your nose, eyes and mouth
• Keep a distance of at least 6 ft (or 2 m) from others in public
• Stay home if you’re not feeling well
• And lastly, wear a mask in public! ADV-Care Pharmacy sells masks and can be purchased here!