There has been a lot of confusion about the legality of certain medications in Missouri since the Supreme Court as removed protections afforded under Roe v. Wade. There have been several news reports and stories about people having issues getting medications from pharmacies. Our goal is give some explanation as to what is legal and what to do if you have issues.
-Oral Contraception (birth control): Legal and unrestricted in Missouri per prescription. The Supreme Court has stated they are supporting the protection of oral contraception currently (Griswold v. Connecticut). If this precedent is removed, there would be no federal protection that I am aware of. Missouri has no laws restricting or limiting oral contraception currently.
-Plan B (morning after pill, levonorgestrel, etc) Legal and unrestricted under Missouri law. Plan B prevents pregnancy and does not end pregnancy. There is no issue currently in Missouri. There have been some health systems concerned that the Missouri AG would file suit against them if dispensed, but this was later reversed. The Missouri AG has specifically said no legal actions would be taken against Plan B dispensing.
Plan B is available by prescription or over the counter. Plan B may not be effective for women over 165lbs. Ella is a prescription emergency contraception that can be used by women up up to 195lbs. Any weight could also have a copper IUD implanted up to 5 days after unprotected sex to prevent implantation. Coverage by insurance varies. Not every pharmacy carries Ella so it may take a business day to get in if they don’t have it on hand.
Missouri legislation is openly discussing making Plan B and IUDs illegal. This may come up in the next legislative cession but would likely be challenged in court.
-Medications that could be used for abortion or other conditions (methotrexate, misoprostol, etc): These drugs have very specific doses when used to induce an abortion. There is no restriction for conditions not relating to abortion. There have been instances where people have been denied medication for other conditions (Rheumatoid arthritis, cancer, Crohn’s, psoriasis, etc). The dosing and duration for these conditions are completely different than that for ending an ectopic pregnancy or intrauterine pregnancy (IM, typically one dose). A pharmacist should know this but they may not. To help avoid issue, ask your doctor to put the ICD-10 (diagnosis code) on your prescription. While it shouldn’t be necessary, it may help prevent any issue.
Some pharmacists have refused to dispense medications due to religious or other beliefs. While there’s no law preventing this in Missouri that I am aware of, it can happen. There are some options if it does. Ask for another pharmacist to fill it. If one is not available, as for it to be transferred immediately to another store (same chain or another pharmacy). I would call that pharmacy first if possible to make sure they have it in stock and no issue. The pharmacy has to transfer the prescription if requested. There is no time limit (a reasonable amount of time) to do the transfer.
If you are having issue getting these medications, call us 314-832-2480. We can give you advice on how to get the medication as quickly as possible.
Bacteria and viruses are all around us in our everyday lives. Both of them can cause us to get sick. They are very small and cannot be seen by the naked eye. Though the two are different from one another in a lot of ways.
Bacteria can be both good and bad for the body. In your stomach there is good bacteria that helps to keep you from getting sick. Bacteria is made up of only one cell. This single cell can survive outside of the body. Bacteria can live in a range of temperatures. It can be found on surfaces and in the environment. When bacteria makes us sick it is usually local and does not spread throughout the body. Bacteria that cause us to get sick can be treated with antibiotics. These drugs kill the bacteria and stop the infection from getting worse. Some sicknesses caused by bacteria include strep throat and food poisoning.
Viruses are different from bacteria. These are even smaller. Viruses require your body to stay alive. They take over the cells in your body and use them to spread the virus. This can cause the sickness to spread throughout the body. Since they need your body to live, they die if on a surface too long. Unlike bacteria, viruses cannot be treated with antibiotics. Antibiotics do not work against viruses like they do against bacteria. Viruses can cause the common cold, the flu and COVID-19.
There are lots of easy ways to avoid getting sick. Wash your hands and clean surfaces that are touched frequently. Remember to cover your mouth when you sneeze or cough. Lastly, wear a mask in public to reduce the spread through the air. All of these actions can be beneficial for everyone’s health in the community.
Many people are familiar with ibuprofen and acetaminophen. These are two over-the-counter drugs that are typically used for pain. You may be wondering though, are these two medications the same? Do they work the same way? You may be surprised that there are some important differences between these two medications.
Ibuprofen is in the drug class known as NSAIDs. This stands for “non-steroidal anti-inflammatory drugs”. Other drugs in this class include naproxen (Aleve) and aspirin. Ibuprofen works by blocking the substances that cause pain and swelling. This is how ibuprofen causes its pain relieving effects. You should ask your doctor before taking ibuprofen if you have history of kidney disease, heart disease, or stomach ulcers, or take blood thinners.
Acetaminophen is in the drug class known as an analgesic. This is a fancy term for pain reliever. It is not completely clear how this drug works, but we know that it can help with pain relief and fever reduction. It is important to realize that this is not considered an NSAID though. Acetaminophen should not be taken if you have history of liver disease or chronic alcohol use.
For both of these medications, we do not recommend to take them long term. Taking them for long periods of time could cause an increased risk for side effects. It is important to check with your doctor or pharmacist before starting either of these medications if you have preexisting health conditions.
Taking your medication on time is very important. There are many reasons why it might be difficult to take your medication on time. Here are a few that we hear of most often.
“I don’t know how to take my medicine.”
When you receive a prescription, it is always important to read the directions on the bottle. It is possible that your doctor has changed your dose or schedule. It is just as important that you understand the directions. If you have any questions, just ask! We are always happy to help.
“I don’t need the medication anymore, or it doesn’t work!”
It is important to not just stop taking medication on your own. You should always talk to your doctor or pharmacist before stopping a medication early. There are many medications that must be gradually decreased before stopping cold-turkey. Other medications may take multiple weeks/months before you start to feel better. Give it time. If you are taking antibiotics, it is important to take ALL of them, even when you’re feeling better. This could cause the infection to come back and become harder to treat.
“The side effects are too much for me”
There are many medications that unfortunately cause some unwanted side effects. Thankfully, there are usually ways to prevent these side effects from occurring. A good example of this is with metformin. When metformin is taken on an empty stomach, there is a higher chance of side effects such as diarrhea. You can usually prevent these side effects by taking metformin with food. Some side effects also go away after a few days of taking them. It is important to let your doctor know of any side effects though, because there may be other options to choose from.
“My medicine costs too much”
Medication may not always be cheap. If you take a brand-name medication, talk to your doctor about possibly switching to a different generic option. If your doctor or insurance prefers the brand name, ask about coupons that are available! These can cut the cost by a lot, and sometimes even make your medication free!
“I forget to take my medication on time” or “I forgot to refill my medication” or “I keep forgetting to pick it up” The stress of daily life can sometimes make it difficult to stay on top of your medications. It is very important though to make sure you always have medication on hand. It may be helpful to make your medication part of your daily routine. If you take your medication every morning, put it by your pot of coffee, maybe. This will make sure that you see it every morning, and may help you to remember to take it. You may also find it helpful to keep a pill box to organize your medicine. This may help you remember to take you medication on time, and to sort your medicine out throughout the day. Here at St. Louis Hills
Medicare drug plans are widely used by older adults. There are many different plans available to people. They can usually find a plan that works best for them and their situation. What a lot of people may not know about is that most of these plans have a coverage gap (also called the “donut hole”).
When a patient reaches this coverage gap, they are often charged a higher co-pay for their brand name drugs. These plans start over each new year. A lot of patients reach this coverage gap towards the end of the year. The drug plans only allow a certain amount of money spent on drugs each year. For 2021, it will be about $4,100 that the patient and their plan will be able to spend before reaching the coverage gap. Medications like insulin and inhalers are often expensive. This can lead to reaching the coverage gap sooner than expected.
If a patient does reach the coverage gap, their co-pay will be no more than 25 percent of the cost of the medication. Some medications may cost $500 a month. Some may cost even more. This can leave the patient with a very high co-pay. Patients are often confused about why their medication has increased so much from last month. The coverage gap is usually the cause. A patient can spend enough to get out of the coverage gap. Often, they must wait until the new year for their prices to return back to normal.
Patients can work to avoid or limit the time to reach the coverage gap. They need to be aware of how much their medications actually cost. Patients might just look at the co-pay and not realize the actual price. Patients can work with their doctors to try and find different medications that may be cheaper. They can find out if they qualify for extra help in affording their medications. Patients can also work with their pharmacist to find out other cost saving opportunities. They can also find coverage plans that work best for them.
Extended Release Meds Vs. Regular (Immediate Release). What’s the difference?
Many medications come in different forms. It is not always clear which medications are regular and which have special release forms. The regular or “Immediate Release” are more common. After a pill is swallowed and makes its way through the digestive tract. It works by releasing the full contents of the med right away when activated in the digestive tract. They will act more quickly and reach their “peak” quicker. Think of it like a roller coaster with a steep incline to the top but also a steep decline back down as it is removed by the body. The downside is that the medication may not last long enough to last all day. This is why we have to take some medications 2 or even 3 times a day. How long a medication can last in the body depends on what medication it is. Certain medications can last longer in the body than others.
There are also medications that will say, “Extended Release” or “ER” for short. Some will say “Delayed Release” or “DR”. These medications work differently than regular or “immediate release” medications. They do not release all of their contents right away like the regular medications. The tablet or capsule is specially designed. It will release the contents more slowly over time. Think of a more gradual slope for the roller coaster. It takes longer to reach its “peak” but it will last longer since it is not releasing all the medication right away. There are special parts that go into making these medications work this way. It is important not to change the pill by crushing it or cutting it in half. This can cause the med to not work the way it was meant to. Your pharmacist will be able to tell you if any of your medications have these special release forms.
The holidays are coming quickly and this means spending time with family and friends whether in person or on-line. One of the hardest things about the holidays is making sure you are eating healthy to keep a healthy weight. This is a hard time for everyone to manage what we are eating. With a few tips on how to eat healthier options and making a plan in advance can help keep the calories down and the holiday weight off.
Holiday gatherings usually mean a whole host of comfort foods and delicious treats await. It is important to make a plan and stick to a few simple steps to help get through the holidays. It is important to look over the options available and only choose the foods you love. Do not just load up on everything on down the buffet line. Be sure to take your time and use those calories wisely. When deciding to go back for a second helping, first take 10 minutes to let your food settle and give your stomach enough time to let your brain know just how full you are feeling.
Do not ignore the fruit and veggie platters. They can make for an excellent snack before meals and as great side dish options. It is also important to not starve yourself in preparation for the main meal. This will help to prevent over eating on items that might not be as good for you. If you do finish your meal early and you might be tempted to get more food. Instead, try socializing and spread some holiday cheer! The more active you are; the less time you will spend eating. Keeping your mind busy will also take your mind off food. You can also stay physically active by taking walks with family members if the weather permits. Be prepared and plan to fit in some time for some exercise activity. Even a short walk can have a positive impact in helping you keep your goals.
Watch the drinks and desserts! Alcoholic drinks have very little nutritional value and offer little but empty calories. They can also change your judgment and cause you to eat more than you might have planned. Desserts are also very high in calories and do not have much else for nutrition. Try a smaller portion of your favorite dessert instead. Make sure to slow down and savor each bite. With these tips and tricks, you can make it through the holidays and come New Year’s, we won’t have the guilt and fear of the scale.
Safe medication storage
People often take multiple medications. It can be easy to lose track of all the pill bottles you have in your home. People often struggle in handling these medications and keeping track of them all. It is important to manage your meds and always be aware of any meds that are expired or ones you are no longer taking. Follow these steps for better medication handling.
- Go through your meds. Make sure you have enough of what you need
- Check to see if any of them are expired. There may also be some meds you are no longer taking. Set those aside for proper disposal.
- Make sure you store them in a dry and safe place in your home. Store them in a safe location like a cabinet or drawer.
- Do not store in places that can be easily reached by children or pets. Avoid areas that can be damp like the kitchen or on a bathroom counter.
Safe Medication Disposal
If you do find meds that are expired or you are no longer taking. Dispose of them quickly and safely. The best way is to look for any medication take-back programs in your area. Many programs have specific dates for medication drop-offs.
The United States Drug Enforcement Agency (DEA) provides many of these programs. They have also set up permanent disposal sites in hospitals and pharmacies. More details about drug disposal can be found here: https://takebackday.dea.gov/
The next best thing is to dispose of the meds in your household trash. First, check the bottle for any special disposal instructions and follow those directions. If there are no special instructions, then follow these steps.
- Take the pills out of the bottle and mix with something like cat litter, used coffee grounds, or even dirt.
- Mix the substance with the pills and place in a container like a sealed plastic bag.
- Throw the sealed container away with the regular trash.
- Remove any personal information from the bottle and place in recycling or trash.
There may be medications you don’t use anymore. There also may be medications that are expired. You can throw these away. It must be safe though. Follow these tips to throw away your medications.
Drug Take Back Programs
Drug Take Back Programs take your old medications. These medications can be expired. These medications can also be unused. It does not matter. Organizations like the Drug Enforcement Agency (DEA) run these programs. They make sure everything is done right. There are some local organizations that do this too. One example is the Missouri Prescription Pill and Drug Disposal program. St. Louis County has one of the largest take back programs in the country. This program is called PDP2. The PDP2 program has many medication drop-off sites. Some sites are at different police stations in the area. Some are also at pharmacies in the area. Call these sites first before you go. Not all sites take back medications. These drop-off sites are available 24/7.
Throwing Away Medications at Home
You can flush old medications down the toilet. This should only be an option if there are no take back programs in your area. Always check the medication information. Some medications cannot be flushed. Some medications can be dangerous to the environment. This is why some of them cannot be flushed. You can tell which medications are safe to flush at https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know.
You can also throw medications away in the trash. Only do this if they cannot be flushed. It still must be done safely though. Follow these steps to throw away medications in the garbage:
- Mix medications with something gross (coffee grounds, cat litter, or dirt)
- Put the mixture in a container that can be sealed
- Throw the whole container into the trash
- Black out any personal information on the original prescription bottle