Is your prescription the right one?

As usual, two weeks before embarking on my upcoming trip, I collected and counted all my medications, throwing in a few extra pills of each kind, just to be safe.

As had been my custom for years, I had checked out each prescription on the Internet before filling it at the pharmacy.

Although the medical sites I was using provided excellent information, they never indicated a medication’s maximum and recommended dosages, stating instead that it was up to the physician to order the proper quantity. Thus I could never find out if the prescribed amount was the right one for me.

This changed when I recently came across www.RxList.com, a website owned and operated by WebMD, an organization that provides timely and credible health information. To my delight, RxList.com clearly presented the mechanism, the recommended and maximum dosages, the interactions and the side effects of numerous pharmaceuticals.

The website turned out to be a life saver for me when, on March 29, 2007, four weeks before my scheduled departure for Europe, I checked out a new medication and discovered that the ordered dosage was twice the recommended one. I then recalled that I had taken the identical drug at the higher dosage the year before and had discontinued it because of major side effects.

RxList.com will also be of great help to travelers who receive a new prescription after seeing a physician abroad.

At home, this website came in handy when my wife, Flory, and I visited our friend Barbara, who two weeks before had undergone a triple-bypass. Although Barbara stated that she felt fine, she looked like death warmed over. Upon closer questioning, she admitted, “I would feel so much better if I were not so nauseated.”

Suspecting that, as usual, the medications were the culprit, I ran them through RxList.com. It turned out that the prescribed doses of several of her drugs were far higher than recommended.

When Barbara confronted her doctor the next day regarding this issue, he promptly eliminated some of her medicines and slashed the quantity of others, which resulted in the prompt cessation of her queasiness.

The only caveat when using RxList.com is that when you insert the name of the medication you are investigating, you must place an asterisk (*) in the search string (such as prozac*) if you are certain of your spelling. Otherwise, the RxList search algorithm finds drug names you were not looking for, since it uses “fuzzy” logic in its attempts to match patterns similar to your input.

Another plus for RxList.com is that it also offers an “RxList Pill Identification Tool,” which quickly identifies generic pills by their shapes and imprints, at www.rxlist.com/script/main/art.asp?articlekey=79140.

If you don’t have a computer, have one of your friends access the Internet to look up your medication before you fill a prescription.

I would like to share with you two other websites that I use to help me make a diagnosis. This is especially helpful if your doctor is stumped with what might be causing your medical condition.

The first is “The Merck Manuals Online Medical Library, Home Edition for Patients and Caregivers” at www.merck.com/mmhe/index.html and the second is the TRIP Database at www.tripdatabase.com/index. html. Each of these sites allows you to enter symptoms and then generates possibilities for a diagnosis. Of course, a Google search also may contribute to your analysis.

ITN readers who have no Internet access might consider acquiring the following books instead: “The Merck Manual of Medical Information, Second Home Edition” (2003, Merck Publishing. ISBN 0911910352) and “The Merck Manual of Health and Aging” (2004, Merck Publishing. ISBN 0911910360).

Checking the resources listed above can help ensure a journey free from mishaps caused by the wrong medication, the incorrect dosage or (heaven forbid) an erroneous diagnosis.

PHILIP WAGENAAR, M.D.

Contributing Editor