Tips for Coping

When You Need to Take Multiple Medications

Practical Tips

by Julianne Kim, RPH and Lisa Zhu, RPH*
(Spice It Up! Issue Winter 2013/2014)

It is not uncommon for people with kidney disease to need to take several medications every day, and in fact, on average, they may require 8 to 12 different medications.1, 2 Often, this is because in addition to kidney disease, they have other medical conditions, and may be treated by more than one physician.1, 3

Managing multiple medications and remembering when to take them can be difficult, so here are some strategies we’d like to share with you to help make things easier.

Keep it simple!
Talk to your pharmacist or doctor about ways you could simplify your medications to make it easier for you to keep track of everything. Ask your pharmacist or doctor to review your medications periodically and reevaluate whether they are still all necessary… sometimes things change! Your pharmacist can also look at the timing of your medications and may be able to make things easier by reducing the number of times that you need to take pills each day. It’s also possible that some of your medications could be switched to a combination pill, which will help reduce the number of pills you take. Keep an eye on dates too – once in a while, go through all your medications to check for those that are unused or expired. We suggest to bring them back to your community pharmacy for safe disposal.

Knowledge is power!
Your pharmacist or doctor can help you to better understand the purpose of each of your medications and how you and your healthcare providers can ensure they are working the way they should.

Keep a list
Writing down a list of your medications with a schedule of when each one should be taken can help you plan your daily routine. If you need help preparing a schedule or want to review a schedule you have made, your pharmacist is the best resource.

Organizing your medications
If you are taking multiple medications, pill organizers that sort medications by day or time of day can be useful, and simple to use. Community pharmacies may offer a medication organizer pack service. Talk to your pharmacist about which product would be best for you.

Set a daily routine
If possible, take your medications at the same time every day and link your medication schedule with other daily activities. For example, you could schedule your pills around meal times, or, if a certain medication needs to be taken at bedtime, you could keep it on your night table to help you remember. If you need to limit your daily fluid intake, remember that any fluids taken with your medications count toward this limit. For medications that you only need to take on certain days, or those that require you to be closely monitored, using a calendar or diary to keep track of when to take them is a good idea.

Set up reminders
Take advantage of the many tools at your disposal to help you remember when to take your medications. You can use cell phone alarms, beepers, e-mail reminders or other devices to prompt you to take your pills. Your pharmacist can help you too, particularly with reminders on when to refill your medications. Many pharmacies offer refill reminder services via telephone or e-mail.

Get help from family and friends
Your family and friends are there to help! If you need a hand organizing your medications, or need reminders on when to take them, ask them to help you.

1. Laliberte MC, Normandeau M, Lord A et al. Use of over-thecounter medications and natural products in patients with moderate
and severe chronic renal insufficiency. Am J Kidney Dis 2007; 49:245-56.
2. Manley HJ, Garvin CG, Drayer DK et al. Medication prescribing patterns in ambulatory haemodialysis patients: comparison of
USRDS to a large not-for-profit dialysis provider. Nephrol Dial Transplant 2004;19:1842-8.
3. Stevens LA, Li S, Wang C et al. Prevalence of CKD and Comorbid Illness in Elderly Patients in the United States: Results From the Kidney Early Evaluation Program ( KEEP). Am J Kidney Dis 2010; 55 ( Suppl 2 ); S23-33.

*Both authors are clinical pharmacists in nephrology at Sunnybrook Health Sciences Centre in Toronto.

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