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Adherence tips
Simple forgetfulness is a common reason for missing doses of anti-HIV drugs, and this can cause them to fail. If you do forget to take your medication don’t be too hard on yourself, but do try to learn from the experience. If you are missing doses consistently, then discuss this with your doctor. It may be possible to make your schedule easier, or change to a more suitable combination.
Keeping a diary
Confusion over which pills to take when, and when food can be eaten or is to be avoided, may be a problem when starting a new combination. To avoid this, your doctor or pharmacist can provide a written daily schedule with your prescription, which you can tick off after taking your dose. Some pharmacists offer stickers for medication containers which have the same function.
Jogging your memory
If the problem seems to be about needing a reminder, then you might find a timer or alarmed watch useful. The Casio Data Bank has five programmable alarms. It costs around £20 and is available at several high street retailers. The alarms are saved in the memory so the watch does not have to be reset every day and an eight letter message can be set to scroll across the watch face with the audible alarm. Computer scheduling programmes can also be adapted for this purpose.
You can also get hold of a pillbox with a timer from Nick Linell (07957 147730) which costs £18.95 + postage and packaging. The Pill Meter II has two count down timers; useful if you have one set of pills that has to be taken every twelve hours and another every eight hours.
Storing & transporting pills
Medimax and Dosett boxes are examples of partitioned containers that you fill once a week or every few days with the individual daily doses. With some versions you can take out a single day’s dose, or several if you may be away for some time. Your HIV pharmacist or community nurse specialist should be able to provide one of these boxes free. Make sure that the box you’re getting is big enough and that you have checked with your pharmacist that all your drugs are suitable for storing out of their original container. Some pills deteriorate if not kept correctly. The bottle that indinavir comes in, for instance, contains small canisters that keep the capsules dry and stop them from leaking. You could also use a clear perspex ‘pill stacker’ from Muji, or even film canisters – but the same advice applies. A scheme called ACT is available to indinavir users through your clinic.
Some people keep doses in the different places that they could be when pill-taking time comes around, e.g. friend’s house, handbag, car. Make sure you store medication safely out of the way of children, and remember that extremes of temperature can damage most medications.
Overcoming difficulties
For some people, taking the pills can be a problem depending on their size, shape and texture. Always mention problems to your HIV pharmacist. There may be another preparation of the medication available, e.g. a liquid or powder that you might find easier to take than a pill.
Taking an accurate amount of liquid formulations can be a bit tricky. An oral syringe from your pharmacist will help with this process, but you do need to wash and dry them thoroughly between uses. To take a single dose with you when leaving home, ask your pharmacist for an oral syringe cap. Though this will allow you to fill the syringe before you leave, you will need something suitable to protect the plunger. Some people inject liquid formulations into gelatin capsules, which can be bought from health food stores. This can be a very messy process and ensuring that you take an accurate dose may be difficult, so discuss this with your pharmacist first.
Using a pill crusher can make some pills easier to take. These are available from your HIV pharmacist who will advise you if it is suitable for the drugs you are taking. Pill crushers look like small jars – put the pills inside and then screw on the top. This crushes the pills inside the container.