Taking Your Medicine Correctly After Discharge from the Hospital

Republished August 13, 2024

If you or a family member has been hospitalized, the first few days after returning home can be confusing. You may have prescriptions to fill for new medicines. You may need to restart some medicines or stop others that you were taking before your hospitalization. Or you may need to take these medicines in different doses, or at different times. These changes may cause you to make a mistake as you try to figure out what medicines to take or how to take them now that you are home.

Just before you leave the hospital, your nurse or pharmacist should review with you a list of medicines to take at home. Because you may have a lot on your mind, what they tell you may seem clear then; but once you are home, you may have questions. You may forget which medicines your nurse already gave you on the day you were discharged. So you might take an extra dose of medicine when you first get home or omit a dose that you should have taken. If your doctor prescribed a new medicine, you may not know whether it replaces an older medicine that should be stopped. Or you may find that you misplaced a prescription or never received one for a new medicine. You may also need a prescription for an existing medicine that you need to take in a different dose.

The directions you were given could also be confusing if the doctor or nurse told you how many tablets to take (e.g., 2 tablets), without also telling you the actual dose (e.g., 10 mg). Because of space limitations, hospitals may stock only one or a few strengths of each medicine. For example, a hospital may stock only 100 mg tablets of Seroquel (quetiapine). Seroquel is a common medicine used to treat bipolar disorder. A patient who needs a 200 mg dose of Seroquel would therefore be given two of the 100 mg tablets at the hospital. But, for home use, the patient would typically take just one 200 mg tablet. When the patient leaves the hospital, they may be told to take two tablets of Seroquel for each dose, since that is what they were taking in the hospital. But two of the higher dose tablets they have at home would be, in this example, equal to 400 mg.

Similar errors can occur with split tablets, as happened in the following case. A woman received half of a 1 mg tablet (which equals 0.5 mg) of Risperdal (risperidone) twice daily while in the hospital. She was told to continue taking half a tablet twice each day at home. But Risperdal, another medicine used to treat bipolar disorder, also comes in a 0.5 mg strength tablet. Before going to the hospital, the woman had been taking one of the 0.5 mg tablets for each dose at home. But upon discharge, she followed the new directions to take half a tablet twice each day. She therefore received only 0.25 mg with each half tablet, not 0.5 mg as prescribed.

Here's what you can do: If you or a family member is hospitalized, follow these guidelines to avoid making mistakes with your medicines after discharge.

Before discharge

• Ask your nurse to review with you clearly written instructions about all the medicines you should take at home. Be sure you know which medicines need a prescription and which can be bought over-the-counter(OTC).
• Ask your nurse to compare (reconcile) the list of medicines you should take at home to a list of medicines you were taking before you were hospitalized. If you don't have a list with you, your nurse should have a list that you or your family provided upon admission.
• Ask your nurse if you should stop or restart any medicines you were taking at home prior to hospitalization.
• If a medicine is new, or a dose has changed for a medicine you were previously taking, be sure you receive a new prescription. Ask if the new medicine replaces any medicines you took before being hospitalized.
• Ask your nurse to write down the medicines (including doses and times) you received on the day of discharge. Also ask them to write down when you should take the next dose of each medicine on the list.
• If the directions you are given for taking your medicine include multiple tablets or half tablets, be sure the total dose you should betaking is also provided. For example: Seroquel, two 100 mg tablets (200 mg per dose) daily. Risperdal, half of a 1 mg tablet (0.5 mg per dose) twice daily.
• Ask your nurse to write down the telephone number for the nurses' station so you can call in case you have questions about your medicines during the first few days at home.

After discharge

• If you have questions on how to take your medicines, don't hesitate to call your hospital nurse, doctor, or local pharmacist.
• When filling a new prescription, tell your pharmacist about any OTC medicines, vitamins, or herbals you are taking, as well as any prescription medicines that were stopped.
• When filling a new prescription, ask to speak with the pharmacist so you can learn as much as possible about any new medicine.
• Properly dispose of any older medicines you are no longer taking.
• If the dose of an existing medicine has been changed, bring the prescription bottle containing the older strength tablets/capsules to the pharmacy so the directions for use can be updated.