The medicine isn't working—what a pharmacist is thinking when that happens

Introduction

"This isn't working for me."

When I am told that,
several checks run through my mind almost simultaneously.

When did you start taking it?
How are you taking it?
What symptoms are you using it for?
Are you taking anything else?

In this article, I would like to share that process
with you exactly as it is.

If you know what a pharmacist is looking for
when you feel like a medicine "isn't working,"
consulting with your pharmacist will become much smoother.

Key points of this article

• When you feel like a medicine "isn't working," the pharmacist first checkshow you are taking it and how you chose it

• There are medicines that "work in one dose" and types that "work by taking them continuously."

• Whether a medicine suits your body is something thatcan only be known by trying it.

• The experience of a medicine "not working" isinformation that serves as a clue for the next step

• If you have underlying conditions, take multiple medications, or have severe symptoms, go to a hospital first

This article is suitable for people like this

• Those who often choose and take medicine on their own

• Those who still have symptoms despite taking medicine and are unsure what to do

• Those who don't know what to tell their pharmacist

If you fall into these categories, please go to a hospital first

• Those who have underlying medical conditions

• Those who usually take multiple medications

• Those who are experiencing severe symptoms that are different from usual

This article is written for those who are trying to overcome minor ailments with medication.
If you have an underlying medical condition, please prioritize seeing a doctor over self-judgment.

What a pharmacist checks first: "How it's taken"

When I hear that a medicine "doesn't work," the first thing that comes to my mind,
even before the contents of the medicine,is how it is being taken.

Are you taking it after meals, before meals, or between meals?
Are you taking it with water, or with another beverage?
How many days has it been since you started taking it?
How many times a day and how many tablets are you taking?

I check these things,
not because I am suspicious.

It is because the effectiveness of a medicine can change significantly depending on how it is taken.

For example, while there are medicines that are absorbed better when taken on an empty stomach,
there are also medicines that are absorbed more effectively when there is food in the stomach.

Taking medicine with something other than water
can also affect how well the medicine works more than you might think.

Just as there are medicines whose effects become too strong when combined with grapefruit juice,
there are some medicines whose absorption changes depending on the beverage.

This is the first thing I want to check.

What to check next: "The mismatch between medicine and symptoms"

If there doesn't seem to be a problem with how it's being taken,
the next thing I consider iswhether the medicine matches the symptoms.

Medicines that contain multiple ingredients, like cold medicine,
are designed to handle various symptoms—headache, runny nose, cough, fever—
a little bit at a time.

While convenient, the downside is that
the power to pinpoint the most painful symptom tends to be weaker compared to specialized medicine.

"My runny nose stopped, but the cough remains."

This is a common story,
and it is often the case that the medicine didn't "fail to work,"
but rather that the symptoms the medicine is best at treating
and your main symptoms were slightly mismatched.

"Medicine that works in one dose" and "medicine that works over time" are different types

This is also something that is surprisingly not well known.

There are broadly two types of medicine.

A type that you take when symptoms appear and works within the same day.
And,a type that works gradually by taking it every day.

If you take it without knowing which type it is,
it is easy to misunderstand that it 'doesn't work'.

The 'take when symptoms appear' type

Pain relievers and fever reducers taken for headaches or fevers fall into this category.

The effect kicks in about 30 minutes to an hour after taking it,
and it leaves the body after a few hours.

The basic way to use it is to 'take it only when necessary',
and if it doesn't work after one dose, it is a sign to consider a different medicine.

The 'take every day' type

Hay fever medication and stomach medicine to suppress stomach acid fall into this category.

By taking it every day, the concentration of the medicine in your blood
gradually stabilizes.

Only when it reaches that state does it become fully effective—

Thinking 'I took it once but nothing changed' is
perfectly normal for this type of medicine.

Stomach medicine to suppress stomach acid often reaches
its maximum effect about 3 to 5 days after starting.

Hay fever medication becomes more stable in its effect
by starting to take it before symptoms appear.

It is common for a medicine that you 'gave up on after one dose'
to actually be a 'continuous use' type.

When the way you take it and the choice of medicine are fine—the issue of 'individual differences'

The way you take it is correct, and it matches your symptoms.
Even so, there are cases where it doesn't work.

At times like this, what I think of isindividual differences.

Even if you take the same medicine in the same amount,
the way it works in the body can differ from person to person.

This is due to differences in genetic constitution,
because the speed at which the body breaks down medicine varies by individual.

People with a constitution that breaks it down quickly
may have the medicine leave their body before it can take effect.
People with a constitution that breaks it down slowly
may experience a strong effect even with a small dose.

It is said that the percentage of Japanese people who have this 'type where effectiveness varies easily'
is higher than in Western countries.

There are parts of "whether a medication is right for you"
that cannot be known for sure until you try taking it.

Therefore, even if the first medication didn't work,
it is not your fault, the medication's fault,
nor was it a poor choice.

It simply means thatyou have gained one piece of information:that the medication and your body were not a good match.

"It didn't work" is a clue for the next step.

There is something I want to tell you here.

The experience of a medication not working is
not a "failure," but "information."

Once we know that the medication was insufficient,
we can try a different option next.

Even in medical practice,
if the first medication does not produce sufficient results,
switching to another medication or changing the combination
is something written in treatment guidelines.

"I wonder if it's okay to come and say it didn't work."
You don't need to be that hesitant.

For a pharmacist, a report that "it didn't work" is
one of the most helpful pieces of informationafter all.

Things I want you to tell me

When you tell me "it didn't work,"
it becomes much easier to answer if you have this information.

• When you started taking it

• How many times a day and how many tablets you took

• When you took it, such as after or before meals

• Which symptoms remained and which symptoms settled down

• Whether you were taking other medications, foods, or supplements at the same time

And when describing symptoms,
I would like you to tell me "how" as much as possible.

Instead of "I have a headache," say "The back of my head throbs after meals."
Instead of "My stomach feels sick,"
say "About 30 minutes after taking the medicine, my pit of the stomach feels achy."

The more detailed you are,
the more clues it gives the pharmacist.

Information that makes you wonder, "Is it okay to ask about this?"
is actually what we appreciate the most.

Conclusion

When medication doesn't work,
many people seem to think, "Is something wrong with my body?"

But when we pharmacists hear that it "didn't work,"
there is nothing to blame you for.

It just means there are more things to check,
and we simply start thinking about "what we can do next."

Medication is something you take, discuss, and adjust.

"It didn't really seem to work."

We can start from that one sentence.

If you reach out to us, we will think about it together.