Medicines are usually prescribed by a doctor. However, other healthcare professionals can also prescribe medicines including:
I have an appointment with a healthcare professional to discuss a problem. Is a medicine the best treatment option for me?
The healthcare professional will listen to what you say about your problem, and may examine you or do some tests, before deciding what treatment, if any, you need. In some cases, you may not need medicine and the healthcare professional may:
- reassure you that there is nothing to worry about
- advise you on lifestyle choices (e.g. healthy diet, less alcohol and more exercise)
- suggest other types of treatment (e.g. physiotherapy)
- advise you to keep a check on your symptoms and make another appointment if they don't get better
If I need a medicine, how does the healthcare professional decide which medicine to prescribe?
If you need a medicine, the healthcare professional will speak to you about your options and listen to what is important to you.
They'll firstly consider the type of medicine you need (e.g. medicine for high blood pressure or pain relief). Sometimes, more than one medicine can treat a medical condition. The healthcare professional will advise on the most appropriate medicine from the different medicines available to treat your medical condition. If you decide that you want to take the medicine your healthcare professional will also advise on the best dose of the medicine for you. To help decide which medicine and dose will be best for you, the healthcare professional will consider your opinions, preferences and many other things, for example:
- any findings from examining you or from tests that have been done
- your age and family history
- other medical conditions that you already have (including how well your kidneys and liver are working)
- whether you're pregnant or breastfeeding
- any other medicines you're taking (including herbal medicines and medicines you buy yourself) and how these might react with a new medicine
- the likely benefits of a medicine
- whether it's safe for you to take the medicine (including the possible side effects and risks of a medicine)
- any treatment guidelines for your medical condition
Your healthcare professional can advise you on the likely benefits and possible risks of your treatment options and how likely these are to happen to you.
The healthcare professional will usually prescribe a medicine by its generic (chemical) name instead of by its brand name (for example ibuprofen rather than Nurofen®).
The healthcare professional will also usually choose a medicine that is included in your health board’s local 'formulary'.
What is a formulary?
A formulary is a list of medicines that are available for routine use in a health board. It offers a choice of medicines for healthcare professionals to prescribe for common medical conditions.
The list of medicines is usually accompanied by other information (e.g. treatment guidelines for medical conditions) to help healthcare professionals make decisions when treating an individual.
Clinical experts in each health board consider whether to add new medicines to their formulary. They use advice published by the Scottish Medicines Consortium (SMC). When SMC considers a new medicine for the NHS in Scotland, it looks at:
- how well the medicine works
- which patients might benefit from it
- whether it's as good or better than medicines the NHS already uses to treat the medical condition
- whether it's good value for money
Sometimes established medicines are a better choice than new medicines. If clinical experts in your health board decide not to make a medicine available for use, other medicines are usually available on the formulary to treat the specific medical condition. However, if you would like to be regularly updated regarding which medicines have been accepted, SMC publish a monthly decisions release in their latest news section.
Health boards publish their formulary on their website.
Can I be prescribed a medicine that’s not on my health board’s formulary?
If a medicine is not included on your health board’s formulary and there's no suitable alternatives on it, a healthcare professional can request to prescribe another medicine if they think you'll benefit from using it.
All health boards have procedures in place to consider requests when a healthcare professional feels another medicine would be right for a particular person.
How can a medicine benefit me?
A benefit is the way a medicine may help you.
Examples of likely benefits of medicines include:
- treatment of a long term condition (a medical condition which lasts more than one year - e.g. asthma, epilepsy or diabetes)
- treatment of an infection
- relief of symptoms (e.g. constipation or hay fever)
- being pain free or having less pain
- being more mobile or being able to do more physical activities (e.g. walking, sports or gardening)
- reduced risk of an early death (e.g. from stroke or heart attach by lowering cholesterol or blood pressure)
Some medicines are given as a short course of treatment (e.g. antibiotics to treat infections). Other medicines may be taken longer term, even if you don't have any symptoms (e.g. medicines for high blood pressure or insulin for type 1 diabetes).
Not everyone gets better with a medicine. Sometimes you may need to try different medicines to find the right one for you. Sometimes a medicine can stop working as well as it did. You can talk to your healthcare professional if you don't think your medicine is working or if you're worried about side effects. You should also tell your healthcare professional if you don't want to take a medicine, even one that may have benefits for you.
What risks are there with taking medicines?
Risk is the chance of harm from a medicine. All medicines can cause harm. Some medicines can cause more harm than others.
Examples of possible risks of medicines include:
- getting side effects
- a new medicine reacting with other medicines, alcohol or some foods
- not getting the results that were expected from a medicine
- suddenly stopping some essential medicines without talking to your healthcare professional
You may be at increased risk if:
- you're under 18 or over 70 years of age
- you're taking more than 5 medicines or are taking some combinations of medicines
- you'e more than one medical condition
- your kidneys or liver don't work properly
Your healthcare professional can help you understand about the risks and what you can do to reduce them.
You may also come to harm if you don't take your medicine as prescribed. For example, if you've been given an antibiotic for an infection, it's important that you finish the full course of treatment, even if you start to feel better after a few days.
What do a medicine's benefits and risks mean for me?
You'll have your own views about medicines and how taking a medicine fits in with your daily life. You may be unsure about the benefits and risks of taking a medicine.
People may have different opinions and preferences about what is important to them when taking a medicine (the benefits) and about the side effects they're willing to accept from a medicine (the risks).
Side effects can be unpleasant but you may be more willing to live with them if the medicine gives you benefits that are important to you. This depends on your circumstances and what matters to you. For example, some medicines for depression can cause drowsiness which could help if you can't sleep.
You can talk to a healthcare professional about whether a medicine is right for you. You should tell them about the things that matter to you (e.g. how your symptoms affect your quality of life or worries about getting side effects from medicine).
How can I get the best from the consultation with my healthcare professional?
You might want to ask some questions such as:
- Why do I need the medicine?
- Are there other treatment options and how will they help me?
- What are the benefits of each treatment option and how many people do they normally work for?
- What are the side effects of each treatment option and how likely are they to happen to me?
- Will the benefits or side effects reduce with time?
- How will I know if the medicine is working?
- How long will it take before the medicine starts to work?
- Do I need any check-ups for my medicine or medical condition?
- What will happen if I decide not to start the medicine?
Asking these questions will help you get the right information to make decisions about your health.
I've been given a medicine and I’m not sure how to take it. How can I find out how to take the medicine properly?
You can ask a healthcare professional at any time if you've questions about your medicine. They'll advise you how to use the medicine safely by explaining:
- what the medicine is called
- what it's used for
- how you should take it
- possible side effects
- whether you can stop any of the other medicines you're taking
It's important that you follow the advice you've been given on how to take your medicine so you take it safely and get the most benefit from it.
You should also get a leaflet with your medicine. The leaflet will give you more information about the medicine. You can ask a healthcare professional to explain anything about your medicine you're unsure about.
A credit card sized Not Sure? Just Ask! card contains some useful questions for you to ask about your medicine. It's available from the Scottish Patient Safety Programme website.
Your medicines have been prescribed specifically for you. Even if two people have the same medical condition they may not be able to take the same medicine so:
- never share your medicines with anyone
- don't take medicines that have been prescribed for other people
A community pharmacist can give you information on medicines you have been prescribed or would like to buy. They can advise you how to get the most from your medicine.
I don’t think my medicine is working. What should I do?
If you don't think your medicine is working properly, you should speak to a healthcare professional.
The healthcare professional will talk to you about your medicine. They'll check that it's working for you and may suggest some changes to your medicine or how you take it. You should follow the advice you've been given on how to take your medicine so you get the most benefit from it.
Some medicines don't work immediately. For example, it may take a few days before you start to feel better if you've been given an antibiotic or it may be a few weeks before you feel better with some medicines used to treat depression.
Do not suddenly stop essential medicines without talking to your healthcare professional. Some medical conditions have no symptoms (e.g. high blood pressure) but taking your medicine helps reduce the risk of an early death (e.g. stroke).
I think I'm experiencing side effects from my medicine. What should I do?
If you experience any side effects and are worried about them, you should speak to a healthcare professional. They'll be able to advise you what to do.
The leaflet which comes with your medicine will give you information on possible side effects of the medicine. All medicines can cause side effects. Some side effects are very rare but some can be more common.
You and your healthcare professional can report side effects through the Yellow Card Scheme which is run by the Medicines and Healthcare Products Regulatory Agency (MHRA). The Yellow Card Scheme helps the MHRA monitor the safety of medicines.
You can also use the Yellow Card Scheme yourself, or on behalf of a person in your care, by:
- making a report on the Yellow Card Website
- downloading the free Yellow Card Mobile App from the Yellow Card Scotland website
- calling 0808 100 3352 to report an adverse effect over the phone (weekdays 10am to 2pm)
- asking your pharmacist for a Yellow Card form which you can send by FREEPOST
I have medicines I no longer need. What should I do with them?
You can take medicines you no longer need to a community pharmacy. They will destroy them safely for you.
You should not flush medicines down the toilet or put them in a household bin. All medicines should be kept out of the reach of children.
If you have a repeat prescription, only order the medicine you need and tell your healthcare professional if you no longer take any of the medicines.