I take two meds, Toprol XL at 4:00 AM and Diovan HCT at 4:00 PM. I quite often forget to take the Diovan before I go to work and when I forget I just take the Diovan at the same time that I take the Toprol. Is this OK or would it be better to just skip the missed dose of Diovan? I've done it both ways without noticeable complications, but I was just wondering what the experts would suggest about missed doses.

I have thought about keeping a bottle of the Diovan at work for days that I forget to take it but it's kind of an expensive drug. I kind of forget a couple of times a week…

The prescribing information for Diovan HCT (a combination of valsartan (Diovan) and hydrochlorothiazide (HCTZ) is here [pdf]. Your question is chiefly one of pharmacokinetics, i.e., the way the drug levels respond to dosing.

Valsartan has somewhat rapid kinetics (quotes are from link above, essentially the package insert required by the FDA):

quote:

...with an average elimination half-life of about 6 hours...Valsartan does not accumulate appreciably in plasma following repeated administration.

So taking the pill a little sooner than scheduled shouldn't really be a problem. What if you wait too long? Also not a problem:

quote:

Abrupt withdrawal of valsartan has not been asssociated with a rapid increae in blood pressure.

The hctz has somewhat longer kinetics:

quote:

...elimination half-life is between 5.8 and 18.9 hours

But the amount of hctz in each pill is small, so occasional higher levels should be safe.

So I'd say it would be better to take the Diovan early rather than to skip a dose.

And all bets are off if you have abnormal liver or kidney function, or if you don't get enough potassium in your diet.

You should of course follow your doctor's advice, but you asked us.

Thanks Professor, That's good information. I don't always trust doctors. I think they must get a kickback from the drug companies for writing prescriptions so I like to ask around to get neutral advice. Pharmacists are even worse. Considering the pills are a dollar each, I doubt they would ever tell you to skip a dose.

RoverRoad, you sure do seem to have some "trust" issues working. First you don't trust President Bush to tell you the truth about everything. Then you say you can't trust the current Supreme Court nominee to adjudicate without regard to his personal political and business bias.

Now, you're telling us that you don't even trust doctors or pharmacists to give you their correct unbiased recommendations for medicines.

Well, all I can say is...I agree with you!

Dwight

I have no idea where I got this attitude from, but it's gotten me this far, so why change now?

Sounds to me you need a spouse who is a "care taker" personality, one who would ask you "did you take your meds?"

Rover, I have meds I take in the morning, and a somewhat didfferent group I have to take just before bed. I had a great deal of trouble remembering to take them, and then sometimes, remembering in mid-afternoon if I took them in the morning. My solution was to keep the meds in the pharmacy bag (white, with a big red logo) right next to the computer. Since the first thing I do every morning is turn the computer on, and the last thing I do at night is to turn it off, I almost always remember now. To help me remember when I last took them, I wrote with a black marker on the front of the bag " Last Taken in Morning." On the other side, I wrote " Last Taken at Night." It makes a huge difference.

Electronic Pill Dispenser Got a spare $150 lying around?!

Cool device! Maybe I'll rob my piggy bank and get one.

What I need is a pill dispenser that will throw the pill down my throat at the right times. This post just reminded me that I'm an hour and a half late taking the Toprol.

Can you somehow remind yourself via a computer message that shows every day at a certain time?

quote:

Originally posted by DorianGreyed:
Can you somehow remind yourself via a computer message that shows every day at a certain time?

That's a good idea. I know ASP so I can design a little web application. Hey, you're smart! You just gave me a new project to pass the time on my day off.