Hesperian Health Guides
Using antiseizure medicines
HealthWiki > Epilepsy and Seizures > Chapter 4: Medicines for epilepsy and seizures > Using antiseizure medicines
Contents
Measuring medicines
Medicines come as tablets, capsules, powders, or liquids. The amount of medicine in a tablet, capsule, or liquid is important to know so the correct dose can be given. The amount is indicated on the label or on a sticker on the medicine packet. Look closely—it may be in small print! The amount of medicine contained in each tablet or capsule is commonly given in grams (g), milligrams (mg), or micrograms (mcg). See below for information about measuring liquids.
When you combine the amount of medicine to take with how many times a day to take it, you get the daily dose.
If a medicine does not come in the exact amount you need, you may need to take pieces of a tablet or more than one tablet. It is usually too difficult to cut a tablet into more than 4 pieces.
Cutting tablets
 | |||
| 1 tablet (one whole tablet) | ½ tablet (half of a tablet) | 1½ tablet (one and one-half tablets) | ¼ tablet (one quarter or one-fourth of a tablet) |
If you need to cut tablets regularly, find out if you can purchase a small, inexpensive, pill-cutting tool to use at home.
Measuring liquid medicines
Doses for syrups, suspensions, injections in liquid form, or liquids taken by mouth will note how much medicine is to be taken, for example: 10 ml (milliliters) or 10 cc (cubic centimeters). A cubic centimeter is the same as a milliliter. Household spoons come in all different sizes and cannot be depended on as accurate measures. If a liquid medicine does not come with a special measuring spoon or dropper, take it to the pharmacy and ask them to measure exactly how much your spoon or small glass or container holds. Try as best you can to measure the exact dose of medicine.
When instructions for a medicine say: Take 1 tsp, this means: Take 5 ml.
How often and when to take medicine
Different antiseizure medicines are effective in the body for different lengths of time. Some have effects that are longer-lasting, while others have effects that wear off more quickly. By taking antiseizure medicine at the same time every day, you are better able to keep a constant level of medicine in your body, which helps the medicine work best.
Taking a dose of antiseizure medicine more often or in a larger amount than recommended may make you feel sleepy, dizzy, nauseous, or slow. It may give you a headache or make you feel distant or uninterested in things. But these may also be side effects of a correct dose of antiseizure medicine. If your medicine is causing these reactions and they are difficult to manage, talk to a health worker.
If you take medicine once a day, get in the habit of taking it before going to bed or when you get up in the morning. Unless the instructions specify a certain time, find a time that works for you that you will remember.
If a medicine needs to be taken two times a day, take it in the morning and 12 hours later in the evening.
If a medicine needs to be taken three times a day, take it 8 hours apart throughout the day. This may mean taking the first dose early in the morning or the third dose late at night.
If you are writing a note for someone about how much medicine to take each day and when to take it, pictures can be helpful. Draw instructions like these and explain that 2 times means 12 hours between doses, and 3 times means 8 hours between doses. Use the spaces under the pictures showing sunrise, daytime, and nighttime to show how much medicine to take. Explain carefully. For example:
| This means take 1 tablet 2 times a day. Take 1 tablet in the morning, and then another tablet 12 hours later in the evening. |  |
| This means take ½ (one-half) tablet 3 times a day. Take ½ tablet in the morning, ½ tablet 8 hours later during the day, and ½ tablet 8 hours later at night. |  |
| This means take 1 capsule 3 times a day. Take 1 capsule in the morning, 1 capsule 8 hours later during the day, and 1 capsule 8 hours later at night. |  |
Remember: Taking more medicine, or taking it more often, may not be better for your seizure control But it will make you run out of medicine faster
Swallowing whole tablets or crushing them
When taking antiseizure medicines as tablets, swallowing whole tablets with water is often recommended. Some tablets can be safely crushed and taken mixed in water. Others must not be crushed because it can affect how the medicine is absorbed in the body. Check with your doctor or health worker about whether a medicine is “crushable” and how best to do so.
Crushed tablets may taste unpleasant. Bad taste can be masked by eating something sweet, like jam or honey, immediately after taking the medicine.
Especially for children and others who have difficulty swallowing tablets and capsules, it helps to sit up or stand when taking medicine and also to drink some water immediately after. Avoid chewing or biting into tablets and capsules.
Taking medicine on a full or empty stomach
Some medicines are more comfortable to digest if taken with food, and others are better taken without food. Check the instructions or ask your health worker if it makes a difference for each medicine.
If the antiseizure medicine works best when taken on an empty stomach, take it:
- at least 1 hour before a meal, or
- at least 2 hours after finishing a meal.
If the antiseizure medicine works better with food, to help reduce stomach upset and diarrhea, take it:
- with a meal or right after.
Try to stick to the same routine daily to help keep medicine levels constant in the body. Listen to your body and pay attention to how your stomach feels. If you have stomach upset or diarrhea, talk to a health worker to see if there are changes to how you take your medicine that might help you feel better.
What to do about missed doses
Sometimes missing a dose of medicine cannot be helped. But when doses are missed regularly, the medicines may stop controlling seizures. If a medicine is missed after the body has gotten used to it, it can trigger a “breakthrough seizure.”
For some people, epilepsy causes memory problems that make it difficult to remember to take medicine. Ask friends or family members to remind you to take your medicine at the right times each day.
If for whatever reason you did not take your medicine, do not take twice as much for your next dose. If it is 6 hours or more until your next dose, take the missed dose as soon as possible. Otherwise, wait to take your next dose as scheduled and continue with the following doses on your regular schedule.
How to remember to take antiseizure medicines
Some people use meals, tea or coffee time, or bedtime as reminders to take their medicine. Others use charts, calendars, phone alarms, mobile phone apps, or weekly pill organizers, or they place the medicine in a spot they see every day. Family members and caregivers can support and encourage people with seizures to keep track of when to take their antiseizure medicine.
Use a weekly pill organizer
Many people use a pill organizer with 7 sections, 1 for each day of the week. They fill it on the same day each week. This way they know what medicine to take each day and can see if they took their medicines. Pill organizers can be made using wood, plastic, cardboard, or very heavy paper to make dividers in a metal tin. Each week, fill the 7 compartments with the pills you need for each day.
Link taking antiseizure medicine with a daily activity
Connect taking medicine with any activity you always do at the same time, such as:
- after brushing your teeth or bathing in the morning,
- when you hear a morning or evening call to prayer, or
- when a favorite television or radio show begins.
Turn the bottle upside down
If you take medicine in the morning, turn the pill bottle upside down before going to bed and place it where you will see it when you wake up. Seeing the bottle upside down will remind you to take your medicine. Then turn the bottle right side up so you know that you took it.
Use a calendar to track medicine
Find or make a calendar that shows each day of the week. Mark it when you take your medicine. A health worker might give you a chart to track your medicine use. You can show and discuss your chart with them during your follow-up visits.
Month: April