Missing a dose of medication

Hey all,
I was always a little anxious about missing a dosage and even with 2 reminders set on my phone I missed a dosage either yesterday or today. Somehow it felt like I had taken my Entercavir this morning but on doing a stock count this evening I realised I’ve got an extra pill!!!
I usually take it at 8:30am and it’s about 7:15pm now, should I take one now even though I’ve just had dinner? Or just go back to routine with tomorrow’s dosage.
Are there any advice on such occurences for future reference?

  • Like when is the latest I can take a skipped dose (10-12hrs before the next one?).
  • Are there any repurcussions from missing a single dose evidenced in any studies?
  • Should I take one now and risk a possible double dosage (if I had missed yesterday’s dose)

Thanks!

Hi @Jonathan medical wise our medical experts in team can give you a suitable answer but I had the similar issue last year with my TDF dose. Last year I had typhoid fever and was put on medications. For 3 days I was in sever fever and couldn’t recognize my surroundings. My wife was giving me the Typhoid fever medications skipping the daily TDF dose.

After 3rd day I was on my own and used the typhoid 2 weeks medications skipping almost 10 days the dose of TDF considering it extra medicine in this period. Even my doctor had not told me what to do if I miss the dose and how important it is to use regularly.

Since then I started back my daily doses but having constant sever liver pain. I doubt I might have developed resistance to this medicine due to missed doses. Did not yet consulted Dr. in INDIA due to COVID 19 travel restrictions while in our country (Afghanistan) there is no gastroenterologist to consult with.

So I recommend to regularly take your doses and don’t miss it.

Hi Jonathan, the general advice is to take your skipped dose as soon as you realize it - for example, if you normally take it in the morning and realize at night that you forgot it, then take your med as soon as you remember. You can then modify the time of your next day’s dose by moving it to lunch or early afternoon (to allow more time between doses). Then the 2nd day resume your normal schedule. Ideally, you don’t want to skip a dose in a 24 hour period. But having been on treatment for more than 15 years, I can confess that I’ve forgotten doses and have been ok. And I’ve also missed doses when my mail order prescription company messed up delivery of my hep b drugs and I had to take my pills every other day to ensure I had enough until they were delivered. According to my liver specialists, it’s going to take more than a few days of missing doses to have liver problems. The problem is if a person routinely or regularly misses doses or skips doses to save on prescription costs. So please don’t panic if you accidentally miss a dose. Just don’t make it a habit! :slight_smile: Always, Joan

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Hi!

Try taking your medication at breakfast time, that way if you miss it you have the rest of the day to catch up. Also, it get done before you start your day and most likely you eat breakfast at home.

It works for me, hope it will work for you.

Espi

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No problems from missing just a dose, anti-HBV drugs have very high forgiveness

Hi @Jonathan, I agree with most of what has been said, particularly from @Joan_Block and @PLampertico. While you should maintain your daily dosage, the occasional missed dose will not matter much.

Personally, I set up my google calendar to send me a notification and an Email. The notification I’ll get from my phone, and I will delete the Email right after I take my pill. That way, if I still see the Email in my inbox later on during the day, I will be reminded.

I also always maintain at least a month’s worth of meds in reserve, which helps minimise stress over availability.

I tend to forget when I am doing something in the morning that is not my daily routine (e.g. being on holiday). I cope in two ways: 1) really making sure that the pills are by my bedside, keys, or phone in these instances to remind me; and 2) not taking many holidays :stuck_out_tongue:.

Hope this helps!

Cheers,
Thomas

Sorry to hear @Abdul Abdul and thanks for the advice. COVID 19 has caused some real complications for a lot of us with Hep B, hope you find some answers soon!

Thanks @espiw I do take it first thing in the morning, mostly so I can squeeze in a breakfast before work! But you also pointed out another good benefit I hadn’t thought about, thanks!

Thanks as always for the wonderful insight @Joan_Block That’s a great way to go about a late dosage, I hadn’t heard of that at all in what I’ve read so far! I was quite relieved to hear I’m not the only one. I’ll be trying my best to not forget again but we’re only human after all. And like you say, in over 15+ years this is bound to happen more than once or twice. Thanks @PLampertico as well for confirming this. I didn’t know that anti-HBV drugs were so forgiving.

Thanks @ThomasTu I hadn’t thought about keeping a reserve. I had been advised by the pharmacist to go onto MedAdvisor and I’ve been keeping a track of my meds and ordering them on there since going on medication. I usually reorder 7-10days before my meds run out but I might start doing it a bit earlier than that.
I do have an alarm at 8:30 to take the medication and then one at 9:15 to remind me. We’ve fostered a cat last week and trying to look after him threw me for a complete loop. The days seemed blurred together which is why when I saw my alert still there on the phone I thought I had taken it :frowning: This will serve as a good lesson to put my own oxygen mask on before trying to look after anyone else.
Glad to see I’m also doing the right thing by keeping it by my bedside so I’m always aware of it when I wake up. And holidays, who needs holidays :stuck_out_tongue:

Thanks again everyone!

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Hi Jonathan, one more “geriatric” piece of advice is to buy a small 7-day pill storage container (most drug stores sell them) and place a week’s worth in. Then you can visually see whether you forgot a pill or not. I started using one 15 years ago when I was just “middle aged,” which felt silly. But it really works since you can see directly if the pill is in the box or not. Thanks again and really glad we could all reassure you that we’re all human! Always, Joan

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