Your prescription says, “Take once daily at the same time each day.” But the drug is expensive and sometimes upsets your stomach – and you’re feeling pretty good today. Do you really need to take it? Would it be okay to miss a day or two? The answer, says Lars Osterberg, MD, is to go ahead and take your prescribed medication doses. You may be feeling okay now, but skipping medication may set you up for bigger problems later.

If you’re taking medicine for chronic pain, for example, skipping medication can make pain harder to treat, says Osterberg, a clinical assistant professor of medicine at the Stanford School of Medicine and an expert in patient medication compliance. NSAIDS and analgesics, for example, are used as much for prevention as treatment. “When pain flares, it’s hard to knock it down again,” he says. “The same goes for inflammation. If you get behind the eight ball and inflammation builds up, it can be hard to suppress that inflammation and pain.”

To work best, some drugs need to remain at therapeutic levels – often over long periods of time – in the bloodstream. Taking them consistently is the best way to ensure that, says Dr. Osterberg. Taking a DMARD or biologic agent only on occasion does nothing. Missing medication doses causes blood levels of the drugs to plummet and can allow dangerous disease flares to occur.

If you are tempted into skipping medication because of side effects, ask your doctor about ways to minimize them, perhaps by taking the medicine with food or adjusting the medication dosage or time of dosage. If cost is a problem, see if you qualify for assistance. The Partnership for Prescription Assistance ( or 888/477-2669) provides information on more than 475 public and private assistance programs. Also, ask your doctor about switching to a generic or other less expensive medication. Even a less effective drug, taken regularly, may work better than the best drug taken hit or miss.