Tag: medicines

When pills and prescriptions run out . . .

Last day's worth of pills in pill box
“Oh dear,this is my last day’s worth of pills.”

How many prescription medicines do you take? When you add up all the pills, drops, injections, teas, lotions and medicinal oils for every member of the family – including pets – how many do you get?

Many families take dozens of pills and prescriptions every single week! Our ability to afford them aside, we have gotten accustomed to being reminded to refill our prescriptions. We count on picking up refills at the local pharmacy or getting them by mail, whenever we order them.

In an emergency, what will happen if you run out?

Will you be troubled  . . . or will your life, or the life of a family member, actually be threatened?

This Advisory has been inspired by a report I heard on the news last night. Actually, it was a phone call coming from a quarantined passenger on one of the cruise ships being held off the coast of Japan. “I ran out of insulin. And although the ship promised they were working on getting me more, it wasn’t happening. Finally I called on friends back home who got my prescription filled and mailed it to me here on the ship. I’m expecting it to arrive tomorrow.”

Going on a cruise isn’t normally considered an emergency! But as we have seen, anything can happen.

Let’s take a look at pills and prescriptions so an unexpected event in our lives doesn’t become a disaster.

Getting an extra supply of essential medicines.

Know what’s essential for you!

Over-the-counter drugs are easy enough. Just buy a few of the ones you take regularly and be sure they are in your Survival Kits or long-term Shelter-in-Place stores.

When it comes to the essential pills and prescriptions, talk with your doctor. Understand which pills you could discontinue without a severe reaction. (You may be pleasantly surprised . . .!)

Ask your doctor for an “emergency preparedness prescription” for 2 weeks or a month’s supply. At the same time, start now to apply for regularly-scheduled refills a few days early. Squirrel away a few extra pills at the end of each month until you have your stash.

Action Item: Try to get at least a 2 weeks extra supply of prescription medicines!

Storing pills and medicines safely.

Many pills have a statement on the label that says something like: Store in dark, dry place. Some eye drops say they need to be refrigerated. Directions on insulin may say “Store in refrigerator.” but the label may continue with something like, “If refrigeration is not available, store at room temperature.” Nearly all medicines have a “Use by . . .” date.

In an emergency you may not have refrigeration. You may not be able to control humidity. You may need to consider taking “out of date” medicines!

Action Item: Talk with your doctor or pharmacist to find out what options you have for safely storing and using your essential medicines.

Organizing your pills and medicines at home.

In our house everything was going along fine until Joe experienced an unexpected and severe reaction to a drug. We’re still coping with the aftermath – and one thing that has meant is managing over a dozen new pills, shots and medicinal creams! The list changed weekly for a while and still changes.

Keeping track of when to take what has been a major effort!

In a disaster, without electricity or communications, or maybe not even being at home, managing medicines will be even tougher. You may not be able to do it safely without a couple of tools.

Tool #1: Your medicines list

You can do this on paper, but using the computer will be a lot more efficient. Keep an updated list of ALL your over-the counter and prescription medicines as well as medicines you doctor doesn’t even know about, like laxatives or pain relievers. Keep your list with you at all times! (Put one on the refrigerator, too, for the use of Emergency Medical Personnel. Read about our Vial of Life program.)

List name of the medicine (generic and/or brand name), dosage, and what it’s for. If you have space, describe the pill (“oval, white”) so that someone else could take over if necessary.

Tool #2: Your medicines calendar

When you have to take six or seven pills a day, it’s easy to skip one, particularly if they all come at different times. When you don’t feel well, managing is harder. As you age, it may become impossible.

Set up a calendar NOW so you can be sure you haven’t missed anything. Be disciplined about marking the calendar each time you take your medicine.

You can create your own layout based on your own logic, but here are the top few rows of the one we’ve developed for our household. As you can see, there is room for 3 medicines per day. You may need more. We put a O in the square where a pill is needed, and then an X inside the O to show it was taken. (If several people need calendars, I’d print them on different color paper.)

Pill Calendar

Packing pills and medicines for a trip or emergency evacuation.

Again, here we’re thinking about having to manage medicines when you are away from home. Here are three recommendations – and I make them from experience!

Pill box or pill container – Actually, I use a pillbox at home, all the time. My own box has roomy compartments, with ergonomic compartments – smooth, no corners — one for each day of the week. (It’s the blue one in the image at the top of the Advisory.)

I can see in a moment if I’m up to date on my pills.

As I mentioned, Joe takes a whole collection of pills these days. He needs a pill box with compartments for different times of day.

Here are two larger boxes from Amazon that I’d consider particularly for travel use. The first is water proof, and the second is smaller, discrete and flexible!

AUVON iMedassist Weekly AM/PM Pill Box, 2nd Gen Portable Travel Pill Organizer (7-Day / 4-Times-A-Day) with Moisture-Proof Design and Large Compartments to Hold Vitamins, Supplements and Medication
Lewis N. Clark AM/PM Folding Pill Organizer + Supplement Case for OTC Medicine, Prescription + Vitamins – 16 Slot Pouch, Black

Individual pill packetsI have used these small baggies for a number of items when I travel – for pills, for herbs, even for (small) jewelry. (Each is about 2 in. on a side.) I tuck the small baggies into a larger see-through container, then just pull one out when I want it.

Ezy Dose Pill Packs | Pill and Vitamin Organizer Pouches | 100 Count | Disposable

Original prescriptions – I don’t know exactly how the woman on the cruise ship managed, but I have had my own experience with being unable to get a prescription filled without at least a copy of the original, showing when it was issued and the doctor’s signature. If you deal with one medical service or one pharmacy, they probably have a computerized record of all your prescriptions. (But if that pharmacy is impacted by the disaster, will the records be available?)

Action Item. Scan and store prescriptions in the cloud. Take pictures of the actual bottles, too. That way you’ll have them in your phone and you can blow up the pictures to read the labels more easily.

This Advisory has a lot of ideas, and your own list of things to do may be even longer. But when it’s a question of life and death of a loved one, the effort is worth it. Please share any of your own good ideas for managing pills and prescriptions on a regular basis or during emergencies!

Your Emergency Plan Guide team

Managing Medicines in an Emergency


Think for a moment. In your household,  how many people take prescription medicines?

In all, how many different pills or medicines do you keep track of on a regular basis?

Different colored medicines and pills

Last week, I told you about Joe’s episode with the allergic reaction. Since then, OUR list of medicines has grown exponentially! New pills with dosages that changes daily. Inhalers.  The doctors assure us it’s a temporary thing, but keeping track of them all is tough!

Managing medicines in an emergency will be so much more difficult!

Imagine how you’ll cope when your home is damaged by flood, fire or winds!

  • First, you have to find all those medicines.  If your home is severely damaged or you had to rush out, it may take a while, or you may not be able to rescue the medicines at all! Do you have an emergency supply packed up so you can grab it and take with you at a moment’s notice?
  • Next, to make sure no one is taking the wrong dose after an interruption, you will have to set up a new schedule. (Surely you have seen bottles that say, “Do not stop taking this medicine!” or, “If you miss a dose,  follow these important instructions . . .”) Consider people taking insulin. You need to know by heart what the appropriate response to missed insulin would be for YOU based on your condition and the type of insulin you take.
  • OK, you have no emergency supply, or you’ve used it up, and the emergency continues. You are searching desperately for a refill, but all the offices and stores where you usually shop have been shut down by the disaster, too. What can you do?

Here are some new resources for managing medicines in an emergency.

Find a pharmacy with RX Open

When Dorian hit a month ago, a website was activated that showed all the pharmacies that were open for business in every state in the southeast. Here’s the notice I got thanks to a post from Michael Smith that appeared in the LinkedIn CERT group. (Not a real clear image, sorry.)

Rx Open displays the precise location on Google Maps of open pharmacies, closed pharmacies, and those whose status is unknown. The site is maintained and is open to the public at no cost during a disaster through the support of Health Care Ready and the National Council for Prescription Drug Programs, (NCPDP) Foundation.

Of course, pharmacies have to sign up to be listed in the RX Open database.  Action item: Next time you head to your pharmacy, ask if they are members.

Get an emergency prescription refill.

Let’s assume you had an emergency supply of prescriptions, and were able to use it. But now you’ve run out. Your doctor is unavailable, and your usual pharmacy is still closed. What are your options for getting an emergency refill?

It turns out that some states have what are called emergency prescription laws. They vary, of course. But they all seem to require that first, an emergency be declared. Then, if a pharmacist can’t reach the usual doctor for authorization, a prescription may be refilled “if failure to refill might interrupt the patient’s ongoing care and have a significant adverse effect on the patient’s well-being.” (These quotes are from a statement issued in 2017 by the CA State Board of Pharmacy.)

This last paragraph applies to California, which seems to allow “a reasonable amount of the medicine.” Some states limit emergency refills to a 72-hour supply. Some states have NO emergency refill laws.

Action Item: Find out about YOUR state’s requirements regarding managing emergency prescription refills! Here are two places to start your research:

Store prescriptions safely at home.

A couple of reminders before we move on. I hope you’re familiar with these.

If you have specific medical conditions or allergies, consider wearing a medical ID bracelet. Essential in an emergency situation.

If you get regular medical treatments (for example, dialysis) find out what the emergency procedures are at your clinic and get a list of back-up service providers in case you need to get treatment in an emergency. Keep that list in your important papers.

Now, we’ve said it so many times. The most LIKELY emergency you’ll encounter will be a power outage. That means no refrigeration.

Your problem: medicines that need to be refrigerated! 

Here are some suggestions that we put into the new Disaster Survival Guide series Workbooks. Will any of these work for you? Build your own Action Item list.

  • Find out the safe temperature range for your medicines. (Some may not really need refrigeration.)
  • In an emergency, could a different formula of your medicine work, one that doesn’t need refrigeration? Check with your doctor on this!
  • If an outage is announced, be ready with an insulated cooler that you can promptly fill with ice to protect medicines for at least a few days.
  • Consider purchasing a solar-powered refrigerator/freezer and know how to use it in an emergency.

Below is an example of a solar-powered portable refrigerator so you can get an idea of size, capabilities, and cost. What to consider as you shop:

  • Capacity – Measured in quarts. How much space do your really need for your medicines?
  • Weight – While most portable refrigerators have wheels so they can be rolled, they are heavy to lift.
  • Temperature achieved – A number of the “camping” or “portable” refrigerators get down to -4 degrees, which is below freezing. The lower the temperature you require, the more expensive the refrigerator you’ll need.  “Cool” or “freezing” is the question.
  • Battery power – Some portable refrigerators have no battery. They simply  plug either into the wall or into the car battery for power. If you want solar, you’ll need a DC connection for solar AND a battery to store the power when the sun isn’t shining. (You’ll probably get an AC connection, too.)
  • Solar panels – The chest itself does not provide sufficient solar panel expanse (if it has any at all) to provide the cooling power. You will need to purchase companion panels (maybe  80 – 120 watt) at additional cost.

Click on the image or the link below to go to Amazon, where we are associates. This particular model of portable refrigerator/freezer has a lot more information below all the sales and comparison information, so scroll down to read it. There are pictures of a complete set-up (with panels and storage battery) and also a couple of homemade videos that I found very useful.

ACOPOWER P40A Portable Solar Fridge Freezer for Car and Outdoor, Lithium Battery Rechargeable with Solar/AC/DC/Car Port, -4°F True Freezing by LG Compressor, Portable Trolley Wheels (42 Quarts)

Thanks for reading, and taking action.

Your Emergency Plan Guide team

P.S. If I had a need for emergency refrigeration, I would probably keep the portable refrigerator pre-cooled all the time, using its electric hookup. Then in the emergency, use the solar to keep the frig “topped off.”

Survival Kit Missing Item


Prescription medicines

Do you recognize this warning?

Do you have basic survival gear packed and ready? The dozen or so basics plus personal items? Water for at least three days?

What about supplies for the longer term?

Enough for 10-14 days

We work on a 10-14 day plan, since that’s how long it could take in a widespread emergency for rescue workers and government agencies or the Red Cross to reach us. And when we look at that time frame, we see an immediate problem. It’s medicines.

Many prescriptions can’t be renewed in advance.

Most medical and pharmaceutical offices have a policy of not renewing prescriptions until the last possible minute – that is, not until the current supply is exhausted, or, at the most, 2-3 days before the last pill or dose is due.

On its surface this seems like a rational policy, and, of course, is probably the best way to manage inventory.

But, on closer examination, the logic breaks down completely. If the disaster hits when you’re down to your last 3 or 4 pills, you could be facing a compound emergency.

“Do not skip doses or discontinue.”

You may survive the disaster only to have created a medical emergency for yourself! How often have you seen a message like the one in the image:  “Do not skip doses or discontinue unless directed by your doctor.”

Power outages will make purchasing medicines impossible.

Following a major disaster, entire regions may be without electricity. This means ATMs, credit cards, and gas stations won’t be working. Mail won’t be delivered.

This also means medical offices and pharmacies, along with all other businesses in the region, may be closed entirely. It could be days or weeks before life returns to normal – and thus days or weeks before you can get your prescription refilled in the normal way.

Discuss this with your physician and pharmacist.

Could your first prescription be renewable after two weeks instead of only after 30 days? Or could the initial prescription contain enough for 45 days, and not just the usual 30? You’d then at least have a chance of having enough pills so you could continue your prescribed treatment even if your normal source of medicines is unavailable.

We suggest that you have this discussion with your physician and/or your pharmacist. Surely they will see the logic of your request — unless they simply don’t see the benefit of preparing for emergencies. You might want to put your request in writing to get “on the record” and give them something to work with.

Consider this fall-back strategy.

In the face of this problem, we order refills as soon as we can: in 25 or 26-day increments. This gives us the chance to build up an extra 14-day supply, 3 or 4 pills at a time.

We keep the extras in our survival kit, rotating them regularly to be sure they are fresh. Naturally, this means the kit has to be opened up and closed up again pretty often.

It seems a shame to have to “outwit the system” this way, but when health (or even survival) is at stake, it’s simply necessary.

Don’t overlook this survival kit item.

If you know friends or family dependent on medications, send this post to them and suggest they print off a copy for their doctor and their pharmacist. And encourage them to consider how they will get that extra 10-14 days’ supply of prescription medicines to keep them going in an emergency.

Emergency Plan Guide
Joe Krueger and Virginia Nicols