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Avoiding Drug Interactions (Article 1)
Here's What You Need to Know

Do you see more than one doctor? Do you take more than one medication? Do you take over-the-counter (OTC) drugs, nutritional supplements or herbal remedies, as well as prescribed medications? Do you drink alcohol?

If the answer to any of these questions is “yes,” you may be at risk for drug interactions.

Some drug interactions can actually be beneficial, and two drugs may be purposefully prescribed together by your physician for improved health or fitness. However, unintended drug interactions not prescribed by your physician can cause serious problems. TRICARE and Express Scripts offer the following information to help you and your family avoid harmful drug interactions.

Lots of Possibilities for Interaction
Medications can interact with a variety of substances—not only other prescription and non-prescription medications, but also vitamins and minerals, herbal remedies, illegal drugs, alcohol, tobacco, caffeine and certain types of foods.

A lot of people think of herbal supplements as being natural and therefore, harmless. In the body, however, they act like drugs. Unfortunately, herbal supplements are not regulated by the U.S. Food and Drug Administration (FDA), so many have not been studied to determine how they may interact with various medications. In addition, the manufacturer is not required to put known interactions on the label.

Drug interactions can produce various effects. One drug, for example, may increase the effect of another drug—or decrease the effect, making it less effective or ineffective. Interactions can change the way your body absorbs, metabolizes or eliminates a drug.

A Few Precautions
It is important to:

  • Tell your doctor everything that you are currently taking—not only prescription medications, but also nutritional supplements, herbal preparations and over-the-counter (OTC) medicines. Also, be sure to tell your doctor if you drink alcohol or smoke.
  • Avoid taking multiple drugs whenever possible.
  • Regularly review your medical status with your doctor to determine whether you need to continue taking medications.
  • Read labels carefully to learn common side effects and interactions.
  • Limit the number of pharmacies you use for your prescriptions and OTC medications.
  • Never take medications intended for someone else.

It’s a good idea to make a list of all your prescriptions and anything else you’re taking before visiting your doctor. Then your doctor will have a written record for reference. Visit Express Scripts  for more information on your prescription drug benefit or call 1-866-DoD-TRRx (1-866-363-8779)

Medications Added to Uniform Formulary
Dr. William Winkenwerder, Jr., assistant secretary of defense for Health Affairs and director of TRICARE Management Activity, approved the addition of 11 new medications to the TRICARE Uniform Formulary.Additionally, he approved moving seven medications to non-formulary status.

The following medications have been added to the Uniform Formulary: Levitra® (PDE-5 Inhibitor); nystatin, clotrimazole, ketoconazole, miconazole, Mentax®, Naftin® (Topical Antifungals); and Rebif®, Avonex®, Copaxone®, Betaseron® (Multiple Sclerosis Disease Modifying Drugs).

Medications moved to non-formulary status include Viagra®, Cialis® (PDE-5 Inhibitors); and ciclopirox, econazole, Oxistat®, Ertaczo®, Exelderm® (Topical Antifungals). Formulary alternatives are available for these medications at a copayment of either $3 or $9.

The implementation date of the $22 copayment for medications moved to non-formulary for the topical antifungal medications was Aug. 17, 2005, and the implementation date for PDE-5 Inhibitors was Oct. 12, 2005.
For more information about formulary medications, their availability and cost, visit the TRICARE Formulary Search.
 

Here's What You Need to Know

TRICARE Reserve Select (TRS) was implemented on April 26, 2005. TRS is available to members of the Reserve Component (and their families) who commit to continued service in the Selected Reserve after release from active duty.

If you (Reserve Component sponsor) meet the following criteria, you may be eligible for this program:

  1. You were called or ordered in support of a contingency operation under Title 10 for a period of greater than 30 days.
  2. You served continuously on active duty for 90 days or more under such call or order. The length of time served determines the maximum period of coverage you may purchase under TRICARE Reserve Select.
  3. You agree to serve in the Selected Reserve for a length of time (in whole years) equal to or less than the period of eligibility for TRICARE Reserve Select.

You can find out if you qualify by visiting the Guard Reserve Portal.

If you qualify, purchasing TRS is a three-step process:

1. Enter into the Service Agreement
You must enter into the Service Agreement prior to leaving active duty.

2. Execute the Service Agreement
Next work with your Reserve Component to execute the Service Agreement. You must be in a Selected Reserve billet by the time TRS coverage begins.

3. Purchase TRICARE Reserve Select
After steps 1 and 2 are completed, download the pre-printed TRS enrollment form from the Guard Reserve Portal, follow
the instructions on the screen and submit it with a one-month premium ($75 per individual, $233 per family) to:
          Humana Military Healthcare Services, Inc.
          P.O. Box 105389
          Atlanta, GA 30348-5389

For additional information about eligibility and enrollment requirements, visit TRICARE Reserve Select.

For a complete list of TRICARE Reserve Select benefits and cost-shares, refer to the TRICARE Reserve Select Handbook, which is available online at TRICARE Reserve Select Materials or contact Humana Military at
1-800-444-5445 for more information.


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Last Reviewed:  December 4, 2007