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Monday, April 6, 2015


To illustrate normal directions that, upon closer inspection, are unnecessarily long or redundant, I offer the following:

1. Zithromax Z-Pak--"Take according to package directions…until gone."
Okay, if they take it according to the directions, it will be all gone.

"Under redundant in the dictionary, it says 'see redundant'". (Robin Williams)

2. Prednisone Tapers and Medrol Dose Packs that end with "…THEN STOP or D/C".
If you give a patient exactly enough tablets to last the course, which the majority of these do, then on the last day, they will take their last tablet. Is it truly necessary to state "then stop"? Should it not be quite obvious? Even taking into account the Stupidity Curve, I have yet to receive a phone call that goes like this:

CP: How may I help you?
Taper Taker: I have a question about my steroid.
CP: Okay.
TT: It said to take 4 for 3 days, then 3 for 3 days, then 2 for 3 days, then 1 for 3 days.
CP: Okay. That's a statement, not a question.
TT: I received 30 tablets.
CP: Again, statement.
TT: Well it's been 12 days and I took them all.
CP: You're getting there. I can almost hear the inflection that alerts me to an audible question mark.
TT: What do I do now?
CP: What do you mean?
TT: I followed the directions for 12 days. Now what do I do?
CP: Be well? Live long and prosper?
TT: I need direction in my life.
CP: Had I taken the time to put "THEN STOP" on your label, would that have been sufficient to prevent this call?
TT: Yes. Then I would have known exactly what to do.
CP: Okay. Please stop.
TT: The medication?
CP: No. Calling me.

My partner received a prescription for this same Prednisone taper while I happened to be cherry picking  the e-rx queue. Her directions ended up reading:
"Take 4 tabs for 3 days, then 3 tabs for 3 days, then 2 tabs for 3 days, then 1 tab for 3 days then stop taking because, quite frankly, you will be out of medication so even if there were more directions, you wouldn't have any medication left."

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