1. Raise cost concerns

Don't hesitate to discuss the cost of medicines with your doctor. Unless you bring it up, your doctor may assume that prescription cost is not a factor for you.

2. Ask why

Always find out why he or she is prescribing a drug. And ask if the drug is FDA-approved for your condition or is being prescribed "off-label," meaning for a purpose other than the ones for which the FDA has certified that it is beneficial. If the drug is being prescribed off-label, ask your doctor about the evidence that shows it will work in your case.

3. Pay little or no attention to drug ads

Granted, the ads can be helpful in telling you when a new medication comes on the market. But don't assume that just because an ad sounds impressive that the drug is really a huge advance over existing medications. Often, it's not.

4. Recognize free samples for what they are

They are given to doctors by drug companies primarily as a marketing tool. But they may or may not be the best choice for what ails you.

5. Don't buy generics from non-U.S.Internet pharmacies

Brand-name drugs are often less expensive on Canadian and European-based sites. But generic drugs are not usually any cheaper on such sites.

6. Watch for problems associated with "polypharmacy"

About half of people over 60 take two or more medicines, and 10 percent take seven or more. But drugs sometimes interact in dangerous ways. So if you take three or more pills, schedule a "medication review" with your doctor. And when you fill a new prescription, ask your doctor and your pharmacist if it interacts with any of your existing medications.

7. Be cautious about supplements too

Some supplements can also interact with drugs, so ask about that possibility as well. In fact, it's a good idea to keep a list of all your medicines and supplements so you don't have to rely on memory to recite them.

8. Ask your doctor about splitting pills

We don't mean to skimp on the dose! But often it does save money to get a prescription for pills that are twice the dose you need and then cut them in half using a pill splitter.

9. Remember that older drugs are often just as good

The evidence is now convincing that many older drugs available as low-cost generics are as good as, or better than, the pricey new ones coming on the market.

10. Know that drugs within a class or group aren't always that different

Drug makers argue that each drug is unique and that each person may respond differently to it. That's true, but it's also true that in some classes of medicines, there are several drugs that achieve pretty much the same results for most people. In other words, you can substitute one for another.

11. Report any bad side effects immediately

Even the lengthy and detailed tests that a drug must pass to reach the market do not always turn up all its problems. Sometimes, adverse side effects are so rare or so subtle that they don't become obvious until years later—sometimes after hundreds of thousands of people have taken the drug. So keep that in mind as you start taking any new medication. If you have a bad side effect, alert your doctor. You can also file a report with the FDA under its MedWatch Adverse Event Reporting System. There's also a special reporting system for problems with vaccines; see www.fda.gov/cber/vaers/vaers.htm for information on that program.