Two of the more frustrating and confusing words in pharmacy for patients are “prior authorization.” Patients hate it. It’s time consuming, but it’s a requirement by insurance companies for certain drugs.

What it means is your doctor must fax a form to the insurance company explaining why the doctor believes you need a particular drug. The patient with a prescription from a doctor can receive the drug without prior authorization, but will have to pay the full cost of the medicine. If the patient receives prior authorization, the insurance company will pay a share of the medication cost.

In some cases, your pharmacist will contact the doctor to let the doctor know that the insurance company requires prior authorization and supply the doctor with the appropriate number at the insurance company so the doctor can acquire prior authorization.

In those cases, it usually takes two to three business days for the proper forms to be completed so the prescription can be filled. If it takes longer, you might want to give your doctor a call to nudge things along.

In other cases, the pharmacist will tell the patient a prescription needs prior authorization, and it’s up to the patient to inform the doctor. Again, the process shouldn’t take any longer than two to three days after you have contacted your doctor.

Q. My child has begun taking amoxicillin for an ear infection and has suddenly developed diarrhea. Are they related and should I be concerned?

A. Yes and no. It is not uncommon for people taking this antibiotic to develop diarrhea. However, as long as it is not severe, it will not be a problem.

Q. My mother is experiencing incontinence, but she won’t wear Depends. It’s driving my husband and me crazy.

A. There are a number of drugs on the market that do give some relief. The most recent is Toviaz. Another drug, Detrol, has been around a while. Also, there are minimally invasive surgical procedures that you might want to investigate with a gynecologist. But I would consult with her doctor to discuss prescription medication as a first step.

Q. I am having trouble hearing in my left ear. It’s not severe, and I really don’t think I’m losing hearing. My wife suggests that I may have a wax buildup in my ear. Is there anything over the counter I can take for it?

A. My recommendation is Debrox. It can be found in the ear/eye section of most every pharmacy. Use the included dropper to place five to 10 drops of Debrox into your ear. Keep the drops in your ear for several minutes. Keep your head tilted, or place a cotton ball in your ear to prevent the drops from draining prematurely. Place a clean tissue over your ear and tilt your head sideways to drain the drops and earwax from your ear.

Q. My boyfriend and I are planning an island getaway. I will be outdoors a lot. Are there any medications that I should be concerned about in regards to the sun?

A. Actually, there are a number of drugs. Avoid prolonged sun if you’re taking drugs in a class called quinolones (Cipro, Levaquin, Avelox), or diuretics (Lasix). Prolonged sun exposure and use of these medications can lead to painful skin rash.

Q. When I go to my doctor’s office, they always ask me to list the drugs I am taking. My boyfriend says I should also tell them about vitamins and the supplements that I take. Do I really need to do that?

A. Most definitely. Drug interactions can occur between prescription drugs and over the counter medications. For instance, you could have a negative reaction between the blood thinner Coumadin (warfarin) and Motrin (ibuprofen), which also has a blood thinning characteristic. I had one patient who was taking both and hadn’t told his physician. He accidentally bit his tongue and the cut required stitches. The bleeding wouldn’t stop because his blood wouldn’t clot. So, it is vital that you inform your doctor of all medications you are taking, including over the counter drugs, vitamins and supplements.

Dr. Daphne Bernard, Pharm.D., is a registered pharmacist in Maryland, Virginia and the District of Columbia. She is currently assistant dean at the Howard University School of Pharmacy and a member of numerous boards and associations, including the Association of Boards of Pharmacy, the District of Columbia Board of Pharmacy, the Nonprescription Medicines Academy, Rho Chi Honor Society, American Society of Health-System Pharmacists, American Pharmaceutical Association and the American Association of Colleges of Pharmacy, Please email her at