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Coping With Drug Side Effects

Medications have the potential to cause unpleasant, and sometimes dangerous, side effects. Know what to ask and what to do.

Published: August 21, 2015 06:00 AM

By the time the 32-year-old mother of three came to see me, she had been experiencing numbness and tingling in her hands and feet for seven months. Because her symptoms coincided with a fall that caused neck pain, she had X-rays and MRIs before she was referred to me. By our appointment, her neck pain had long been resolved but the pins and needles sensation continued.

But the fall was a red herring, misleading doctors about the real cause of her symptoms. A review of her medication history indicated that her doctor had prescribed an anti-epileptic drug, and she was experiencing a side effect. After her doctor reduced the dose, the tingling quickly went away.

Mild side effects

Side effects are known or expected effects of a drug—but not the intended theraputic ones. Every medication, whether over the counter or prescription, has the potential to cause them. Many are mild and subside over time; some linger or cause more significant problems. They can occur after you have been on medication for a while, but they’re more common after taking a new drug or with a change in dosage.

If you’re taking a new medication or your doctor has prescribed a higher dose, ask what mild reactions are likely and how to handle them. If a side effect is dry mouth, for example, you might be able to manage it by keeping a water bottle handy. If you’re taking a drug that causes slight sedation, ask whether you can take it at night instead of in the morning.

Knowing that some drugs I prescribe can cause initial sleepiness, I usually explain to patients that the effect is likely to be transient. I also start them on a low dose, discuss adjusting it over time, and tell them that increasing the dose slowly often helps reduce or resolve unwanted side effects. Without that knowledge, patients often simply stop taking a medication that’s causing an unwanted side effect.

So if you experience a mild, bothersome effect, ask whether it will abate over time and whether you can try a lower dose in the meantime.

Learn more about 10 drugs you should avoid and steps that could naturally reduce the need for drugs.

Serious side effects

Adverse drug events (ADEs) are side effects that are usually unexpected, cause harm, can lead to hospitalization, and in some cases are fatal. They often occur with normal drug doses. Older adults are up to seven times more likely than younger people to experience an ADE, especially if they’re taking multiple medications.

And some medications are more likely to cause serious harm. Medications that are most likely to cause ADEs that lead to hospitalization include blood thinners such as aspirin and warfarin; diabetes drugs such as insulin and oral hypoglycemic agents such as glyburide and glimepiride; and drugs used to treat high blood pressure and heart disease, including diuretics, anti-arrhythmic agents, and cholesterol-lowering statins. Also on the list are analgesic drugs, opioid painkillers, antidepressants, and antipsychotics.

Talk with your doctor about the risks and benefits of any treatment, especially the medications above. Ask whether a newly prescribed drug carries the risk of a serious ADE, and if so, how likely it is for you. And ask about the early signs to look for.

What your doctor should know now

The ability to tolerate side effects is highly individual. Some people can manage slight nausea or light-headedness; others can’t. And what’s safe for you might depend on your work and lifestyle. I would be alarmed if, say, a bus driver or heavy-equipment operator was even slightly sedated. Context is also important. You might tolerate nausea from chemotherapy during cancer treatment because the benefit outweighs the discomfort. But if you find an effect intolerable, ask whether an alternative medication might help. And if you’re concerned that a negative effect might be putting your health at risk, tell your doctor right away.

Have you experienced medication side effects?

Tell us your story below.

Orly Avitzur, M.D.

Medical Adviser
Editor's Note:

 

This article also appeared in the September 2015 issue of Consumer Reports on Health.



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