Do the Benefits Outweigh the Risks?
Taking medicine is part of a daily routine for many people. Prescription and over-the-counter (OTC)medications treat disease and improve health in many ways. Lowering cholesterol, fighting infection, controlling blood sugar levels, reducing pain—these are just some of the helpful effects. Along with the benefits of feeling better and getting well, medicines also pose the risk of unwanted side effects or unexpected adverse events.
Just about every medication (from aspirin to expensive brand-name prescription drugs) comes with side effects. They can range from minor inconveniences like dry mouth or night sweats to more serious conditions like liver damage or internal bleeding. The most common times that side effects occur are when a medicine is started and a dose is changed. But it’s not always easy to understand what your risk for side effects might be.
Several factors can affect who experiences a side effect: age, allergies, other health problems, and other medications and nutritional supplements that are taken. Starting at about age 40, our kidneys and liver begin to slowly reduce the ability to process and clear medications. Therefore, it is important to review your prescription and OTC medications and supplements with your healthcare provider on a regular basis. It’s possible your medications need to be adjusted as your condition(s) stabilize, as you age, have weight changes, or for other reasons. It is common for providers to order lab tests to spot early signs of a developing problem. For example, a blood test can check thyroid hormones to be sure they are in a safe range if you take medicine for a thyroid condition.
In Case You’re Curious…
The terms “side effect” and “adverse event” are sometimes used interchangeably but they have different meanings. A side effect is a tolerable, generally mild, reaction to a medication that may go away over time or can be managed. An example of a side effect is nausea; it can often be minimized by taking medicine with food.
An adverse event is a serious and intolerable reaction to a medication that usually leads to it being stopped. Using the example above, if the nausea is also associated with serious, regular vomiting and diarrhea, this is considered an adverse event.
The long list of side effects you hear when a medication is advertised on TV can be scary. In TV commercials, the mild side effects are grouped with the serious ones as if the risk is the same. Since you won’t decide whether or not to take a medication based on a commercial, ask your provider to explain how the risks apply to you. Also remember that medicines affect everyone differently. Just because a friend had a certain reaction to a medicine does not mean that you will have the same reaction.
Too much medicine in the body is called drug toxicity. It refers to a gradual buildup of medication in the bloodstream that is like being poisoned. Toxicity can be the result of a dose that is too high or because the body is unable to clear the medicine. You can help avoid toxicity by reporting any concerning symptoms to your provider.
Reducing the Risk
When starting a new medication or deciding to continue taking one, it’s wise to review the benefits and risks with your doctor. This can help you understand how medicines will help and what to expect. Here are some ways to reduce risks associated with taking medications:
- Show your current list of medications, vitamins and supplements to your providers. If each provider knows what medications the others have prescribed, your care can be better coordinated. Discuss any concerns you have, and report allergies, sensitivities or difficulties with swallowing pills.
- If a new medication or new dose is recommended, ask how it will help, what the possible side effects are and which symptoms you should report right away if they occur. Inquire about any food or beverage restrictions, and of course, if there are any alternatives. Also, ask if it could interact in any way with your current medications/supplements, or make you susceptible to other problems. For example, taking or using some medications can make your skin more sensitive to the sun so extra protection in sunny conditions will be needed.
- Use the same pharmacy for all your medications and supplements. Your pharmacist can serve as another set of eyes watching for unsafe drug combinations.
- Read and follow the directions for how and when to take medications. Some medicines are meant to be taken with a meal to avoid side effects. On the other hand, some medicines won’t be effective if taken with food so a waiting period before or after eating is needed. If a side effect is drowsiness, then that medicine is best taken at night or other time when you don’t need to be alert.
- Use an AM/PM medication box to organize your pills and remind yourself if you’ve taken your daily doses.
- Know what medicines you should never take given your medical conditions. For example, someone with a history of stomach ulcers shouldn’t take Advil, Naproxen, ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDS) because these medicines can increase the risk of stomach bleeding.
- If you wish to stop taking a medicine, be sure to discuss it first with your provider. Suddenly stopping some medications can have serious side effects. Plus, you will want to have a new plan in place for treating the condition.
- Be sure to tell your provider if you are or might become pregnant, or if you are breast-feeding.
- If you use pain medications, know what dose is safe for you. Acetaminophen (or Tylenol), for example, is found in numerous products like cold medicines. It can also be called paracetamol or APAP. The maximum safe dose is 4,000 mg a day and taking too much can damage the liver. Be sure to look at ingredient lists so that you don’t accidentally double up on the same medicine.
- Stay current on recommended vaccinations to reduce the risk of avoidable illnesses.
Worse than the Disease
Sometimes medicines can cause such serious side effects that leave patients wondering which is worse, the drug or the disease. Chemotherapy for cancer treatment is sometimes described that way. Patients often decide to suffer the very difficult side effects in the short-term for the long-term hope of a cure. The disease would otherwise progress and worsen without treatment. But each circumstance is different, and the risk-benefit analysis is an important part of any decision to take medication. Use your professional resources to help you decide what is right for you!
If you find yourself taking a medicine to treat a side effect of another medicine, don’t hesitate to request a medication review. Report new symptoms to your doctor and ask about alternatives. Your doctor or KnovaSolutions clinician can look for overlapping medications and alternatives that may result in reducing the number you take — and the side effects.
We can help! Give KnovaSolutions a call with all your medication questions. Call us at 800/355-0885, Monday to Friday, 8 am-8 pm, Mountain Time.
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The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider. If you have concerns about your health, please contact your healthcare provider.