How To Know When You Should (Or Shouldn't) Be Concerned About Side Effects Of Medication
Safety first!
Unsplash: Velizar Ivanov All prescription medications have side effects. Truthfully, if we were to read every word of the manufacturers' warning labels, most of us would refuse to take any medications prescribed by our physicians.
Television commercials glamorize the results of medications for common problems, but while medication is often necessary, knowing when you really should (or should not) be concerned about potential adverse side effects and drug interactions before taking new meds can be understandably confusing.
What else should you know before agreeing to take a medication, and who can you trust for advice and to check on any risk from interactions with other medications, alcohol, or even simple foods?
While side effects are an initial concern, the greater concern is the long-term effects of taking the medication.
Starting to take a medication is like dipping a toe in the pool, but not jumping in the pool to see what the water temperature is really like. This similar to acknowledging that that there is some information we’d rather not know, which in this case may be a newly diagnosed medical condition.
Medications are prescribed for both temporary and long-term chronic health conditions.
By the age of 65, most of us will be diagnosed with one or more chronic health conditions, including, but are not limited to, high blood pressure, diabetes, chronic obstructive pulmonary disease (COPD), cancer, asthma, and arthritis. And yet, the long term effects of these conditions are rarely explained in full by physicians.
In my 20-plus years working as a care advocate for aging and disabled adults, I’ve been involved in many situations in which medications were prescribed and once taken, could not later be changed, despite the fact that these patients had agreed to medications and treatments that had not fully been explained, and which resulted in serious negative effects later.
Here are 10 tips and questions to ask your doctor to help you be better informed about potential side effects before deciding whether you should or should not take medications or supplements.
1. Have a thorough discussion with your physician before agreeing to take any medication.
Based on my experience as a care advocate, this discussion rarely occurs at any level of detail.
What usually happens is that the physician makes a recommendation, then the patient nods and is handed a piece of paper or directed to the pharmacy to pick up the prescription.
It's important to ask which medical condition this medication is being prescribed. While many medical appointments are brief, perhaps 15 minutes at the most, be sure to get all of your questions answered, even if you have to call back and speak to a nurse.
2. Ask if the condition is temporary or chronic and if there are alternatives to taking medication.
Many people agree to take a medication without asking about the long-term effects or if there is anything else that might be done to address the temporary or chronic health condition.
For example, if cholesterol medication is recommended, might the alternative be trying a change in diet first, such as eating more oatmeal and avoiding fried foods, rather than immediately take the drug? If a change in diet is not sufficient, ask about the long-term consequences and effects.
High cholesterol results in heart problems. Clogged veins may result in clogged arteries later requiring bypass surgery. Constricted veins result in dementia and Alzheimer’s disease. Some chronic conditions have serious negative long-term effects and foregoing necessary treatment, even medication, puts you at serious risk.
Think about yourself not only today, but also what you want your health to like at 65, 75, 85 and even 95.
3. Ask about the dosage and pill size.
Find out whether the medication being prescribed has a low to high dosage. For example, one medication may begin at 25 mg and over time be increased to 200 mg.
Ask additional questions about how the physician monitor the correct dosage, i.e., through blood work or self-monitoring, and whether the medication being prescribed comes as a whole pill that needs to be cut. A small 25 mg pill prescribed at 12.5 mg that has to be cut may crumble and be wasted. If there is a version at the exact dosage necessary available, request that this be the specific pill prescribed.
And on the opposite end of that spectrum, ask if the medication is large ask if it can be cut in half or crushed and placed in applesauce. Some people are unable to swallow pills, but are able to crush them and place them in applesauce, pudding, or peanut butter instead.
4. Ask about the potential positive and negative side effects, and which differences you should expect.
Common side effects include thirst or dry mouth, a skin rash, constipation or loose stools, stomach upset, dizziness and headaches. There should also be positive side effects or results, meaning the resolution of the medical condition for which the drug was provided.
f you experience a side effect, be certain to have the specific details permanently noted in your medical chart. Twenty years down the road when you are in the hospital, you may be asked about a medication listed in your chart as a reported allergy. Rather than advising you cannot take the medication, it is more helpful to note that the medication made you dizzy, nauseous, or resulted in some other effect.
5. Ask if there are foods, medications or other over-the-counter products that might make the medication less effective.
Let your doctor know every medication and over the counter supplement that you take, as some foods and over the counter supplements make medications less effective.
For example, a person takin Coumadin should avoid grapefruit juice and foods high in vitamin K like green tea, spinach, and green leafy vegetables. For other medications, calcium in dairy products blocks the ability of the medication to be absorbed into the body.
6. Agree to add or discontinue no more than one new medication at a time.
Adding multiple medications at the same time prevents the ability to tell which medication is having what effect.
Also, if a medication is discontinued, ask the physician if there is a specific time that it takes for the medication to clear the body. Age, metabolism, weight, and health conditions effect the ability of the body to clear medications. For older adults the time to clear may be longer due to age and decreased liver and kidney function. The liver and kidneys clear toxins from the body.
Take the appropriate time to discontinue one medication and then begin the next. For some medical conditions, titration — decreasing one medication and adding another — is permitted at the same time.
7. Fill and take the medication exactly as prescribed.
And as reported in the New York Times:
“Studies have consistently shown that 20 percent to 30 percent of medication prescriptions are never filled, and that approximately 50 percent of medications for chronic disease are not taken as prescribed ... People who do take prescription medications — whether it’s for a simple infection or a life-threatening condition — typically take only about half the prescribed doses.
"This lack of adherence ... is estimated to cause approximately 125,000 deaths and at least 10 percent of hospitalizations, and to cost the American health care system between $100 billion and $289 billion a year."
Read the bottle carefully, take your medications as prescribed, and never give medications you are prescribed to a friend to try.
8. Make certain the medication is in your prescription insurance formulary.
A formulary is defined as, "A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list."
Physicians frequently prescribe medications that are not in an insurance formulary, which results in you arriving at the pharmacy only to be presented with a $500 bill, even though a less expensive alternative is available.
Ask your physician if he or she is able to confirm that the medication is within your health insurance plan. Your pharmacist may be able to contact your insurance company if a non-formulary medication was ordered.
9. Make your pharmacist your new best friend.
When the person at the counter asks if you have questions about the medication, say yes. Pharmacists know more than most physicians about medication interactions, side effects, allergic reactions based on your health history if provided, and foods that counteract the medications.
Their job is to educate patients coming to fill prescriptions, and they generally enjoy doing so.
10. If you are wary of taking medication, investigate other options.
For some medical condition, there may be over-the-counter options available. Some individuals prefer to see naturopathic practitioners as an alternative to taking a prescription drug. And others prefer alternative health practitioners like Reiki therapists, chiropractors, acupuncturists, massage therapists, and professionals in other specialties to resolve health concerns.
While taking medications may be necessary, being proactive with health is better.
Understanding a diagnosed medical condition and the alternatives to taking the medication has the potential to resolve the health condition. So many of my older adult clients, with advanced health concerns, tell me that if they “knew that when” they would have made different choices about their health.
Make good health choices today and be healthy and active to age 100!
Pamela D. Wilson, MS, BS/BA, CG, CSA, is a caregiving advocate who supports family caregivers and professionals working in healthcare, elder law, and financial planning. Subscribe to her free caregiving library for access to articles, podcasts, and videos.