A few people here have recently expressed fear over taking some medications
because they are afraid of the side effects. Here is an excellent comment on
this issue taken from the Arthritis Foundation's web site:
Scared By Side Effects
Q: After reading the pharmacy sheets listing side effects of the medications I
take for rheumatoid arthritis (RA), I can't help but wonder if the "cure" is
worse than the disease. Is it possible I'd be better off skipping the
medications and taking my chances with the RA?
A: I would really hate to see you - or anyone with a potentially disabling
disease such as RA - completely give up medications. But I certainly can
understand your concerns: No medication is completely safe, and the potential
risk of side effects can be frightening. Anytime you interfere with one bodily
process you may interfere with others - sometimes in undesirable ways. But the
dangers of untreated RA, in most cases, far outweigh the risks of the drugs used
to treat it. Each day, medications ease pain, prevent joint destruction and
improve the lives of countless people with arthritis and related conditions. In
some cases, medications can literally save lives.
The pharmacy sheets are provided as a service to make you aware of side effects
that can occur with a certain medication. Keep in mind that the key word here is
"can." You shouldn't assume that the listed side effects will necessarily occur
in you. Even if you do experience one or more side effects, you may be able to
reverse or halt them by stopping or changing medications. In most cases, no
action is needed; the side effects resolve on their own.
Many factors can influence how your body reacts to a drug. Some are largely
controllable - such as when and how you take your medicine. Factors that can't
be changed, such as your age and other health problems, may be compensated for
with choice of medication or a dosage adjustment. Life is full of risks.
Sometimes we have to risk experiencing a side effect to gain a medication's
benefits. The key is weighing risks against potential gain. Your doctor can help
you weigh those risks and choose the drugs that provide the most help and do the
least possible harm.
There are also several things you can do to reduce your risk of drug side
effects. Here are a few:
Let your doctor know about any other medications you are taking - even
over-the-counter (OTC) ones- because some can add to the side effects of others.
For example, taking aspirin along with a prescription nonsteroidal
anti-inflammatory drug (NSAID) can increase your risk of stomach ulcers and
other side effects.
Don't underestimate the power of nutritional supplements. Nutritional
supplements, too, can affect the way a drug works. In some cases - such as
taking folic acid along with methotrexate - vitamin supplements can reduce the
risk of certain side effects. In other cases, taking nutritional supplements or
herbs in addition to prescribed medications can interfere with the action of the
medication or even enhance its potential side effects.
Find out if there are certain foods you should eat or avoid while taking a
medication. Most drugs, including NSAIDs, should be taken with food to reduce
the risk of stomach upset. For others - such as minocycline, an antibiotic that
is being used increasingly to treat RA - taking with food can decrease the
drug's absorption.
Forgo alcohol - it can add to the side effects of most drugs, from analgesics to
antidepressants. If you can't or don't want to give up alcohol altogether, set a
limit of two drinks (including beer) per week.
Ask your doctor to prescribe the lowest beneficial dose of a drug and never take
more than the prescribed amount. Many side effects are related to dosage. High
doses of glucocorticoids such as prednisone, for example, can cause a wide range
of side effects, including fluid retention, fragile bones and increased
susceptibility to infections. Low doses, which are often effective in managing
inflammatory arthritis, have a low risk of side effects.
Take the drug at the time designated by your doctor. Timing, in some cases, can
influence a drug's side effects. For example, taking the osteoporosis drug
alendronate when you get up in the morning, rather than before lying down at
night, can cut the risk of esophageal ulcers. Timing can also influence some
drugs' wanted effects. By taking a drug at the optimum time, you may actually be
able to reduce the dose and, thus, the risk of side effects.
Never stop taking any medication without consulting your doctor. A drug can't
help you if you don't take it, but abruptly stopping a drug can hurt you. The
dosage of drugs such as prednisone, for example, must be tapered to avoid
serious adverse effects.
Let your doctor know if you suspect a side effect. He can determine whether the
side effect requires treatment or if discontinuing a drug or perhaps educing its
dose is in order.
Doyt L. Conn, MD, Rheumatologist