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What are side effects? — Side effects are unintended or unwanted effects that medicines can cause. Most people take medicines without having side effects, but some people do have them.
Side effects can be different depending on what medicine or medicines you take. Some common side effects of medicines include:
●Nausea or vomiting
●Upset stomach, diarrhea, or constipation
●Feeling more or less hungry than usual
●Dry cough that doesn't go away
●Feeling tired or sleepy, or getting tired easily
●Feeling sad, depressed, anxious, or jittery
Can side effects be dangerous? — Yes, in rare cases, side effects can be dangerous or even life-threatening.
Call for an ambulance (in the US and Canada, call 9-1-1) or have someone bring you to the emergency department if you start a new medicine and have any of the symptoms listed below:
●Wheezing, or trouble breathing or talking
●Chest pain or tightness
●Passing out, or feeling like you might pass out
●Swelling of your face, lips, tongue, or throat
●Blisters or rash around your eyes, lips, mouth, or genitals
These symptoms could mean that you are having a severe allergic reaction. If so, you need emergency treatment.
When can side effects start? — If side effects are going to happen, they will usually start soon after you begin a new medicine or when your dose is increased. Some side effects can happen in the first hours after taking a medicine, such as an allergic reaction or upset stomach. Others might not start for a week or even months, such as rashes or a dry cough.
What should I do if my medicines cause side effects? — Call your doctor or nurse anytime you have a possible side effect that bothers you. But it's especially important to call right away if you start a new medicine and get any of the symptoms listed below:
●Hives or rash (raised bumps on the skin that can be itchy)
●Confusion, or feeling like you want to hurt or kill yourself
●Severe stomach ache, vomiting, or diarrhea
●Not wanting to eat
●Aches, pain, fever, weakness, or no energy
●Dark-colored urine, black stools (bowel movements), or yellow skin or eyes
●Other symptoms that worry you
If you have other symptoms that you think might be related to your medicine, talk to your doctor. Do not simply stop taking the medicine that you think is causing the problem. The medicine might be very important for your health, and stopping the medicine might cause other problems. Also, it's possible that what you think is a side effect is not actually a side effect at all.
Your doctor can help you figure out if the symptoms you are having are really side effects of your medicines or are caused by something else. If your symptoms are actually side effects, your doctor might be able to adjust your dose or switch you to a different medicine. There are often ways to help you feel better.
Even if your side effects can't be avoided, it's still important to talk to your doctor. They might be able to help you understand why the medicine you are taking is worth it even if it causes side effects.
Some things you should know or do to prevent or cope with side effects:
●Take medicine correctly to prevent side effects – Take the dose that is written on the prescription label (figure 1). This dose considers your age, weight, and specific health problems as well as the other medicines you take. Carefully follow all of the instructions on the label and printed patient education that comes with the medicine. (For example, some medicine labels say "take with food," "avoid alcohol," or "avoid driving until you know the effects of the medicine on you.") Also, follow the instructions your doctor gives you. They might tell you to start at a low dose and increase the dose slowly, so you don't have side effects.
You can also use a pill box that has a section for each day of the week. This can help you avoid taking too much or too little of your medicines (picture 1).
●Have your medicines checked to be sure that you are taking them correctly – Bring a bag with all of your medicines to your doctor's office. Have your doctor or nurse go over them with you.
●Be careful about mixing medicines – Some medicines do not mix well with other medicines, alcohol, or herbal products. Tell your doctor and pharmacist about all of the medicines you take, including nonprescription ("over-the-counter") medicines, herbs, and any other drugs. Have them check for drug interactions.
●If you take acetaminophen, do NOT take too much – Acetaminophen (known as paracetamol outside of the US) is in many different medicines. Taking too much is dangerous. Check the labels of all medicines you take. Make sure that you do not take more than 3000 mg of acetaminophen a day in total from all of your medicines.
●Remember that some side effects go away over time – As your body gets used to the medicine, the side effect might go away. For example, medicines to treat depression can sometimes bother your stomach for a while. But that side effect goes away after 1 or 2 weeks.
●Work with your doctor to find ways to manage your side effects – There are usually simple things you can do to make side effects less bothersome. For example, some medicines can make you feel sleepy, but if you take them just before bed, this is not a problem. Other medicines can make you constipated, but you can reduce constipation if you can eat more fruits and vegetables, drink more water, and use a stool softener. If a blood pressure medicine or antidepressant causes sexual problems, you might be able to take another medicine to improve sex.
The important thing is to talk to your doctor about any side effects that bother you. That way, they can offer solutions. Not everyone has the same side effects, so your doctor won't know what's happening with you unless you tell them.
How can I find out the known side effects of my medicines? — There are a few different ways you can find this out:
●Ask for an UpToDate article that goes over side effects for the kind(s) of medicine(s) you take.
●Ask your doctor or nurse what side effects to expect when they prescribe the medicines.
●Ask your pharmacist about the side effects when you get your prescriptions filled.
●Ask what you should do to avoid side effects and what to do if they do happen.
●Read the printed information for patients that comes with the medicine.
●Many medicines come with a Medication Guide. You can search for information about specific medicines online at www.fda.gov/drugs/drug-safety-and-availability/medication-guides.
●Check online at www.medlineplus.gov for information about the medicine.
For more detailed information about your medicines, ask your doctor or nurse for the patient handout from Lexicomp available through UpToDate. The Lexicomp handouts explain how to use and store your medicines. They also list possible side effects and warn you if your medicines should not be taken with certain other medicines or foods.
Patient education: Taking medicines when you're older (The Basics)
Patient education: Coping with high drug prices (The Basics)
Patient education: Brand versus generic medicines (The Basics)
Patient education: Going home from the hospital (The Basics)
Patient education: Stevens-Johnson syndrome and toxic epidermal necrolysis (The Basics)
Patient education: Drug allergy (The Basics)
Patient education: Hazardous medicine safety at home (The Basics)
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