Stop Side Effects Before They Start

Catherine Yeulet

Many drug reactions are preventable if you learn to ask the right questions to your doctor and pharmacist.

Use the same intelligent shopping skills for your medications as you use for buying cars and computers. That's medicine-safety advice from Jay S. Cohen, M.D., associate professor of family and preventative medicine at the University of California at San Diego, and author of Make Your Medicine Safe and Over Dose.

A recognized expert on the subject, Dr. Cohen shows an important way to prevent drug reactions is to begin with a low dose.

Start Low, Go Slow

Whenever possible, begin at the lowest effective dose and increase if necessary until the desired effect is achieved.

Dose-Lowering Methods

Ask your doctor for an alternative medication that allows for more flexible dosing.

If the lowest-available dose is still too high, ask if your doctor thinks you should split a pill or open a capsule and pour some out. Or ask for a prescription to a compounding pharmacy, which can customize medications at any desired dose. For more on compounding pharmacies, go to www.iacprx.org.

Communicate Effectively with your Physician

Medical expert, Dr. Ray Strand, M.D., outlines important questions to ask your doctor:

1. Are there lifestyle changes that can improve my condition? Can I delay starting the medication and aggressively change some eating habits or maybe start an exercise program?
2. If your physician says you need to start medication immediately: Can lifestyle changes help me improve enough so I can ease off the drug in the future?
3. Can the new medication potentially cause a drug interaction with my other medications? (Give your doctor a list of all your prescription and over-the-counter meds. Include your history of any adverse drug reactions, and if you are sensitive to alcohol or caffeine or certain foods.)
4. What is the expected outcome from taking this particular medication?

Physicians simply do not have enough time to go over medications in full detail, so this is only the start of the information-gathering process. The next step is at the pharmacy counter.

Many serious drug interactions are caused by combining short-term drugs (like antibiotics or pain pills) with long-term medications. For example, patients who took Erythromycin after having been on Seldane or Hismanal were at risk for sudden death! And that's why those drugs are now off the market. “Be assured other drug interactions can potentially bring the same results,” warns Dr. Strand.

Choose a Pharmacy where a Pharmacist will Talk with You

Get all your prescriptions filled at one pharmacy. “It is critical that you use one source for all your medications,” advises Dr. Strand, “ this may be one of the most important changes you need.”

Do Your Homework

Always ask for, and read, the manufacturer's drug-package insert. Pharmacy computer-printouts are far less complete. Use the Internet to research medications. Many drug manufacturers publish their drug-inserts online. Also, Dr. Cohen maintains a website at medicationsense.com.

Protect yourself and take charge of your health. Learn all you can about the use and inherent dangers of drugs. Learn to communicate effectively with your doctor and pharmacist about the drugs being prescribed.