Monday, June 11, 2007

What about the side effects?


Yes, medicines can have effects on you that are not intended but that you may find obnoxious or may even be dangerous. These would be side-effects, and this is different from the actual desired effects of the medicine such as reducing pain, lowering blood pressure and so forth.

This can occur with prescription medicines, and also over-the-counter ones (OTC's) and also with vitamins, herbs and supplements.

In the case of prescription and OTC medicines (not herbs and supplements, though), the effectiveness and also the safety of the medicines is regulated by the federal government's Food and Drug Administration (FDA).

Believe it or don't, the FDA frowns on medicines that have side-effects that are dangerous. However, if a medicine causes a side-effect that is pretty rare (say, one in 10,000 people who take it), a lot of people are going to have to take it before a pattern of harm from the medication becomes apparent. Drug companies have to do incredible amounts of testing and trials before the FDA will even approve the drug for sale, but it's not realistic to expect them to test 100,000 people before FDA approval to uncover rare side-effects that affect 1 in 10,000 people.

This is not to say that once a drug goes on the open market that that's the end of the story. There is actually ongoing surveillance afterwards to be able to detect rare side-effects as people start to be prescribed the medication in offices by their doctors.

Even so, that's why being prescribed a medicine should involve discussion of what the benefits of taking it are balanced against the risks involved. In this less than perfect world, perfect benefit with absolutely zero side-effect is often not possible. However, as long as the probable good to you far outweighs the potential for serious harm taking a medicine is probably an overall good idea.

Sometimes, this is obvious and sometimes it's not.

For example, it's usually clear that taking an antibiotic for pneumonia is worth risking the antibiotic causing a rash or stomach upset versus letting the pneumonia kill you.

On the extreme opposite end of the spectrum, taking medicines for osteoporosis (low bone density) very clearly reduces your risk of falling and breaking a hip which in itself is known to have a 50% risk of being dead or in a nursing home within the following six months. However, with the TV coverage of jaw necrosis, you would scarcely know that the risk of having jaw necrosis happen to you is literally one in one million. Since the risk of dying in a fall is one in 281, taking the medicine is probably a safe bet. Just goes to show that TV finds bad/scary news sells ad time, but good/calming news doesn't: "if it bleeds, it leads" journalism at work.

So, bottom line:
  • Medicines can have side effects, but dangerous ones are rare.
  • Make sure that you understand and are comfortable with why you are being asked to take a medicine, what's in it for you, and what is the potential for any down side.

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