Innovations Medication Management

Katrin Olavessen-Holt, PharmD, CPGx

Over 1.5 million adverse drug events, otherwise known as side effects, hospitalize people every year in the United States.¹ According to the FDA Adverse Events Reporting System (FAERS), in 2024, there were over two million reported events, over one million serious events, and over 145,000 deaths associated with medications and biologic products.² With over 60% of American citizens taking at least one prescribed medication, and approximately 36% taking at least three prescribed medications daily, the odds of experiencing a side effect is high.³ This article aims to review how to speak with a doctor when these side effects arise.

UNDERSTANDING SIDE EFFECTS

Side effects, adverse drug events, range from mild to severe. According to the Merck Manual’s classification of an adverse event, mild effects require no treatment or antidote and can include: a cough from an angiotensin-converting enzyme inhibitor, dry mouth from an antidepressant, or drowsiness resulting from an antihistamine. Moderate reactions require a change in therapy where a medication dosage may be decreased or another medication may be added, or hospitalization may be required and prolonged. Severe reactions are potentially life threatening and require stopping the medication. There is usually prolonged hospitalization.⁴ While these may sound alarming, there are effective strategies to reduce risk:^5-8

• Make a list of all prescribed, over-the-counter (OTC) medicines, and supplements taken.
• Ask a doctor/pharmacist about potential side effects and how to treat mild effects.
• Ask a doctor/pharmacist about drug interactions with other drugs, food, alcohol, and supplements.
• Ask a pharmacist/doctor with any addition of a new supplement, OTC, or prescription.
• Read the label in direct light, understanding all instructions, wear glasses if prescribed.
• Ask questions of the pharmacists and/or doctor if you do not understand the instructions.
• Get needed lab work to help ensure values stay in range.
• Always use dosing device given by the pharmacy and never a household utensil.
• Check dosages, color, and shapes with each medication refill to ensure you are taking the correct medication.
• If in doubt, call your doctor/pharmacist.

PREPARING FOR YOUR DOCTOR’S APPOINTMENT

In between doctor’s appointments, there are some things people can do to effectively address concerns. When prescribed medication, in order to spot adverse effects, keep a journal. Note any symptom, its duration, severity, times, and effect on quality of life. In relation to administration of the medication, note the time it takes for the symptom to occur. If taking other OTC or supplements, note timing of reactions related to their ingestion or administration as well. Moreover, list things that make it better. Being aware of the potential for side effects helps allay some concerns.^7-9

EFFECTIVE COMMUNICATION WITH YOUR DOCTOR

If side effects occur, do not panic. Preparing for them can make all the difference. When speaking with your doctor, whether it is by phone, telehealth, or in-person, it is important to describe the exact symptoms and their impact. Avoid vague statements. Be specific. Use descriptive adjectives like pain versus discomfort, and the type of pain (i.e., sharp, stabbing, dull, or aching). Express concerns without fear. Share all symptoms for appropriate treatment. Also, ask the following questions:^8,9

• Is this a normal side effect?
• Will it eventually go away?
• Can the dosage be adjusted/lowered?
• Are there alternative medications?
• Can lifestyle changes help manage the side effects?

Advocate your concerns without fear and be a part of the decision-making process. After all, you know your body best.

WHEN TO SEEK IMMEDIATE MEDICAL ATTENTION

Sometimes, even after our precautions, an immediate side effect occurs. If this happens, please call your local emergency medical service. The following symptoms should prompt a quick response:⁸

• Difficulty breathing
• Hives
• Swelling of the face, lips, tongue, or throat
• Feeling faint or fainting

Remember, if in doubt, call.

EXPLORING ALTERNATIVES AND SOLUTIONS

Even mild side effects can wreak havoc on our lives. In the event these continue, ask the doctor about the potential to adjust dosing. Sometimes, a lower dose can alleviate the symptoms. If the effects disrupt daily life, then perhaps an alternative medication will work. There is usually more than one medication in a particular drug class with potentially fewer side effects. Moreover, ask about dietary changes, exercise, or other lifestyle changes that may reduce the effects.^8,9

ADVOCATING FOR YOURSELF IN HEALTHCARE

If concerns are dismissed, consider a second opinion. Living with a side effect(s) that disrupts quality of life may be avoidable. Sometimes, a second opinion, if accessible, is warranted. An additional protection is to bring a trusted family member or friend to appointments for added support. This person can also help with questions and concerns that arise. Also, use the popular healthcare patient portals to address any concerns between doctor’s appointments. This is a quick and easy way to address a non-urgent health concern in writing. These typically get answered within 24 to 48 hours.^10,11

Open and honest discussions with healthcare providers may prevent many unwanted side effects from commonly prescribed medications. By taking an active role in your own health, it puts the control back into our own hands and makes us a part of the healthcare decision. Side effects should never be ignored and can progress into life-threatening situations. By addressing them through open communication with healthcare providers, we can lower our risks and improve our quality of life.

If you need a medical writer with pharmacist expertise, contact me at innovationsmedicationmgmt@gmail.com.

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References:

1. CDC. FastStats: Medication Safety Data. Medication Safety Program. Published May 3, 2024. https://www.cdc.gov/medication-safety/data-research/facts-stats/index.html
2. FDA. Qlik sense. fis.fda.gov. https://fis.fda.gov/sense/app/95239e26-e0be-42d9-a960-9a5f7f1c25ee/sheet/7a47a261-d58b-4203-a8aa-6d3021737452/state/analysis
3. Mykyta L, Cohen R. Products – Data Briefs – Number 470 – June 2023. http://www.cdc.gov. Published June 1, 2023. https://www.cdc.gov/nchs/products/databriefs/db470.htm
4. Smith DE. Adverse Drug Reactions. Merck Manual Professional Edition. Published March 6, 2023. https://www.merckmanuals.com/professional/clinical-pharmacology/adverse-drug-reactions/adverse-drug-reactions#Etiology_v1109624
5. MacMillan A. How to Deal With Side Effects of Medicine. WebMD. Published July 30, 2015. https://www.webmd.com/a-to-z-guides/features/manage-drug-side-efects
6. CDC. Medication Safety and Your Health. Medication Safety Program. Published May 15, 2024. https://www.cdc.gov/medication-safety/about/index.html
7. FAHS CAB MD. How to talk to your doctor about medication. Harvard Health. Published April 23, 2018. https://www.health.harvard.edu/blog/how-to-talk-to-your-doctor-about-medication-2018042313696
8. Dealing With Medicine Side Effects and Interactions | HealthLink BC. Healthlinkbc.ca. Published 2023. Accessed March 10, 2025. https://www.healthlinkbc.ca/healthwise/dealing-medicine-side-effects-and-interactions
9. Ellis S. How to Talk to Your Doctor About Medication Concerns – APG Health. APG Health. Published January 21, 2025. Accessed March 10, 2025. https://www.apghealth.com/how-to-talk-to-your-doctor-about-medication-concerns/
10. Hubinette M, Dobson S, Scott I, Sherbino J. Health advocacy. Medical Teacher. 2017;39(2):128-135. doi:https://doi.org/10.1080/0142159x.2017.1245853
11. Tulane University. Why healthcare advocacy is important. publichealth.tulane.edu. Published March 1, 2021. https://publichealth.tulane