Polypharmacy is Medspeak for taking more than one prescription medication at a time. About one in five Americans over age 49 is a polypharmicist, of sorts.
Ideally, doctors and pharmacists should do what’s called medication reconciliation each time you see them, said Kuldip Patel, the senior associate chief pharmacy officer at Duke University Hospital in North Carolina. To do this, his team reviews the list of medications people are taking whenever they are admitted to or discharged from the hospital. But that doesn’t always happen in every medical setting, he said.
Experts suggest asking a primary care doctor or pharmacist to do a full medication review at least once a year. Many pharmacies offer such evaluations under free medication therapy management programs. Make a list of your medicines — including supplements and over-the-counter drugs — or grab all of your pill bottles and take them with you to the appointment, Dr. Patel said.
Common Medication Side-Effects
Many ingested medicines cause gastrointestinal side-effects, such as constipation, nausea, or diarrhea. Many people get upset stomachs when they try a new food at a new restaurant. The controlled toxic effects of a medication usually cause much worse such side-effects. On a similar note, many topically-administered drugs, like arthritis creams, cause skin irritation.
Usually, these effects are temporary. Although they may not disappear entirely, they usually improve significantly after two or three doses. Drug makers usually insist these side-effects are “mild.”
Other drugs have side-effects because they block one type of chemical. The resulting chemical imbalance inevitably causes side-effects. Benadryl (diphenhydramine) is a good example. Though it eases allergy symptoms, it also blocks the chemical acetylcholine, leading to drowsiness and a host of other side effects, such as dry mouth.
Everyday products sometimes interact with medicine as well. Alcohol and painkillers might be the best (or worst) example.
Sometimes, medication side-effects are pleasant. During clinical trials in the late 80s and early 90s, finasteride, a prostate drug, was found to regrow hair. Now it’s marketed for that purpose under the name Propecia. Similarly, minoxidil was originally marketed as a pill for high blood pressure and found to grow hair by people who used it. Today, as a cream or foam, it’s a popular baldness remedy.
Learning About Side-Effects
The Food and Drug Administration requires drug makers to list possible side-effects on product labels. The warning must be proportional to the risk. For example, drug makers can include diarrhea, dry mouth, and other such common side-effects on a long, fine-print list of side effects. But if the drug could cause cancer or another serious illness, even if the risk is extremely remote, manufacturers must prominently display such warnings. Cancer’s latency period could be up to forty years. Other serious diseases also have long latency periods. So, drug makers may not know the full side-effects of a new medication for decades.
The FDA relies almost exclusively on company-provided data during this process. So, unless the company voluntarily comes forward with such information, it probably won’t make it onto the label.
How You Can Help Yourself
Always expect some side-effects, no matter what the label says, and plan accordingly. If your doctor prescribes a new medicine, don’t plan any unusual activities, like trips, until you know how this medicine affects your body.
Furthermore, when you have side-effects, speak with your doctor, especially if side-effects don’t dissipate after one or two doses, or they get worse instead of better. Even relatively mild side-effects might be a symptom of a much more serious condition.
If you do have a serious medical condition, early treatment is usually the key to a successful outcome. The longer you go back and forth with your doctor, the smaller that window gets.
