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You Trust Your Medications, but Could They Cause You Harm?

While many modern medicines are designed to be safe, some, when used improperly, can become harmful medications. Here's what to know.
Harmful medications

Modern medicine has extended and improved our lives in countless ways. Modern pain relievers stifle and give us the power to endure pain that would be otherwise unbearable. Antibiotics and antivirals fight our smallest and most potent enemies. Chemotherapy and immunosuppressants help us survive onslaughts by our own bodies. Each of these is a powerful weapon against disease and decay, but it’s important to remember that power comes at a price.

When used correctly and when our bodies cooperate, these medicines are miracles. When they turn on us, though, they can be killers. Understanding how medicines work and how they interact with each other and the human body is the first step to ensuring our modern medical weapons are working for us instead of against us. Here are some common medicines with a dark side and tips for avoiding the damage they can cause.

Pain Relievers

Woman taking a pill

Many individuals think nothing of popping a couple of aspirin or other over-the-counter pain relievers at the first sign of an ache or pain. These medications are generally safe when taken as directed. Still, when taken in larger doses than recommended, for an extended period of time, or by people with compromised kidneys or other disorders, they can have a destructive effect instead of a beneficial one.

NSAIDS

Stacks of pills

NSAIDS, or non-steroidal anti-inflammatory drugs, are extremely helpful in relieving pain and reducing inflammation. They do have a few drawbacks when overused or when taken by certain populations, including individuals with kidney issues, high blood pressure, or chronic gastrointestinal disorders and those over 60 years old. Overuse of these medications can be particularly hard on the digestive system. It can lead not only to indigestion and an aching stomach but, in severe cases, can lead to ulcers as well. Those with ulcers should avoid NSAIDS as they can worsen the condition. They can also increase blood pressure and, in rare cases, harm the kidneys and liver.

NSAIDs are available over-the-counter (OTC) and are frequently used in hospitals. OTC multi-symptom medications, like cold and flu treatments, may also include NSAIDs in their formula. Taking multiple types of NSAID at once can increase the chance of adverse effects. In addition, NSAIDs react unpredictably with several other medications and can increase blood pressure, including warfarin, diuretics, lithium, and SSRIs. Medications categorized and NSAIDs include, but are not limited to:

  • Aspirin—OTC (Bayer, Excedrin)
  • Celecoxib (Celebrex)
  • Diclofenac (Voltaren)
  • Diflunisal (Dolobid)
  • Etodolac (Lodine)
  • Fenoprofen (Nalfon)
  • Flurbiprofen (Ansaid)
  • Ibuprofen—OTC (Motrin, Advil, Midol)
  • Indomethacin (Indocin)
  • Ketoprofen—OTC (Orudis KT)
  • Ketorolac tromethamine (Toradol)
  • Meclofenamate sodium (Meclomen, Ponstel)
  • Mefenamic acidmeloxicam (Mobic)
  • Nabumetone (Relafen)
  • Naproxen sodium (Anaprox)
  • Naproxen sodium—OTC (Aleve)
  • Oxaprozin (Daypro)
  • Phenylbutazone (Butazolidin)
  • Piroxicam (Feldene)
  • Salicylate (Trilisate Disalcid)
  • Sulindac (Clinoril)
  • Tolmetin (Tolectin)

These medicines should be taken as directed to avoid negative side effects. In addition, at-risk populations or those on other prescription medications should speak to a doctor before adding NSAIDs to their regimen.

Acetaminophen

Like NSAIDs, acetaminophen is used to relieve pain and inflammation. It is even recommended by doctors in conjunction with NSAIDs occasionally, especially when the pain is particularly intense or persistent. It is generally well tolerated, even by children, and is gentler on the stomach than NSAIDs. Unfortunately, when taken in large doses, acetaminophen becomes toxic to the liver, causing approximately 2,600 hospitalizations and 500 deaths each year in the United States.

Well-known over-the-counter varieties of acetaminophen include Tylenol, Panadol, and Paracetamol. It’s important to know that acetaminophen is also added to other multi-symptom formulations as well, which is often how accidental overdoses occur, especially in children. Indications that someone has overdosed on acetaminophen are frequently delayed. Significant symptoms usually begin occurring 24-72 hours after injury to the liver has occurred and worsen over the next few days. Symptoms can include nausea, vomiting, jaundice (yellowing of the skin and the whites of the eyes), pain in the upper right quadrant of the abdomen, disorientation, and exhaustion.

Warfarin

This medication is an anticoagulant prescribed to help individuals manage blood clots. While warfarin doesn’t dissolve established clots, it does help prevent established clots from growing and prevents new ones from forming. Warfarin may be recommended not only for those who have had clots in the past but also for those who are at risk of developing clots. This can include patients with atrial fibrillation or who have undergone heart valve replacement.

Red Blood Cells

There is no doubt that this medication saves lives, but in some cases, it also has the potential to cause some grave side effects. The main side effect of warfarin involves bleeding irregularities. This can present in a number of ways, however, and can range in severity from mild to life-threatening. Bleeding problems are more commonly seen in older adults, those that are genetically predisposed to be more sensitive to warfarin, and individuals with kidney problems, ulcers, cancer, liver disease, or uncontrolled blood pressure. The following symptoms can indicate a bleeding problem and should be addressed by a medical professional immediately:

  • Black or bloody stools
  • Coughing up blood
  • Exceptionally heavy menstrual bleeding
  • Joint pain and swelling
  • Red or brown urine
  • Severe bleeding
  • Severe headache or stomachache
  • Unexplained bruising
  • Vision changes
  • Vomiting with blood or specks that look like coffee grounds

In rare cases, necrosis can result from the use of warfarin. When it does occur, it typically starts within just a few days of starting the drug. Symptoms of skin necrosis include changes in the color or temperature of your skin, new sores, and severe pain. If you notice any of these, especially in the first few days after starting warfarin, contact a medical professional immediately.

Warfarin Interactions

It is crucial to be aware of dietary habits and additional medications when taking warfarin, and be sure to discuss any changes, including herbal supplements, with your doctor. Several drugs interact negatively with warfarin, including aspirin, acetaminophen, antacids, some antibiotics, cold and flu medications, and medications meant to treat irregular heart rhythms.

In addition, common herbal supplements, like dong quai, garlic, ginseng, and even vitamins E and K can interfere with how warfarin works, as can foods naturally high in vitamin K. If you are taking warfarin, you’ll want to discuss your diet with your doctor as well. Food and drinks like cranberries, grapefruit, alcohol, black licorice, and even an increased intake of leafy green vegetables can interfere with this medication.   

Bisphosphonates

Osteoporosis affects approximately ten million people in the United States, and low bone density may affect up to 44 million Americans. The first line of defense for these individuals is bisphosphonates, a category of drugs that contains several medications. Oral bisphosphonates in the United States include alendronate (Fosamax) and risedronate (Actonel). Bisphosphonates delivered by IV include pamidronate (Aredia) and zoledronic acid (Reclast and Zometa). The bisphosphonate ibandronate (Boniva) comes in both an oral and an IV formulation.

These medications work by slowing down the natural reabsorption of bone to slow the progress of osteoporosis and other degenerative bone disorders. They are both effective and generally well tolerated by both adults and children in the short term. Possible short-term side effects can include gastrointestinal issues, such as irritation of the esophagus, gastritis, and stomach ulcers. When taken by IV, some patients may experience flu-like symptoms the first few days after the medication is administered.

Broccoli

Unfortunately, bisphosphonate medications are excreted through the kidneys and are associated with impaired renal function. For a person with healthy kidney function to begin with, the rewards are typically more significant than the risk. For individuals with chronic kidney disease, however, it can cause an increased risk of renal failure. Due to this risk, doctors will closely monitor the kidney function of individuals who are prescribed bisphosphonate medications. Not all bisphosphonate medication is equally detrimental to the kidneys, however. Zoledronic acid and pamidronate were more likely to cause kidney damage than the other bisphosphonates, so other varieties may be recommended for those with impaired kidney function.

In Conclusion

While modern medicine can help us to live longer, less painful lives, it comes with risks. Fortunately, there are many steps we can take to reduce the likelihood of a negative reaction, such as:

  • Avoid alcohol.
  • Be cautious about mixing medications.
  • Don’t take more than the recommended dose.
  • Know what to do if you miss a dose.
  • Learn about interactions with your medication, including interactions with food and drink.
  • Report any new, unusual, or worsening symptoms to your doctor immediately.
  • Take medications only as prescribed.

It’s important to discuss the risks and benefits of new medications with your doctor. Understanding signs and symptoms that indicate an adverse reaction and being mindful of any potential dangers, especially interactions with other medications and food, will help protect you from unnecessary harm.

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