“There’s a new medicine that sounds as if it could help, but I’m not sure about the side effects.”
This was our first patient’s response when we asked about her upcoming specialist visit for worsening psoriasis. You have probably said or thought the same kind of thing at some point, as many patients have. After acknowledging her concern, we asked how she planned to bring up the topic of side effects with her specialist.
“Well,” she replied, “First I’ll go online and look up all of the side effects of the medicine. Then I’ll bring the list with me to my appointment and ask about them.”
We applauded her initiative and self-advocacy, and then asked whether she had considered any downsides to that approach.
“Well, I suppose I may surprise or overwhelm the doctor.”
We agreed this was a possibility, along with being time consuming for her, and we suggested another idea. Here are three questions that can help you talk productively with your doctor about medication side effects:
1. Start by asking your health-care provider, “What are the most common side effects of this medication?” Searching online or reading a drug’s published product information will yield a lot of information, but little perspective. By law, these documents must list every side effect reported during the time a drug was being studied in clinical trials. It does not mean that you will experience them.
Further, not all of these symptoms are proven to be directly caused by the drug. It can be difficult to discern from a list which side effects, if any, are of significant concern.
2. Next, follow up with, “Are there any serious or dangerous side effects, and how likely are they to happen to me?” A drug’s product information may contain a section of text enclosed in a black border. This “black box” is the FDA’s strongest warning and refers to a more dangerous or life-threatening potential side effect. Be sure to ask whether your medication has a “black box” or other serious side effect warning and whether it applies to you.
3. Last, it is important to know, “What should I do if I think I may be experiencing a side effect?” In some cases, it can be dangerous to stop taking a medication abruptly. Before you leave the office, you should learn how best to reach your health-care provider’s office quickly if a medication concern arises.
Our patient liked these ideas, and felt better prepared for her next specialist visit. Doctors and other medical providers should thoroughly review side effects with you whenever a new medicine is prescribed, but it is best to know how to raise this issue in a way that will meet your unique needs.
Remember that side effects are reactions that may happen, but usually do not. You can work collaboratively with your health-care provider to decide whether a recommended medicine’s benefits outweigh any risks.
Jeffrey Millstein is an internist and regional medical director for Penn Primary Care. Maggie Pecsok is a second-year medical student at the Perelman School of Medicine of the University of Pennsylvania.