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Managing Common Drug Side Effects

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 23, 2020.

Overview

Every drug has side effects. How vulnerable you are to these side effects depends on many different factors, which can be generally grouped as patient-related, drug-related, and environmentally or socially-related. Find out if you have any characteristics that will increase your susceptibility to drug-related reactions, and what you can do to manage some of these possible side effects.

Risk of Developing Side Effects

Every one of us is unique. However, certain individual factors make some of us more likely to develop side effects than others.

The most significant of these factors is age. The very young and the very old are ALWAYS more susceptible to unwanted reactions.

Children are not small adults. The way their bodies absorb metabolize and eliminate drugs differs from adults, and this is especially true in babies. Younger children tend to absorb medicine more slowly from the stomach but have faster intramuscular (IM) absorption rates. In early life, they have a higher body water to lipid ratio and a larger liver to bodyweight ratio. Liver enzymes are immature as is their kidney function. In addition, the permeability of their blood-brain barrier (the layer of cells that restricts the passage of substances from the bloodstream to the brain) is higher.

Older adults typically take more medicines and studies have shown they are twice as likely to go to ED because of an adverse drug event and seven times more likely to be hospitalized. They are more likely to be on medicines with a narrow margin between being effective or toxic such as warfarin, insulin, digoxin, and anti-seizure medications. Their bodies tend to have more fat and less water which may increase the duration of effect of certain drugs. In addition, metabolism in the liver and excretion through the kidneys is typically reduced. Their brains are also more sensitive to the sedating effects of drugs, and pre-existing problems, such as dizziness, eye, and ear problems, may be exacerbated increasing the risk of falls.

Individual Factors That Also Increase Risk

Several other factors also play a significant role in the likelihood of side effects. Some notable examples include:

Drug-Related Factors

Drug-related influences include:

Environmentally or Socially Related Influences

Environmentally or socially-related influences include:

List of Common Drug Side Effects

The following table lists some of the more commonly encountered drug-related side effects and suggestions for their management.

Allergic Reactions

Potentially could occur with any medication. Symptoms range from a mild rash to a severe anaphylactic reaction (including facial and throat swelling, difficulty breathing and a widespread rash).

Prevention and management strategies:

Blurred Vision

May occur with antihistamines, antipsychotics, bupivacaine, bupropion, duloxetine, esomeprazole, etodolac, gabapentin, opioids, and several other drugs.

Prevention and management strategies:

Bruising and Bleeding

Common with medicines that “thin the blood” such as aspirin, clopidogrel, enoxaparin, and warfarin. Also, common with NSAIDs, steroids (such as prednisone) and medicines to treat cancer.

Prevention and management strategies:

Constipation

Common with opioids, diuretics, calcium antagonists, antidepressants, aluminum-containing antacids, ondansetron, and iron supplements.

Prevention and management strategies:

Cough

Common with ACE inhibitors (these can cause a dry, hacking, chronic cough in up to 20 percent of patients).

Prevention and management strategies:

Dehydration

Common with antihistamines, blood pressure medications, chemotherapy, and laxatives.

Prevention and management strategies:

Diarrhea

May occur with some antibiotics, antidepressants, magnesium-containing antacids, proton pump inhibitors (eg, lansoprazole, omeprazole) and chemotherapy agents.

Prevention and management strategies:

Drowsiness or Sedation

Medications that cause drowsiness include benzodiazepines (such as lorazepam, diazepam), some antidepressants, antiemetics, older antihistamines (such as diphenhydramine, chlorpheniramine), some heart medications, muscle relaxants and narcotics.

Prevention and management strategies:

Dry mouth (Xerostomia)

May occur with antiarrhythmics, anticholinergics, antihistamines, drugs for high cholesterol, anti-inflammatory agents, diuretics, vasodilators, drugs for Parkinson’s Disease, and antipsychotics.

Prevention and management strategies:

Erectile Dysfunction or Decreased Sexual Desire

More common with antidepressants, antihistamines, benzodiazepines, beta blockers, diuretics, and H2 blockers.

Prevention and management strategies:

Esophageal Damage

May occur with a wide-range of drugs including aspirin, bisphosphonates (such as alendronate), doxycycline, potassium chloride, quinidine, and vitamin C.

Prevention and management strategies:

Indigestion or Gastroesophageal Reflux Disease (GERD)

May occur with drugs that irritate the stomach lining (such as aspirin, iron, NSAIDs, steroids), those that relax the lower esophageal sphincter (LES) (such as anticholinergics, calcium channel blockers, and nitrates) or reduce LES pressure (such as progesterone, theophylline, and tricyclic antidepressants).

Prevention and management strategies:

Falling or Unsteadiness on Feet

Medicines that cause confusion, fatigue or sedation such as antipsychotics, some antidepressants, benzodiazepines, sedating antihistamines, antiepileptics, narcotics, and some heart medications.

Prevention and management strategies:

Gingival Enlargement (Growth of the gums around the teeth)

May occur with cyclosporine, calcium channel blockers (eg, nifedipine), and phenytoin.

Prevention and management strategies:

Gout

May occur with aspirin (low dose), chemotherapy agents, cyclosporine, frusemide, and thiazide diuretics.

Prevention and management strategies:

Headache

Common with asthma medications, angina and blood pressure medications, oral contraceptives, erectile dysfunction treatments, and stimulants. Rebound headaches can be caused by overuse of acetaminophen, aspirin, NSAIDs, and opioids.

Prevention and management strategies:

Infection

Corticosteroids, immunosuppressants, chemotherapy and several other medicines suppress your immune system and increase your risk of developing an infection.

Prevention and management strategies:

Hair Loss

May affect all body hair or just scalp hair. Common with chemotherapy or radiation therapy. May also occur with certain acne treatments, antibiotics, antidepressants, oral contraceptives, and cholesterol-lowering medicines.

Prevention and management strategies:

Muscle Pain or Muscle Weakness

Common with statins (used to reduce cholesterol levels). May be due to an effect on muscle proteins or a decrease in coenzyme Q10 (CoQ10).

Prevention and management strategies:

Nausea and Vomiting

Common with chemotherapy or radiation therapy. May also occur with drugs that tend to slow or block the bowel, when electrolytes are imbalanced or with infections.

Prevention and management strategies:

Taste Disturbances

Common with many drugs including antibiotics (such as ciprofloxacin, metronidazole), anticonvulsants, antidepressants, aspirin, blood pressure medications, lithium, metformin, and muscle relaxants.

Prevention and management strategies:

Tendonitis (tendinitis) or Tendon Rupture

Most commonly reported with fluoroquinolone antibiotics (eg, ciprofloxacin norfloxacin, ofloxacin, levofloxacin). More common in people over the age of 60, taking corticosteroids, or with a history of organ transplant.

Prevention and management strategies:

Weight Gain

Common with antipsychotics, most antidiabetic drugs (except for metformin), antidepressants and antiepileptics.

Prevention and management strategies:

See also

Sources

  1. Stephenson T. How children’s responses to drugs differ from adults. British Journal of Clinical Pharmacology. 2005;59(6):670-673. doi:10.1111/j.1365-2125.2005.02445.x.
  2. Adverse Drug Events in Adults. Centers for Disease Control and Prevention. Medication Safety Program. cdc.gov/medicationsafety/adult_adversedrugevents.html
  3. Risk of Drug Side Effects Rises as You Age. Consumer Reports. https://www.consumerreports.org/drug-safety/risk-of-drug-side-effects-rises-as-you-age/
  4. Anderson, GD. Chapter 1. Gender Differences in Pharmacological Response. International Review of Neurobiology. Volume 83, 2008, Pages 1-10
  5. Dean L. Codeine Therapy and CYP2D6 Genotype. 2012 Sep 20 [Updated 2017 Mar 16]. In: Pratt V, McLeod H, Dean L, et al., editors. https://www.ncbi.nlm.nih.gov/books/NBK100662/
  6. Alomar MJ. Factors affecting the development of adverse drug reactions. Saudi Pharmaceutical Journal 2014;22(2): 83-94
  7. Lucas C. Martin J. Smoking and drug interactions. Aust Prescr 2013;36:102-43 DOI: 10.18773/austprescr.2013.037 https://www.nps.org.au/australian-prescriber/articles/smoking-and-drug-interactions
  8. Hair Loss. American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/hair-loss.html
  9. How to overcome drug-induced constipation. January 21, 2021. The People’s Pharmacy. https://www.peoplespharmacy.com/articles/how-to-overcome-drug-induced-constipation
  10. Taste Disorders. National Institute on Deafness and other Communication Disorders. May 2017. US Department of Health and Human Services. https://www.nidcd.nih.gov/health/taste-disorders#6
  11. Bartok V. Drug-Induced Dry Mouth. Nov 2011. https://www.pharmacytimes.com/publications/issue/2011/november2011/drug-induced-dry-mouth
  12. Gastroesophageal Reflux Disease (GERD, Heartburn). Updated May 2020. Drugs.com. https://www.drugs.com/health-guide/gastroesophageal-reflux-disease-gerd.html
  13. Drug-induced diarrhea. Updated Oct 2019. Medline Plus. US National Library of Medicine. https://medlineplus.gov/ency/article/000293.htm

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.