An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

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adverse effects of drugs


Disease and Drug Family Information
  • Adverse Drug Reactions [hide all summaries]
    Although some adverse drug reactions (ADR) are not very serious, others cause the death, hospitalization, or serious injury of more than 2 million people in the United States each year, including more than 100,000 fatalities. In fact, adverse drug reactions are one of the leading causes of death in the United States. Most of the time, these dangerous events could and should have been avoided. Even the less drastic reactions, such as change in mood, loss of appetite, and nausea, may seriously diminish the quality of life.
  • Allergy and Hayfever [hide all summaries]
    If you suffer from an itchy and runny nose, watery eyes, sneezing, and a tickle in the back of your throat, then you probably have an allergy. An allergy means a hypersensitivity to a particular substance called an allergen. Hypersensitivity means that the body’s immune system, which defends against infection, disease, and foreign bodies, reacts inappropriately to the allergen. Examples of common allergens are pollen, mold, ragweed, dust, feathers, cat hair, makeup, walnuts, aspirin, shellfish, poison ivy, and chocolate.
  • Antipsychotic Drugs: Dangerously Overused [hide all summaries]
    Antipsychotic drugs, also called neuroleptic drugs or major tranquilizers, are properly and successfully used to treat serious psychotic mental disorders, the most common of which is schizophrenia. In younger adults, an alarming number of those with schizophrenia who could and often have previously benefited from antipsychotic drugs are not receiving them. They are seen, among other places, on the streets and in homeless shelters. In older adults, the problem is not underuse but, rather, gross overuse by people who are not psychotic.
  • Arthritis and Inflammation [hide all summaries]
    At least 31.6 million Americans suffer from some form of arthritis. The three most common types are rheumatoid arthritis, osteoarthritis, and gout. Each has a different cause, treatment, and probable outcome.
  • Benign Prostatic Hypertrophy (BPH) [hide all summaries]
    If your BPH symptoms are minimal, no treatment is necessary, no matter what the size of your prostate gland. If you have BPH symptoms and do not have a very enlarged gland, then an alpha-blocker such as terazosin would be the best choice. If your prostate is very enlarged, treatment with an alpha-blocker would again be the best choice. Finasteride should be used only if an alpha-blocker failed to relieve your symptoms.
  • Constipation [hide all summaries]
    When do you really need to take a laxative? You should not take a laxative to “clean out your system” or to make your body act more normally. It is untrue that everyone must have a bowel movement daily. Perfectly healthy people may have from three bowel movements per week to three bowel movements per day.
  • Cough and Cold [hide all summaries]
    Many prescription or over-the-counter drug combinations of two or more ingredients should not be used because they are irrational combinations of single ingredients, some of which are safe and effective and sensible to use alone if treating the symptom for which they are intended. The combinations, however, present extra risks for extra ingredients that will usually not add any benefit (possibly a risk) to the first ingredient and will invariably cost much more than the single ingredient alone.
  • Depression: When are Drugs Called For And Which Ones Should You Use? [hide all summaries]
    Ironically, one of the kinds of depression that should not be treated with drugs is depression caused by other kinds of drugs. If someone is depressed and the depression started after beginning a new drug, it may well be drug-caused. Commonly used drugs known to cause depression include the following:
  • Diabetes Prevention and Treatment [hide all summaries]
    Diets that are very complicated or very different from what you are used to are hard to follow. The American Diabetes Association (ADA) diet is a highly structured plan based on exchange lists. Although it serves its purpose of regulating calorie and sugar intake quite well, the ADA diet may be difficult for older people to use. Successful use of this diet requires considerable time spent planning meal patterns and food portions. Older people often have trouble with this diet because the food lists are long and complicated and require considerable memorization.
  • Diarrhea [hide all summaries]
    How to Treat Acute Simple Diarrhea Do not eat or drink milk and dairy products, fresh fruits and vegetables, coffee, spicy foods, or other food you do not tolerate well. Do not consume drinks with a high sugar content, such as grape juice, apple juice, and soft drinks, including cola, ginger ale, and sports drinks. Do not eat highly sweetened foods such as candy, ice cream, or Jell-O because they have too much sugar, which can make the diarrhea worse.Drink plenty of ORS (see formula in box).
  • Dietary and Herbal Supplements [hide all summaries]
    In the other chapters of this book, we have had access to published articles describing randomized, controlled trials in medical journals, medical textbooks, the FDA-approved label, and, importantly, the detailed review of the drug (based on a review of the raw data from the sponsor’s clinical trials) conducted by the FDA medical officer, at least for more recent drugs. This evidence base is far from complete for any dietary supplement. By definition, no supplement has passed an FDA safety and efficacy review (otherwise it would be a drug).
  • Drug-Induced Diseases [hide all summaries]
    Each year, more than 9.6 million adverse drug reactions occur in older Americans. The referenced study found that 37% of these adverse reactions were not reported to the doctor, presumably because patients did not realize the reactions were due to the drug. This is not too surprising considering that most doctors admitted they did not explain possible adverse effects to their patients.
  • Elevated Cholesterol Levels [hide all summaries]
    The evidence for treatment, especially with cholesterol-lowering drugs, is much weaker for people who have not yet had the cardiovascular disease described above, known as primary prevention. This is especially so for those people who do not have more than one of the following risk factors: hypertension, diabetes, smoking, obesity, or a close family history of premature heart attacks or strokes.
  • Fluoroquinolones [hide all summaries]
    One of the biggest-selling and most overprescribed classes of drugs in the United States is the family called fluoroquinolones. One clue that a drug your doctor wants to give you is in this class is the fact that the generic names of all such drugs approved in the United States include the sequence floxacin. These drugs have been alternatives for individuals allergic to, or with infections resistant to, other antibiotics. Some fluoroquinolones are commonly misprescribed for colds, sore throats, bladder infections, or community-acquired (as opposed to hospital-acquired) pneumonia.
  • High Blood Pressure [hide all summaries]
    A study of nutritional therapy showed that over one-third of people who previously needed drug treatment for high blood pressure were able to adequately control their blood pressure with nutritional therapy alone.Several factors should be taken into account when considering whether your high blood pressure should be treated. One is the benefits of the treatment for your blood pressure, which vary significantly depending on how high it is, your age, and whether you have other risk factors such as high cholesterol or are a smoker or a diabetic, and whether you have had a heart attack, heart failure, a stroke, or have kidney damage. The other consideration is the risks or the adverse effects of the treatment, which will vary depending on what is being considered.
  • Hormone Replacement Therapy [hide all summaries]
    In 1991, the Health Research Group published the Women’s Health Alert. The largest chapter in the book was on hormone replacement therapy (HRT). By then, the evidence was clear that these drugs caused breast cancer, and very serious doubts had been raised about their ability to protect against heart disease. The first sentence in this chapter began: Female replacement hormones may someday be remembered as the most recklessly prescribed and dangerous drugs of this century.
  • Migraine Headaches [hide all summaries]
    For reasons of both safety and cost, the newer migraine drugs known as triptans should be used only after determining that the NSAIDs and acetaminophen fail to work. The triptans can dangerously, even fatally, narrow arteries in the heart.
  • Muscle Relaxants [hide all summaries]
    Some of the widely prescribed muscle relaxants covered on this web site have been on the market for more than 40 years. Yet five of these drugs were among the top 200 most frequently prescribed medications in the United States in 2002, with more than 30 million prescriptions dispensed. Since their original marketing, there has been very little reliable evidence that these drugs actually relax muscles.
  • Opioids [hide all summaries]
    Most of the time when someone is able to swallow, they should first try a non-opioid drug such as aspirin taken by mouth. If aspirin alone is not effective, it can be combined with an opioid, such as codeine. These two drugs work in different ways, and when they are used together, they generally relieve pain that would otherwise require a higher dose of an opioid, while causing fewer adverse effects.
  • Oral Contraceptives [hide all summaries]
    The pill can cause many adverse effects. Some of them are merely a nuisance, while others can be life-threatening. The pill can cause headaches, bloating, nausea, irregular bleeding and spotting, breast tenderness, weight gain, or vision changes. Other more serious adverse effects that can occur from a few months to a few years after starting oral contraceptives include high blood pressure, gallbladder disease, liver tumors, depression, and metabolic disorders, such as diabetes. Temporary infertility has been associated with the period of time right after pill use is stopped. But the two most dangerous risks associated with taking birth control pills are blood clots and cancer.
  • Osteoporosis [hide all summaries]
    Osteoporosis is a reduction in bone mass and weakening of bone architecture that increases the susceptibility of bone to fracture. Bone is a living tissue that is constantly being broken down and resynthesized at 1 to 2 million microscopic sites in the adult skeleton. Osteoporosis occurs when the rate of breakdown is faster than the rate of resynthesis. The history of the treatment or prevention of osteoporosis is strewn with drugs such as estrogens—discussed below—and others in this chapter with marginal effectiveness or with risks clearly outweighing the benefits.
  • Penicillins and Cephalosporins [hide all summaries]
    Penicillins are a group of antibiotics used to kill bacteria or prevent infections. They are probably the least toxic of all the antibiotics. The penicillins are some of the most commonly prescribed antibiotics and are often the drugs of choice for people who are not allergic to them. Cephalosporins are relatives of the penicillins and have a similar, if slightly expanded, range of action. They have a good safety record but certain problems can occur with their use. Diarrhea is the most common adverse effect, and it may become so bad that treatment must be stopped.
  • Salicylates and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) [hide all summaries]
    The salicylates are used to relieve pain and to reduce fever and inflammation. Aspirin, a nonsteroidal anti-inflammatory drug (NSAID), is the most well-known and frequently used salicylate. Other salicylates discussed on this web site are salsalate and choline and magnesium salicylates.
  • Sleeping Pills and Tranquilizers [hide all summaries]
    Older adults have a much more difficult time eliminating benzodiazepines and similar drugs from their bloodstreams and these drugs can thus accumulate in their bodies. Also, older adults are more sensitive to the effects of many of these drugs than are younger adults. For older adults the risk of serious adverse drug effects is significantly increased. Serious adverse effects may include: unsteady gait, dizziness, falling (causing an increased risk of hip fractures), increased risk of an auto accident, drug-induced or drug-worsened impairment of thinking, memory loss, and addiction.
  • Tetracyclines [hide all summaries]
    Tetracyclines are rarely the antibiotics of choice to treat bacterial infections that are common in older adults. In general, tetracyclines are used to treat such infections as urethritis (inflammation of the urinary tract), prostate infections, pelvic inflammatory disease, acne, Rocky Mountain spotted fever, recurrent bronchitis in people with chronic lung disease, walking pneumonia, and other miscellaneous infections.
  • Ulcers and Gastroesophageal Reflux Disease (GERD) [hide all summaries]
    There are nondrug treatments, with no safety concerns, and less expensive drugs that may be effective for GERD; these should be tried before you use any drugs for heartburn. First, try to avoid foods that trigger your condition (e.g., fatty foods, onions, caffeine, peppermint, and chocolate), and avoid alcohol, smoking, and tight clothing. Second, avoid food, and particularly alcohol, within two or three hours of bedtime. Third, elevate the head of the bed about six inches or sleep with extra pillows.
  • Vitamins and Minerals [hide all summaries]
    One promotional strategy of supplement suppliers is to make people worry about whether they are getting enough nutrients. But do most people really need to take vitamins and minerals to supplement their diets? Or are they a waste of money? Are there better alternatives to taking supplements to ensure adequate nutrition? This section will attempt to answer these questions and help you sort through the fact and fiction surrounding nutritional supplements.
Additional Information from Public Citizen
Health Letter Articles
  • Proton-Pump Inhibitors: Dangerous and Habit-Forming Heartburn Drugs [hide all summaries]
    (September 2011)
    PPIs are now one of the most widely used classes of prescription drugs, with an estimated one out of every 20 people in the developed world currently taking one of these medications. However, given that recent research shows PPIs may be habit-forming, that the majority of PPI use is probably inappropriate, with minimal or no benefit to the patient, and that new, life-threatening risks with long-term therapy are continually emerging, it is time for the medical community to re-evaluate the role of PPIs in everyday practice.
  • Backsliding on Childhood Immunization [hide all summaries]
    (June 2008)
    More and more Americans are choosing not to have their children vaccinated, and as a result, obsolete diseases are making a come-back.
  • What Happened in U.S. Health Care in 2007? [hide all summaries]
    (December 2007)
    This article summarizes 14 important health events that occurred in 2007, including seven that involve the pharmaceutical industry or its increasingly close financial partner, the FDA. Seven other reviews involve our so-called health care system.
  • Research as Public Relations: Antidepressants and Suicide in Youth [hide all summaries]
    (October 2007)
    Because of evidence from a number of studies, the Food and Drug Administration (FDA) recently required a “black box” label for all SSRI (selective serotonin reuptake inhibitor) antidepressants indicating that use in children could lead to an increased risk of suicidal behavior. Now comes a study published in the prestigious American Journal of Psychiatry (Volume 164, pp. 1356-1363) purporting to show, in effect, the opposite: the FDA warnings had caused the rate of pediatric SSRI prescriptions to plummet and as a result young people are killing themselves due to lack of treatment. If this were true, it would be a clear example of the unintended consequences of regulation. The paper and its subsequent publicity appear to be little more than a public relations ploy. The editors of the AJP should not have allowed such gross misrepresentations to pass into print unscathed, and journalists who cited this study as if it deserved equal credence to the RCTs are just as guilty.
  • Diet Drug Poses Risks, Few Benefits [hide all summaries]
    (February 2006)
    On January 23rd, an FDA advisory committee voted to recommend that the agency allow the weight-reduction drug orlistat (Xenical) to be marketed in an over-the-counter form that will be known by the brand name ALLI. However, the drug caused only a minimal increase (4-5 pounds) in weight loss compared to placebo, and studies showed that over time, weight could begin to return. There are also significant safety concerns including the possibility of drug-induced malnutrition and GI effects, including loss of bowel control. The drug is not useful and should not be made over-the-counter.
  • Sleight-of Hand: Merck Tried to Reformulate Vioxx in 2000 While Denying Risk [hide all summaries]
    (August 2005)
    Merck aimed to re-formulate the arthritis drug Vioxx five years ago in order to reduce the potential for heart attacks, adding to previous evidence that the company was fully aware of the dangers of the drug well before it withdrew it from the market last year.
  • A Reminder About The Dangers of Aspirin and Reyes's Syndrome [hide all summaries]
    (October 2003)
    Children and teenagers should not use aspirin when they have the flu.
  • Meridia — Weight Loss or Health Loss? [hide all summaries]
    (October 2003)
    Against the better judgment of both the physicians who reviewed the data for the Food and Drug Administration (FDA) and the FDA’s external Advisory Committee, the weight loss drug Meridia (sibutramine) has been on the market for over five years. Both the agency’s own doctors and its advisors are on record as saying that the benefits (loss of a few pounds in weight) do not outweigh the risks (increased blood pressure and thus increased risk for heart attack and stroke).
  • Drug Safety Withdrawals: Who is Responsible for Notifying Patients? [hide all summaries]
    (December 2002)
    The following editorial, by Health Letter Editor Dr. Sidney Wolfe, appeared in the December issue of Pharmacoepidemiology and Drug Safety. Ultimately, the cost for such notification should be borne by the pharmaceutical company making the dangerous drug. Pharmacists and/or physicians, if the latter have record access, should be reimbursed for doing the company’s work. In addition, the FDA should be given new legislative authority to impose mandatory drug recalls with an enforceable withdrawal schedule governing the level and rapidity of recall and patient notification.
  • FDA Caves In to Industry, Fails to Adequately Address Tylenol Overdoses [hide all summaries]
    (November 2002)
    Most of us remember the 1982 debacle in which Tylenol capsules laced with cyanide were held responsible for seven deaths. These tragic events led to a reimagining of tamper-resistant drug packages. Yet a far greater Tylenol-related tragedy has been unfolding before and since 1982—preventable deaths due to overdoses from acetaminophen (the active ingredient in Tylenol and many other prescription and over-the-counter drugs) and the resultant liver damage. In fact, acetaminophen is the leading cause of toxic drug ingestions in the U.S.
  • Will a Vitamin a Day Keep the Doctor Away? [hide all summaries]
    (October 2002)
    Will a vitamin a day keep the doctor away? If you are malnourished or a strict vegetarian trying to prevent chronic disease due to a vitamin deficiency maybe, but there is also the possibility of harm. If you are a well-nourished elderly person living at home, taking vitamin E may actually increase the number of times you must see your doctor.
  • Outrage: Department of Health and Human Services Fails to Ban Ephedra or Issue Adequate Warnings [hide all summaries]
    (July 2002)
    The   following is a statement by Health Letter Editor, Dr. Sidney Wolfe in response to this decision: Today's announcement by the Department of Health and Human Services (HHS), which not only fails to ban ephedra dietary supplements but also fails to seriously warn against the use of these products, should result in the firing of all officials in HHS and the Food and Drug Administration (FDA) who are responsible for this dangerous cowardice. The idea that more studies are needed and that the more than 100 deaths and hundreds of other cases of serious damage to users of these products, many of which are extremely well-documented and have occurred at recommended doses, is not enough for a ban is in sharp contrast to what has usually occurred with the removal of dangerous prescription drugs from the market.
  • Outrage: Possible Corruption at the American Heart Association [hide all summaries]
    (May 2002)
    In an article in the March 23, 2002 issue of the British Medical Journal, journalist Jeanne Lenzer lays bare the evidence that the biotech firm Genentech inordinately skewed the American Heart Association's (AHA's) guidelines on the use of "clot-busters" like Genentech's tPA (also known as alteplase or Activase), the only Food and Drug Administration-approved treatment for acute stroke.
  • Outrage: Do Not Use Ephedra [hide all summaries]
    (October 2001)
    This Is a Dangerous Substance and Should Be Taken off the Market.
  • COX-2 Inhibitors Vioxx and Celebrex: Keep Staying Away--It Gets Worse [hide all summaries]
    (March 2001)
     In light of the above discussion, we continue to advise the patient-protective five-year-rule for these drugs, as we do for all other new drugs that are not breakthroughs. Do Not Use.
Worst Pills, Best Pills Newsletter Articles
Drug and Dietary Supplement Profiles - Each profile is a comprehensive review of the safety and effectiveness of this drug. If drug is not a Do Not Use product, information on adverse effects, drug interactions and how to use the medication are included.
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