Medications Archive

When the risks of medication outweigh the benefits.

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Taking over-the-counter or prescription painkillers may seem like a simple solution for chronic pain. It's actually a bit more complicated, yet many older adults aren't aware of potential problems. "They think that if it doesn't require a prescription, it's safe. But there are some long-term health risks," says Dr. Edgar Ross, director of the Pain Management Center at Harvard-affiliated Brigham and Women's Hospital.

Here's what you should know about some commonly used pain relievers.

Take control by using helpful gadgets and talking to your doctor about reducing your medications.

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There are many reasons why people are unable to stick to a medication regimen prescribed by a doctor, such as high costs or drug side effects. Often, those issues can be resolved by asking your doctor if a switch to another drug will help.

Another reason for what doctors call "non-adherence": too many pills and confusion about taking them. "It is a bigger problem than organization, and not always the patient's fault. Often providers write too many prescriptions without explaining them, or create a complicated schedule," says Dr. Sarah Berry, a geriatrician and assistant professor at Harvard Medical School.

It appears that adverse drug events that lead to visits to the emergency department are increasing among older adults.

A conversation with this health professional can help you avoid making harmful mistakes.

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When your pharmacist hands you your pills, he or she is likely to ask, "Any questions?" This is an invitation to tap into a vast store of knowledge—and one you should accept. A few minutes with your pharmacist may spare you some serious health consequences.

"People are often in the dark regarding the purpose of their medication," says Dr. Gordon Schiff, associate professor of medicine at Harvard Medical School. Although prescriptions come with a lengthy package insert containing detailed information about the drug, the information is often written in technical terms and printed in microscopic type. The lack of clear information and the confusion and misunderstandings that result figure into more than a million preventable medical complications annually.

Intrarosa, a vaginal insert containing dehydroepiandosterone (DHEA), improves vaginal lubrication to alleviate pain during intercourse.

In a large, long-term clinical trial, people taking the diuretic chlorthalidone had significantly fewer hip fractures than those taking the calcium-channel blocker amlodipine or the ACE inhibitor lisinopril.

Despite new research, the answer is unclear. Use caution when taking any pain medication on a routine basis.

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People with aching joints from arthritis—which affects nearly one in four adults—often rely on drugs known as NSAIDs to ease the pain of this often-debilitating condition. These popular medications also relieve headaches, cool fevers, and dampen inflammation. But with the exception of aspirin, most NSAIDs pose a risk to the cardiovascular system, notes Harvard professor Dr. Elliott Antman, a cardiologist at Brigham and Women's Hospital.

"Taking NSAIDs routinely over a long time period can raise the risk of blood clots, increase blood pressure, and accelerate cardiovascular disease," says Dr. Antman. While the danger is greatest in people with heart disease, it's also present in people without any signs of the disease.

Tracking your progress and symptoms can help you discern the difference.

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You probably know that when you take a medication, you need to tell your doctor about any side effects that develop. But being aware of side effects can be challenging when you're older. "In many cases, the signs of aging are similar to side effects of medications," says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Similarities

The fix

Certain cholesterol-lowering medications—namely, ezetimibe (Zetia) and drugs known as bile acid binders—also appear to be effective at lowering cholesterol and reducing the risk of serious cardiovascular events. 

Splitting a pill into two equal halves is sometimes necessary when needing to adjust dosage, or as a means to save money buy purchasing higher-dose pills. However, splitting is not safe for all pills, so a person should always consult a pharmacist or doctor.