Medications Archive

Articles

Gene discoveries may pave the way for new blood pressure drugs

The discovery of 44 gene sites associated with high blood pressure may provide leads for developing new drugs to treat this common condition. 

Ask the doctor: Herbal supplements to treat erectile dysfunction?

Herbal supplements are sometimes advertised to improve a man’s sex life by increasing blood flow to the penis, but many are not proven effective for treating ED and may cause serious side effects.

Should you take a drug holiday?

A break from a medication is beneficial only in certain cases.


Image: Rallef/ThinkStock

When you think of a holiday, your medicine cabinet probably doesn't come to mind. But for people who take medications long-term, a drug holiday—a break from a medication for days or even years—may be helpful, for some medicines. "For some people, it gives the body a chance to recover the systems that have been suppressed by the drug," says Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School.

Why take a break?

How to take a break

You must work with your doctor if you'd like to take a drug holiday. He or she will determine if you're a candidate for a break, and consider chronic health conditions you have and other medications you take. "Everybody's experience will be different," says Dr. Miller.

If your doctor says a drug holiday is not appropriate for your medication, but you feel the drug is not working or is causing unwanted side effects, ask about switching to another drug, how to do that safely, and whether a new medication would have potential side effects or long-term risks. Remember, too, that sometimes finding the right medication takes trial and error. Don't give up; stick with it, and stick to the rules for proper use.

Drug holidays: Don't try them on your own

In general, stopping a medication abruptly can be risky and even life-threatening. For example, if you suddenly quit taking a proton-pump inhibitor, such as lansoprazole (Prevacid) or omeprazole (Prilosec), used to reduce acid reflux and heartburn, you can suffer a rebound effect—a relapse marked by a surge of stomach acid. People with advanced Parkinson's disease who stop taking the often-prescribed drug combination of carbidopa and levodopa (Sinemet) may experience severe rigidity, fever, a change in consciousness, and even death. "In the 1980s, a drug holiday was thought to reduce the side effects of the medication by resetting the brain receptors. But the evidence does not show a difference in long-term improvement. We now know there can be severe complications from abruptly withdrawing.

I feel that drug holidays have no role in treating Parkinson's disease," says Dr. Albert Hung, a Parkinson's disease specialist at Harvard-affiliated Massachusetts General Hospital.

Other medications you must never stop on your own include those to treat high or low blood pressure, diabetes, high cholesterol, severe pain, anxiety, or insomnia.

What if you're experiencing side effects from your medication, or you feel it isn't working? "That's not time for a holiday, but it may be time to switch to another drug. But, with your doctor's advice, be sure to taper one while starting another," says Dr. Michael Craig Miller, assistant professor of psychiatry at Harvard Medical School.

 

Preventing blood clots: Is warfarin still right for you?

Using warfarin effectively is challenging—perhaps even more so than doctors have realized.


 Image: arun011 /Thinkstock

For more than 60 years, warfarin has been a mainstay for people with atrial fibrillation. Used properly, warfarin may prevent as many as 60% of strokes related to this common heart rhythm disorder each year. But warfarin is notoriously tricky to manage because blood levels have to be kept within a narrow range to avoid side effects such as unwanted bleeding.

As a result, warfarin users must get frequent blood tests (see "What is an INR?") when they start the drug to fine-tune their dose. Once their INR values are consistently in the right range, most people scale back to testing every month or so. But a recent study suggests that people who take warfarin need to stay extra vigilant over the long term.

Many older adults take unneeded blood pressure drugs

About 66% of adults over age 70 still take antihypertensive medication even though they now have low pressures, says a study from the University of Kent in the United Kingdom. Researchers say this exposes adults to medication side effects like dizziness and falls. 

Is an “exercise pill” coming your way?

Researchers are developing pills that provide many of the effects of exercise. But none provides all the benefits of physical activity.


Image: Dmitry Fischer/ Thinkstock

Health experts are fond of saying, "If exercise were a pill, everyone would want to take it." And scientists seem to agree. Over the past several years there has been an accelerated push to develop drugs that mimic the effects of exercise. The promise is enormous—such medications could be a boon to people whose physical activity is limited by medical conditions or injuries. They could provide a head start for people who are beginning an exercise program. They could also confer the health benefits of exercise on healthy people who can't fit physical activity into their schedules or just don't want to get off the couch.

"While the idea of an exercise pill is a good one, it has many, many limitations," says Dr. Laurie Goodyear, head of the Section on Integrative Physiology and Metabolism at Harvard-affiliated Joslin Diabetes Center. Just as a vitamin capsule won't provide all the benefits of a healthy diet, a single pill is unlikely to provide all the benefits of exercise.

Is a heartburn drug hurting your health?

Long-term risks are associated with proton-pump inhibitors, but there are other options for treating acid reflux.


Image: Eranicle/ Thinkstock

Proton-pump inhibitors (PPIs), which reduce the amount of acid produced in the stomach, are so effective at treating heartburn and ulcers that they've been among the world's top-selling drugs for 25 years. Initially available only by prescription, PPIs, which include omeprazole (Prilosec), lansoprazole (Prevacid), and esomeprazole (Nexium), have been sold over the counter for several years. However, now that millions of people are taking PPIs, the drugs have been linked to an increasing number of health risks, such as fractures, kidney problems, vitamin B12 deficiency, low magnesium, and—most recently—dementia and heart attack.

"These studies—especially those suggesting a relationship to dementia and heart attack—are concerning," says Dr. Jacqueline Wolf, a gastroenterologist and associate professor of medicine at Harvard Medical School and author of A Woman's Guide to a Healthy Stomach: Taking Control of Your Digestive Health.

Can I take an expired medication?

Most drugs remain potent after their expiration dates. You may want to move it to the refrigerator, though, because drugs stored in cool temperatures usually remain potent longer.

Shunning osteoporosis treatment isn’t a wise decision for most women

Forgoing drugs that slow bone loss to avoid rare side effects can be the wrong decision for your hips and spine.


 Image: wildpixel/Thinkstock

A front-page article in the June 1, 2016, edition of The New York Times carried this headline: "Fearing drugs' rare side effects, millions take their chances with osteoporosis." The article described a situation all too familiar to doctors. Women are declining prescriptions of bisphosphonates—drugs that slow the rate at which the body breaks down bone—or discontinuing the medications far earlier than recommended. In fact, according to a 2015 report in the Journal of Bone and Mineral Research, the rate of bisphosphonate use fell by half between 2008 and 2012. That article documented a wave of media coverage of scientific studies that reported two rare side effects—osteonecrosis (bone death) of the jaw and atypical fractures near the top of the femur (thigh-bone)—and suggested that the reports had kindled fears that had led women to abandon bisphosphonates.

"The perception of risk is so much greater than the actual risk," says Dr. Meryl LeBoff, director of the skeletal health and osteoporosis center at Harvard-affiliated Brigham and Women's Hospital. Compared with many other common diseases, we are fortunate that we have good therapies to reduce the risk of osteoporotic fractures by 70% at the spine and 40 to 50% at the hip. She points to statistics referenced in the New York Times article: for every 100,000 women taking a bisphosphonate, fewer than three will have osteonecrosis of the jaw and one will have an atypical femur fracture, but 2,000 will have avoided an osteoporotic fracture.

Are your medications causing nutrient deficiency?

Long-term doses of certain medications may rob you of calcium, folic acid, and crucial B vitamins.


Short-term medication use will not lead to nutrient deficiency. But long-term use may interfere with your body's ability to absorb nutrients or produce them.
Image: Gruzdaitis Andrius/Thinkstock

Medications are well known for causing side effects such as nausea or drowsiness. These are the kinds of side effects you notice and can do something about. But sometimes a lesser known side effect happens without giving you any warning: nutrient deficiency.

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