How to get the best out of prescription drugs
Dr Vernon Coleman
My book `101 Things I have Learned’ is exactly what the title suggests. In the essay numbered No 67 I explain that I have learned that patients improve their chances of benefiting from a drug — and they also minimise the risk of problems — if they know what to expect (and if they understand what side effects they should expect). Here is the text of no 67 from `101 Things I Have Learned’:
You have a right to know what you are taking — and why. Don’t be shy. Here are some questions you should ask your doctor:
1. What is this medicine for?
2. How long should I take it? Should I take it until the bottle is empty or until my symptoms have gone?
3. What should I do if I miss a dose?
4. What side effects should I particularly watch out for? Will the medicine make me drowsy?
5. Am I likely to need to take more when these have gone? Should I arrange another consultation?
6. Are there any foods I should avoid? Should I avoid alcohol? Should I take the medicine before, with or after meals?
7. How long will the medicine take to work — and how will I know that it is working?
Whenever your doctor gives you a drug to take it is vitally important that you watch out for side effects. Four out of ten people who are given drugs by their doctors will suffer uncomfortable, hazardous or even lethal side effects.
Drugs which are highly promoted when they are launched, but which are eventually shown to be totally useless, often cause illnesses far worse than the complaint for which they were prescribed. Far more people are killed by prescription drugs than are killed by illegal drugs such as heroin and cocaine. And as I have pointed out on many occasions no less than one in six hospital patients are there because they have been made ill by their doctor.
Perhaps the most convincing evidence of the failure of our current drug testing systems to protect patients lies in the number of drugs which have had to be withdrawn after they have been passed as ‘safe’ by the authorities. I know of over 80 drugs which have had to be withdrawn or restricted because they were considered to be too dangerous for widespread use. Some of these drugs were withdrawn after months. Others were taken off the market after being sold for years.
Can you imagine the outcry if testing methods were so inadequate that 80 types of motor car or 80 varieties of food had to be withdrawn because they were found to be unsafe?
Doctors, the drug industry and the Government all claim that nothing can be done to avoid this drug scandal. I don’t believe this is true. If governments really wanted to protect patients there are many things they could do.
Since the end of the 1970’s, I have argued that we need an international, computerised drug monitoring service — designed to make sure that doctors in one part of the world know when doctors in other countries have spotted problems. Astonishingly, no such system exists.
You might imagine that when a drug is withdrawn in one country other countries will take similar action. But you would be wrong. One drug that was officially withdrawn from the market in the USA and France was not officially withdrawn in the UK until five years later!
I believe that one of the main reasons for the international epidemic of drug-induced illness is the greed of the big international drug companies. They make a fortune out of making and selling drugs and their ruthlessness and levels of profit make the arms industry look like a church charity.
Governments could dramatically reduce the incidence of lethal, dangerous and uncomfortable side effects by insisting that drugs be extensively tested before being prescribed for millions of people around the world. At the moment drugs can be launched onto the mass market after relatively few tests have been done. The authorities admit that they don’t know what side effects will be produced until a drug has been on the market for a while.
And patients would be far, far safer if drug companies were stopped from testing drugs on animals. Pharmaceutical companies love to test drugs on animals because they can’t lose. If the animal tests show that the drug doesn’t produce side effects in animals the company will proclaim the drug ‘safe’ and put it on the market. But if the animal tests show that the drug causes side effects the company will dismiss the results as irrelevant — and put the drug on the market anyway — ‘because animals are different to people’.
If you have ever suffered unpleasant side effects the chances are high that the drug you were given was tested on animals. The evidence available now shows that animal experiments are so misleading and inaccurate that they result in many human deaths.
Despite the fact that one must hold the pharmaceutical industry directly responsible for most of the side effects (and deaths) caused by drugs there is no doubt that the number of problems could be reduced if patients were more aware of how best to protect themselves from side effects.
It is a sad fact that of all the drugs prescribed only a relatively small number are taken in the way that the prescriber originally intended them to be taken. Drugs are taken at the wrong time, they are taken too frequently and they are sometimes never taken out of the bottle at all.
It is important to remember that modern prescribed drugs are not only potentially effective but also powerful and potentially dangerous.
Here are some tips to help you minimise your risk of developing a side effect if you have to take a prescription drug.
* Some drugs can be stopped when symptoms cease. Others need to be taken as a complete course. A small number of drugs need to be taken continuously and a second prescription will have to be obtained before the first supply has run out. The patient who knows what his drug is for, why he is taking it and what the effect should be, will be more likely to know when a drug is to be stopped.
* If a drug has to be taken once a day, it is usually important that it is taken at the same time each day. If a drug has to be taken twice a day it should usually be taken at intervals of 12 hours. A drug that needs to be taken three times a day should usually be taken at eight-hourly intervals and a drug that needs to be taken four times a day should usually be taken at six-hourly intervals. The day should be divided into suitable segments.
* Some drugs which may cause stomach problems are safer when taken with meals. Other drugs may not be absorbed properly if taken with food.
* A number of patients (particularly the elderly) are expected to remember to take dozens of pills a day. When a day’s medication includes tablets to be taken twice daily, three times daily, mornings only and every four hours, mistakes are inevitable. If a patient needs to take a number of drugs a day mistakes can be minimised by preparing a daily chart on which the names and times of different drugs are marked. Such a chart will reduce the risk of a patient taking one dose twice or struggling to remember whether a particular pill has been taken yet.
* To avoid the risk of over-dosage sleeping tablets should not be kept by the bedside. It is too easy for a half-asleep patient to mistakenly take extra tablets. In the case of a suspected overdose medical attention must be sought.
* Always follow any specific instructions that you have been given by your doctor. Read the label on your bottle of pills and take notice of what it says!
* When you’re not using them drugs should be stored in a locked cupboard out of reach of children, in a room where the temperature will be fairly stable. The bathroom is probably the worst room in the house for storing medicines. Your bedroom — which probably has a more stable temperature — is much better.
* Never take drugs which were prescribed for someone else. Return all unused supplies of drugs to your pharmacist.
* It is wise to assume that all prescribed drugs can cause drowsiness. You shouldn’t drive or operate machinery after taking a drug until you are sure that you are safe.
* Drugs do not mix well with alcohol. If you want to drink while taking drugs ask your doctor whether or not it will be safe.
* Do not take non-prescribed medicines while taking prescribed drugs unless your doctor has told you that you can.
* Do not stop taking drugs suddenly if you have been advised to take a full course. Ring your doctor for advice if you need to stop for any reason. Some drugs have to be stopped gradually rather than abruptly.
* Be on the look out for side effects and remember Coleman’s First Law of Medicine: if you seem to develop new symptoms while taking a prescription drug then the chances are high that the new symptoms were caused by the treatment you are taking for your original symptoms.
* Report any side effects to your doctor — and ask him if he’s going to report the side effects to the authorities. The vast majority of doctors never bother to report side effects — with the result that potentially hazardous drugs remain on the market for far longer than they should.
* If you need to see a doctor while taking a drug make sure he knows what you are taking — particularly if he intends to prescribe new treatment for you. Many drugs do not mix well together and may, indeed, react together in a dangerous way.
* Do not assume that a doctor you have seen in the past will remember what he prescribed for you on a previous occasion.
* Learn the names and purposes of the drugs you take. If you are not sure when to take the drugs that you have been given ask your doctor or the pharmacist. If you think you will forget the instructions you are given ask for them to be written down. The name of the drug should always appear on the container.
* Do not remove drugs from their proper containers except when you need them or if you are transferring them to a device intended to improve compliance.
* Try to see the same doctor as often as possible. If several doctors are prescribing for you there may be an increased risk of an interaction between drugs which do not mix well.
* Use drugs with care, but do use them when they are required. Doctors sometimes divide patients into two main groups: those who are willing to take drugs for any little symptom and who feel deprived if not offered a pharmacological solution to every ailment, and those who are unwilling to take drugs under any circumstances. Try not to fall into either of these extreme groups.
The essay above is taken from Vernon Coleman’s book `101 Things I Have Learned’. To find out how to purchase a copy please CLICK HERE
Copyright Vernon Coleman May 2025
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