In pain? It could be your meds
Alert your doctor to side effects of prescription drugs
Many people turn to the medicine cabinet to treat their pain. But surprisingly, the prescription drugs in that cabinet also can be the source of the hurt.
Sometimes the pain can be minor, especially compared to the drug’s benefits. Other times, however, it can be severe and may continue long after you stop taking the drug.
Whatever the case, don’t keep it to yourself.
“If you start feeling a new pain, especially after starting a new drug, it’s important to communicate that fact to your doctor,” said Phillip Morris, interim pharmacy director of the Christus Santa Rosa Medical Center. “Don’t assume it’s something you have to put up with.”
Take note of where you’re having pain, how it feels (dull, sharp, tingly) and when it occurs, especially in relation to when you’re taking the drug. This can make it easier for your doctor to determine if the pain is being caused by the medicine or something else.
“The good news is that in most cases, there is an alternative drug or a strategy that can help reduce or stop the pain,” said Raymond G. Mattes, a pharmacotherapy resident at the University of the Incarnate Word.
Both Morris and Mattes stress that patients not stop taking any prescription medicine or adjust the dosage without first consulting a doctor or pharmacist.
Here’s a look at several common types of drug-induced pain and the medications that can cause them:
Body pain
Statins. These cholesterollowering drugs are some of the most widely prescribed in the U.S. According to Harvard Medical School, 15 percent to 20 percent of those taking them will develop myalgia, or muscle pain.
Fortunately, there are several types of statins — including
atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor) — so your doctor can change your prescription or put you on a lower dose to see if the pain goes away.
You also may want to try redoubling your efforts to make lifestyle changes that may lower your cholesterol, including eating better and exercising more. Even if this doesn’t work, you’ll still be healthier for the effort.
It’s unknown why statins cause myalgia. One theory holds that the drugs deplete the body’s supply of coenzyme Q10, a nutrient that occurs naturally in the body and also in many foods. Taking CoQ10 supplements may help relieve the pain.
Diuretics. Used to treat conditions such as high blood pressure and congestive heart failure, diuretics can cause potassium levels in the blood to drop too low, resulting in muscle cramping.
“Fortunately, there are usually other drugs available to treat these conditions,” Morris said. “Talk to your doctor about possible alternatives.”
Bone pain
Bisphosphonates. Used to prevent bone loss and treat osteoporosis and similar bone diseases, bisphosphonates can, ironically, also cause severe bone pain — as well as muscle and joint pain. The mechanism for this pain is unknown.
There are several types of bisphosphonates available, so consider switching. Fortunately, symptoms tend to disappear once the drug is discontinued.
Headache
Nitrates (including nitroglycerin). Often prescribed for angina, or chest pain, these drugs dilate, or widen, blood vessels to allow more blood flow to the heart. But they have the same effect on blood vessels in the brain, which can lead to headaches.
Try using acetaminophen, such as Tylenol, to treat the pain. But avoid nonsteroidal anti-inflammatories such as ibuprofen and aspirin.
For many people, the headaches eventually go away. For others, temporarily lowering the dose may help them develop a tolerance so they eventually can return to the full strength.
Medication overuse. Pain medications used long enough — from NSAIDs to opioids — may eventually stop working and actually trigger headaches.
Here again, the strategy is either to stop taking the medication or switch to a different type in the hope that the headaches will go away.
Neuropathic pain
Metformin. This popular diabetes drug can lead to B12 deficiency, which then can lead to peripheral neuropathy. This is a type of stabbing, pins and needles or burning pain caused by nerve damage that usually strikes the hands and feet first.
Have your B12 levels checked. “It may also make sense to proactively start taking a B12 supplement,” Mattes said.
Antibiotics. A class of antibiotics called fluoroquinolones are commonly used to treat respiratory, urinary tract and other infections. They also can lead to potentially serious nerve damage, so contact your doctor immediately if you experience neuropathic pain.
Although the pain often goes away once the drug is discontinued, this can take months, or it could become permanent. Consider switching to an older, safer antibiotic that may not trigger neuropathy.
Stomach pain
Iron supplements. In addition to stomach pain, people taking these supplements to treat anemia or other conditions and during pregnancy also can suffer constipation or diarrhea, nausea and vomiting.
Food reduces the body’s ability to absorb iron, so it’s usually taken on an empty stomach. Taking it with food, though, may help avoid these side effects.
NSAIDs. A class of pain relievers that includes aspirin, ibuprofen and naproxen, nonsteroidal anti-inflammatories can, over time, damage the stomach lining, leading to painful ulcers.
You can reduce this risk by taking NSAIDs with food, combining them with an antacid and taking them for the shortest period of time possible. If you’re at risk of ulcers, consider switching to an acetaminophen pain reliever, such as Tylenol.