Any medication comes with the risk of side effects—but experts reveal specific signs that suggest your medicine is making you sick.
15 Silent Signs Your Medications Are Making You Sick
Updated Oct. 04, 2024
Why medications can make you sick
All medications have the potential for side effects, explains Prianka Chawla, MD, a primary care physician at Tufts Medical Center. “Typically, the likelihood of side effects is weighed against the benefit of the medication for your health.” Still, when it comes to adverse drug events (ADEs)—defined as harm experienced by a patient due to exposure to a medication—research suggests that at least half of ADEs are preventable, according to the US Department of Health and Human Services.
“The best way to reduce your likelihood of medication adverse reactions is to speak with your doctor about what to expect from your medications, what common adverse reactions are, and what serious adverse reactions would require stopping a medication,” says Brenna M. Farmer, MD, MBA, MS, FACEP, Chief of Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital. “You should also always ask about specific drug-drug and drug-food interactions and how to avoid them.”
If you’re feeling unwell when taking medication, it’s important for your doctor or pharmacist to determine if it is indeed a medication effect or something else, Dr. Chawla says. But there are some signs that your medications (or your behaviors around taking them) may be making you feel sick.
You just started a new medication
You may feel some side effects when starting a medication, which will pass as your body gets used to the drug, Dr. Chawla explains. “For example, certain medications for mood can cause some initial irritability before the benefit kicks in, other cardiovascular medications can make people feel a bit lightheaded at first, and weight loss medications can cause GI symptoms in the beginning,” she says.
Yet it’s just as important that patients know if certain side effects will not go away, explains Heidi N. Anksorus, PharmD, clinical assistant professor at the University of North Carolina’s Eshelman School of Pharmacy in Chapel Hill. “Blood pressure medications may cause a cough that won’t go away,” for instance.
With more serious side effects such as blood in the urine or stool, shortness of breath, blurred vision, or an intense headache, Anksorus emphasizes that you don’t want to take a wait-and-see approach—any major changes to your health require a call to your doctor or trip to the emergency room. “Any rash or major GI disturbance should be brought to [your doctor’s] attention if they occur after starting a medication,” Dr. Chawla adds.
Your doc doesn’t know about all your meds
According to 2020 research published in The American Journal of Emergency Medicine, patient medication history forms have a high rate of discrepancies—and for an estimated one in five people, this incomplete information is associated with high-risk medication issues.
“Make a list of all the medications, vitamins, supplements, and herbal remedies you are taking and keep it up to date,” Anksorus says. This includes over-the-counter medicines you take, too. While keeping track of your medications can be cumbersome, it’s the only way healthcare providers can help prevent known drug interactions.
And specificity is important. “Telling your doctor that you ‘take a little white blood pressure pill that starts with an ‘A’ won’t help—there are a million little white pills that start with an A,” says Dr. Anksorus. Keeping this list on hand ensures you’re prepared when you go to see your healthcare professional or pharmacist.
You’re taking a supplement
Only about 30% of patients inform their doctors or pharmacists about their supplement use, generally because they believe these supplements are equivalent to food and usage is totally safe, according to 2022 research published in Nutrients. But “There are certain supplements and herbal remedies that may impact the metabolism of prescription medications—like blood thinners—so it is very important to let your doctor know everything you take at home,” Dr. Chawla says.
For instance, ginkgo can increase your risk of bleeding, especially if you already take aspirin or blood thinners (anticoagulants), Dr. Farmer says. Another example: St. John’s wort is known to weaken the effects of medications such as anti-depressants, those for heart disease, and birth control pills, according to the US Food and Drug Administration (FDA).
You’re taking medications at the wrong time
The timing instructions for your medication ensure it gets to the therapeutic range needed to treat whatever conditions or symptoms it is being used for, Dr. Farmer explains. And people may miss the prescribed timing for any number of reasons. “They may not like taking the night dose because it may keep them up or send them on several trips to the bathroom, or maybe the drug is giving them embarrassing side effects, such as gas,” says Anksorus. But “We don’t want the person to write the medication off when we could have adjusted the timing of the dose.”
Plus, your healthcare provider can’t get a good sense of how well a medication is working if they don’t know how you take it. “If a patient is on a blood pressure medication and they are supposed to be taking it twice a day, but they don’t, they will go back to the doctor and still have high blood pressure—and they may get prescribed another med,” explains Anksorus.
You’re not absorbing your medication
“Some medications will not be absorbed properly if [taken with food]—for example, certain thyroid medications should be taken on an empty stomach,” Dr. Chawla says. But it’s important that you follow your doctor or pharmacist’s specific instructions with any medication, as even drugs that treat the same condition may need to be taken differently. For instance, rosuvastatin—a statin used to treat high cholesterol—is best absorbed on an empty stomach. However, another type of statin called lovastatin has significantly improved absorption when taken with food.
Your diet is messing with your meds
Your doctor or pharmacist may also issue instructions to avoid eating or drinking with a medication due to concerns for drug-food interactions, Dr. Farmer says. These interactions can change the way your body metabolizes the medication—meaning your body either doesn’t get enough of the dose or absorbs too much. “These instructions may be more specific, such as avoiding dairy products due to [its interference with medication] absorption, or grapefruit juice due to its effects on a metabolic pathway.”
Leafy greens high in vitamin K are also known to interfere with blood thinners like warfarin, says Ann Tritak, EdD, RN, a registered nurse and Professor Emerita for the School of Nursing at Felician University in Rutherford, New Jersey. “Kale and leafy greens can interfere with Coumadin to prevent a clot,” she explains. In addition, those who are on medications to lower their blood pressure should avoid licorice root/tea and black licorice, which contains glycyrrhizin, a substance that raises blood pressure.
Your stomach is irritated
Sometimes, your doctor or pharmacist will recommend taking a medication with food simply so that the drug doesn’t irritate your stomach lining, Dr. Chawla says. Skipping this guidance can make you more vulnerable to side effects like nausea or gastric reflux.
You’re experiencing a well-known side effect
“There is a broad range of adverse reactions that medications can cause,” Dr. Farmer says. “Some are worrisome, requiring the medication to be stopped, while others are easy to treat or become tolerated as your body becomes used to the medication.”
For instance, developing a yeast infection is a common adverse reaction to antibiotics, as the drugs can kill the normal, necessary, healthy bacteria in the body. “This reaction does not require you to stop the antibiotics, and there are likely ways to try to prevent a yeast infection while taking antibiotics.” Some diabetic medications, particularly rapid-acting insulins known as sulfonylureas, can cause low blood sugar.
Other high-risk medicines include anticoagulants, such as warfarin, which can cause bleeding, and opioids, such as oxycodone, hydrocodone, or fentanyl, which can cause drowsiness. “It is always a good idea to ask your physician and pharmacist about possible adverse effects of your specific medications and how to prevent [or manage] them,” Dr. Farmer says. “You should also discuss what adverse reaction would require you to stop taking a medication.”
For example, “Allergic reactions such as rash, hives, anaphylaxis with throat swelling or difficulty breathing can occur with any medication use,” Dr. Farmer explains. If you experience any sign of an allergic reaction, stop taking the medication and seek medical attention immediately.
The drug isn’t treating your symptoms
What you think is a side effect of the medication may actually be a symptom of the condition you are trying to treat, says Anksorus. “If you take warfarin and are experiencing shortness of breath or swelling in the calf, I’d be worried that it might be a blood clot in your leg—sometimes the cautions that are listed may not be related to the drug but to the disease state.”
In general, see your doctor regularly when taking prescription medications, Dr. Chawla advises. “Be sure that any needed lab monitoring is done and the doses are addressed—and that the medication is having the intended effect on improving your health.”
Your dose is too high
It’s important to be on the lowest effective dose of your medications where possible—and to identify opportunities to eliminate medications that may no longer be needed, Dr. Chawla explains.
This is because too much of a medication can have unintended consequences. For example, if the dose is too high, blood thinning medications can cause you to bruise easily, bleed from your gums when you brush your teeth, or have blood in your urine or stool, Dr. Farmer says.
Or, you may be accidentally taking too much of a certain medication by combining your prescription with over-the-counter drugs. Some prescribed pain medication can have acetaminophen, so avoid taking acetaminophen over-the-counter, Tritak says. “You may end up increasing the dose of acetaminophen, which is toxic to the liver,” she says. Aspirin can cause a similar double-dosing effect. “A person taking meds to prevent clots may take an aspirin and then end up in the emergency room bleeding.”
You decided to change your dose—on your own
You may feel like your medication is not working right, but it is important that you do not self-diagnose or change the dose of your medicine without talking to the prescriber first, especially if you are taking antidepressants or beta-blockers.
“Changing your dose makes it more likely that you will experience a side effect,” says Jennifer Bacci, PharmD, endowed associate professor at the University of Washington School of Pharmacy in Seattle. Depending on the medicine, a side effect could be caused by changing the dose too much or too quickly, decreasing dosage, or stopping a prescription can also trigger problems.
You’re on multiple medications
Dr. Farmer says that it’s not uncommon for a patient to have to take multiple medications to manage multiple medical conditions—a situation called polypharmacy. “The problem with polypharmacy is that it can increase the risk of drug-drug interactions and increase the risk of adverse reactions,” she explains. “If there is a need to use a medication for those adverse reactions, it adds to the risks [with] a cycle of medication prescribing, worsening polypharmacy.”
To manage this risk, she says it’s important to talk to your physician about removing any medications that are unnecessary. “This ‘de-prescribing’ helps to decrease the risks of polypharmacy. You should also discuss if there are any non-medication ways to treat a certain medical condition.”
The drug may be risky for your age
Started in 1991 by Mark Beers, MD, and colleagues, the Beers List is a list of 34 potentially inappropriate medications for older patients. Sometimes people have been on a drug for years, and they reach a certain age and discover the medication is on the Beers List, says Anksorus, “This list indicated medications with high risk that should not be prescribed for people older than 65.”
Long-term blood pressure medication use
“While it is usually rare for a medication to cause adverse reactions after many years of use, there is one example that is well-known amongst emergency physicians,” Dr. Farmer says. “A class of blood pressure medications, known as ACE Inhibitors, can cause a condition known as angioedema.” Angioedema involves swelling of the lips, tongue, throat, head, or neck—but it’s not an allergic reaction. In extreme cases, the swelling can require placing a breathing tube until the swelling is improved.
It’s the nocebo effect
The nocebo effect is a phenomenon that occurs when a patient experiences negative side effects from a drug—and not because of the medication itself, but because they believe it will make them sick. Research has shown that this effect is especially strong around statin drugs that treat cholesterol. A 2021 study published in the Journal of the American College of Cardiology found that up to 90 percent of adverse symptoms reported by statin users were “nocebo”.
About the Experts
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Sources
- Prianka Chawla, MD, Primary Care Physician at Tufts Medical Center
- Brenna M. Farmer MD, MBA, MS, FACEP, Chief of Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital
- Heidi N. Anksorus, PharmD, clinical assistant professor at the University of North Carolina’s Eshelman School of Pharmacy in Chapel Hill
- US Department of Health and Human Services: “Medication Errors and Adverse Drug Events”
- The American Journal of Emergency Medicine: “Accuracy of patient self-administered medication history forms in the emergency department”
- Nutrients: “Differences in the Perception of Dietary Supplements between Dietary Supplement/Medicine Users and Non-Users”
- US Food and Drug Administration: “Mixing Medications and Dietary Supplements Can Endanger Your Health”
- American Pharmacists Association: “Beers revised: Drugs not to use in older adults”
- Journal of the American College of Cardiology: “Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment”
Medically reviewed by Originally Published: June 11, 2017
