Side effects from a long-term medicine are worth addressing rather than tolerating, partly because they are often fixable and partly because tolerating them tends not to last. People who find a medicine unpleasant eventually take it irregularly or stop, which is a worse outcome than the side effect.
There is almost always something between carrying on unchanged and stopping.
Common side effects during long-term use
Adjustments that often help, in roughly the order they get tried:
- Timing. Moving a dose to bedtime helps with drowsiness; moving it to the morning helps with insomnia. Blood pressure medicines causing dizziness sometimes suit a different time of day.
- Food. Many medicines that upset the stomach are better tolerated with food, though some must be taken on an empty stomach, so check rather than assume.
- Dose. Many effects are dose-related. A lower dose, or a slower increase when starting, resolves a great many of them.
- Formulation. Modified-release versions are often gentler on the stomach; a liquid may suit if swallowing is difficult; a patch or gel avoids the digestive tract entirely for some medicines.
- A different medicine in the same class. Statins and blood pressure medicines in particular vary between individuals, and switching within the class often works.
- Adding something protective, such as stomach protection alongside an anti-inflammatory, rather than stopping the medicine.
Some effects genuinely do settle with time, particularly digestive ones in the first weeks. Knowing which are likely to settle and which are not is worth asking about explicitly. See whether chronic medication side effects go away.
Serious or persistent symptoms to discuss with a clinician
Not everything should be managed. Get help rather than adjusting for yellowing of the eyes or skin, passing much less urine than usual, unexplained bruising or bleeding, severe muscle pain with dark urine, a rash that blisters or peels, or difficulty breathing.
See serious medication side effects.
Dose changes, missed doses and monitoring tests
Keep a short record before your appointment. What the effect is, when it happens relative to the dose, how bad it is, and what it stops you doing. Two weeks of notes turns a vague complaint into something a prescriber can act on, and it also reveals patterns you may not have noticed, such as an effect that only follows the evening dose.
Be concrete about impact. Saying a medicine makes you too drowsy to drive safely, or that nausea means you skip doses twice a week, changes the conversation in a way that saying you do not feel right on it does not.
If you have already been skipping doses, say so. Prescribers work out doses on the assumption you are taking it as prescribed, and a medicine that appears not to be working may simply not be getting taken.
Interactions with OTC medicines and supplements
Before assuming a chronic medicine is the cause, check what else changed. A pharmacy product or supplement started around the same time is a common explanation and is easily missed. See OTC medicines with chronic medication and supplement and medicine interactions.
Do not add an over-the-counter product to manage a side effect without checking, since that is how interactions start.
What to ask your doctor before changing treatment
- Is this likely to settle, or is it one that persists?
- Would a different time of day, or taking it with food, help?
- Is there a lower dose or a modified-release version?
- Is there another medicine in the same class that might suit me better?
- Is there something we can add to counter this rather than stopping?
- What should I do about this medicine if I get a stomach bug?
A pharmacist can answer several of these without an appointment, which is often the faster route.
Related chronic medication guides
- Chronic medication side effects
- Should I stop my chronic medication
- OTC medicines with chronic medication
- Medication side effects hub
- Report a side effect in South Africa
Medical Disclaimer: This content is for informational and educational purposes only and does not constitute medical diagnosis, prescription, or professional advice. Always read the patient information leaflet and consult a qualified doctor or pharmacist regarding any medicine or health concern.