If this were a perfect world, we would have one medication that would cure painful conditions without any nasty side effects. What a world that would be!! No pain, no nausea, no headaches, no itchy skin, no drowsiness and no constipation; wouldn't that be fantastic? Let me know when you find that world because I'd like to live there.
For now, I live in a world where medications do cause side effects. We can only hope that the medication chosen for you provides more benefit than harm. When you start your new medication, please expect some initial side effects that usually will go away within a week as your body adjusts to the new, foreign chemical. So you need to give this medication a good college try before we can decide whether or not it will work for you. During this trial phase please alert me to any side effects that you may be experiencing.
Here are some common side effects that you are likely to encounter with the medications I usually prescribe for pain.
- Drowsiness: You are very likely to experience initial drowsiness. For this reason, please refrain from driving when initiating a new medication. If the drowsiness becomes intolerable, I may need to lower the dose you are taking or switch to another "sister" drug that is less likely to cause drowsiness (but likely to be more expensive).
- Constipation: Difficulty moving your bowels is the most common side effect that nearly everyone experiences. So, you are not alone. Your other "bowel buddies" find dietary changes helpful like drinking more water or eating more fiber. Some need to use laxatives daily like senna products, glycolax or Metamucil. If nothing seems to be helping, let me know because there are new medications like Relistor that might help your situation.
- Headache: If you don't have a headache now, you might experience one in the future due to medication use. Some medications cause headaches directly as a side effect. Other medications cause headaches when they start to wear off. Depending on the reason for your headache, I may be able to remedy it by changing your medication or adding another medication. For example, anti-histamine medicines like Benadryl can work very well for certain types of headaches caused by medications.
- Itchiness: Some pain medications like morphine are very well known to cause itchiness, especially initially. Again, anti-histamine medications can help and usually this side effect subsides over time.
- Nausea: If you were to name one thing that is worse than pain, nausea might be on your list. Vomiting most certainly would be on your list. Sometimes, the medications I prescribe will cause some initial nausea and even vomiting. Hopefully, we can work through this together and find a solution, either a new medication or an additional medication to counteract this side effect. Surprisingly, even Benadryl can occasionally remedy this problem.
- Stomach Burn: Different than nausea, this usually feels like a gnawing pain in the pit of your stomach. Usually this is caused by too much stomach acid, a common side effect from anti-inflammatory medications like ibuprofen, Motrin, Aleve or Advil. Even though these drugs are available without a prescription, these drugs are not completely benign. If you eat before taking medications, that can help. If you take stomach medicines like Prilosec, Zantac or Tagamet, that can help too. Or you can ask me for help because other medications might be less likely to upset your stomach.
- Swelling: Swelling in your legs, arms and hands can be caused by medications used to treat pain like Lyrica or morphine. This side effect may merely be an annoyance or it could grow to a bigger problem that is unlivable. "Water pills" like Lasix can help but I prefer to find an alternative drug that will not cause swelling because Lasix causes its own set of problems too.
I am sorry that I do not have a perfect drug to give you. I am also sorry that I cannot predict how exactly you will react to a particular medication. Everyone is different. Over time I hope that we can find the right combination of medications that helps return some quality of life to you but does not cause more harm than good.