“There is no such thing as a safe drug. Each medication is a double-edged sword, with a good side and a bad side.”
We wrote those words thirty years ago in the first edition of our book The People’s Pharmacy. They are as true today as they were three decades ago.

We went on to say that “Successful treatment is a careful balance between the beneficial and harmful effects, hopefully weighted in favor of the beneficial.

Unfortunately, just the opposite is often the case. The original disease may be less of a problem than the reaction to treatment, and the old dictum ‘The cure was worse than the disease’ has frequently been all too true.'”

In 2005, it is quite possible that we are less safe from medication mishaps today than in 1975. It’s not that medications have become more toxic, but our attitudes have changed. Americans have become far more cavalier about the pills we pop.

Part of that is due to advertising. If you watch a 30 second commercial on TV for Viagra, Lipitor or Nexium (the Purple Pill) you may start to think of potent prescription drugs as if they were consumer products like shampoo or beer.

Recent experience with Vioxx and Celebrex, however, suggests that patients, physicians and drug regulators are not being cautious enough. Someone who took Vioxx to relieve knee pain or tennis elbow and ended up having a heart attack might well conclude the cure was worse than the original problem.

How can patients protect themselves from drug disasters? The first thing to recognize is that the FDA cannot guarantee that your medicine is safe. Although the law requires all medications be proved “safe and effective” before approval, these are relative terms.

The agency routinely approves medications that cause serious side effects for some people. They even allow products on the market that occasionally cause life-threatening reactions. The FDA relies on precautions and warnings in the labeling to alert prescribers to these hazards.

All health professionals-doctors, nurses, pharmacists and others-realize that drugs are double-edged swords. But many do not share that awareness with their patients.

For patients to use medicine safely, then, they must become better informed themselves. Here are some key points to remember:

* Be slow to jump on the bandwagon with a new drug. Our experience with Vioxx, Bextra and Celebrex shows that it can take a lot of time to learn about serious adverse reactions.

* Find out about side effects. Every drug has them. Some are common and some can be life threatening.

* Learn which symptoms should trigger a call to the doctor or a trip to the ER.

To help you organize this information, we offer readers of this column a Drug Safety Questionnaire and Medical History form. It will assist you and your physicians in organizing crucial drug data and alerting you to key side effects, drug and food interactions. It is free with a long (no. 10) self-addressed stamped envelope: Graedons’ People’s Pharmacy, No. QH-3, P. O. Box 52027, Durham, NC 27717-2027.

Although there are no 100 percent safe drugs, there can be safer patients. Information is your best defense against dangerous drug reactions.

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