Prescription Drugs: How safe are they?

  • 12 Mar 2009
  • Reading time 14 mins
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Many of us take less trouble researching prescription drugs than we would buying a new TV. When it comes to your health doing some research will help you know if you are taking the right drugs and if they really work for your ailments.

Doctors can answer differently too. Following concerns about one drug in the States, the number of prescriptions halved within a year. Here in the UK, however, where far less coverage was given to the problem, prescription numbers actually went up. Because Americans do have to pay for their drugs, the amount of information available over there from sources like Congressional hearings and court cases is much greater. So here are some recent findings about five commonly prescribed types of drugs that you probably won’t be told about and you might want to consider when weighing up whether to go down the drugs or the nutritional route.

Diabetes drugs – Avandia (rosiglitazone) Avandia is one of a class known as thiazolidinediones that has a history of problems, including weight gain, heart problems and liver failure. The other is Actos (pioglitazone). About 2 million prescriptions are made out for these drugs in England every year. Doctors are keen on them because they are effective at controlling blood sugar, but at what cost?

Eighteen months ago a study found that Avandia raised the risk of heart disease. [1] A few months later, another found it increased heart attacks but not the chances of dying from one. [2] In the States, as a result, Avandia prescriptions dived sharply. In the UK, however, the drugs watchdog – the Medicines and Healthcare products Regulatory Agency (MHRA) – asserted that all was well and prescriptions have actually risen. Further studies didn’t always find the risk. However, some local bodies have come out against Avandia, including the UK Midlands Therapeutics Review and Advisory Committee (MTRAC) who don’t recommend either Avandia or Actos,[3] consultants in the Greater Glasgow and Clyde area are not giving Avandia to any new patients,[4] and the National Institute for Health and Clinical Excellence (NICE), which offers guidance to healthcare professionals, has warned about the increased heart attack risk. [5] And in the last few months, two more serious problems with Avandia have been identified – liver failure and bone fracture.

The excellent American consumer watchdog Public Citizen has called for the drug’s withdrawal after identifying 14 cases of liver failure on the official FDA Adverse Events Reporting System (AERS) database.[6] Then a study found that use of thiazolidinediones for more than one year can double the risk of bone fractures in women – that’s on top of the raised risk of fractures that comes with diabetes anyway.[7] Despite all this, the most recent advice available on the DiabetesUK website dates from July 2007 and says that thiazolidinediones "are a safe and effective treatment for Type 2 diabetes”. If you’d like to find out more about the nutritional approach see the Special Report ‘Preventing and Reversing Diabetes’ on my website (log on to the Advice section to access).

Cholesterol-lowering drugs – Statins
The official line is that virtually everyone over 50 should be on these drugs to lower their cholesterol and protect against heart attacks. However, what you are rarely told is just how tiny their benefit is, if you haven’t had a heart attack already. Take the latest big trial known as Jupiter, which was reported as if it was a great success. It found that the statin Crestor reduced the risk of heart attack and strokes by 50% over two years. However, the actual figures are less impressive: 37 people out of 10,000 on a placebo had a heart attack or stroke versus 17 out of 10,000 on a statin. Twenty fewer attacks among 10,000 people means that 500 people (10,000/20) need to take a statin daily for two years to prevent one event.[8]

The most favourable other studies report benefits of 1/100. Then there are the side-effects. Muscle weakness is a well known one, although there is a big disagreement about how many are affected. A recent paper suggests as many as 9% experience it;[9] supporters claim it is a few as 1/1000. But the Jupiter trial threw up a risk that is much less commonly mentioned – diabetes. While 216 people on a placebo developed diabetes, 270 did in the statin group – an increased risk of 61 in 10,000. That is indeed small but it is greater than your chance of avoiding a heart attack! So perhaps not such a good bet.[10] And there are other reasons for caution with statins. Makers of the best-selling statin Lipitor are currently being sued on the grounds there is no evidence it prevents heart attacks in women.[11] The special feature of the Jupiter trial was that it wasn’t testing for cholesterol-lowering – what statins are known to do – but for reducing a marker for inflammation known as CRP (C-reactive protein) which has been linked with heart disease risk. But if reducing inflammatory markers is your aim, then many nutritional supplements can do the same, without the risk of harmful side effects such as diabetes or muscle pains. For instance, a randomised trial involving 160 healthy men and women who were smokers found a 25% reduction in CRP levels with 515mg a day of vitamin C. [12] Another study comparing 602 people who took high levels of a number of supplements had greatly improved CRP levels compared to those who took a single supplement or none.[13] If you’d like to find out more about the nutritional approach to reducing cholesterol, read the Special Report ‘What To Do If You Have High Cholesterol’ on my website.

Painkillers – aspirin and the NSAIDS Almost everyone takes an aspirin or some other NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen occasionally with little chance of harm. But used chronically for such conditions as arthritis and joint pain they are famously linked with an increased risk of bleeding and damage to the small intestine.[14] American figures estimate this causes 103,000 hospitalisations and 16,500 deaths.[15] Even so NSAIDS are widely used long term – 70% of people over the age of 65 take them at least once ......

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