How Much Is Too Much Prescription Medication?

One size does not fit all in prescription medication.

What the experts have figured out is that the best dose of any medication is the lowest dosage that works. The problem is few physicians have the time or the motivation to customize drug doses for all their patients. For instance, someone starting on a low dose may require extra monitoring in the beginning to make sure the dose is working adequately. The advantage of this approach is that overtime there is more efficient use of the medication and probably less side effects from too much medication.

The fact is there are major problems caused by approved drugs in which the dosage is too high for individual patients. Besides being possibly lethal, many people stop taking their medication because the side effects of a large dose are unbearable.

One of the reasons for the overdosing is that drug companies recommend starting amounts that apply to all adults and one size does not work for everyone. A pill that is one dose for all patients may be much easier for a doctor to prescribe then choosing from a selection of dosages, but it may also cause problems for some patients.

Pharmaceutical companies tend to use high doses of a drug in clinical studies submitted to the FDA to demonstrate the drug works. If all goes well, the FDA usually approves the drug at those levels. Because older people are not typically included in clinical trials, these recommended doses are often too high for them. The problem is complicated when a patient is on other drugs and they react with the new drug or the patient is ill.

Women may also be more sensitive then men to medication because they usually weigh less than men. Besides, until very recently, women have been left out of most clinical trials so it may not be known what are their responses.

Unless there is an emergency situation, the sensible thing to do is to start low and boost the dose if necessary. This approach should work with chronic illnesses and easily monitored disorders such as elevated cholesterol, blood-pressure, or glucose.

WHAT YOU CAN DO
If you are sensitive to alcohol or become anxious and have trouble sleeping after taking decongestants or caffeine, let your doctor know. Some of the ingredients in these over the counter medications may also be found in prescription drugs.

When prescribed a new drug for a chronic condition, ask your doctor if you can start with a lower dose. That is particularly important if you are female, thin or small and have bad reactions to medication.

If you do start with a low dose, make sure you are monitored by your physician to make sure the dose is working.

Ask about side effects of any new medication. Keep a log and list any symptoms and problems you have developed when you started the medication.

Do not assume that listlessness, confusion, constipation, unsteady gait are normal signs of aging.

Bring all your medications, including supplements and herbal remedies to your doctor at least every 6 months. Check for doses that can be reduced.

This may take a bit more time on your part to organize your medications but after all, you are responsible for your health. It is a partnership with your doctor and well worth your efforts.

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