Tracking medication side effects: what to tell your doctor

You started a new medication, and a few days later you began to feel different: an upset stomach, drowsiness during the day or a rash on your skin. Deciding whether it has anything to do with the medicine isn't your job; but noting what you notice regularly helps your doctor and pharmacist make an accurate assessment. In this post, we explain what to write down, how to write it, and when to get help without waiting.

What is a side effect, and when can it appear?

The US Food and Drug Administration (FDA) describes side effects as unwanted effects that may be linked to a medicine. Both prescription and over-the-counter medicines can cause them. Upset stomach, dry mouth and drowsiness are among the common ones, but side effects can range from minor problems to serious ones.

According to the FDA, side effects can appear especially at these moments: when you start a new medicine or a supplement such as a vitamin, when you stop a medicine you've taken for a long time, or when the dose is increased or decreased. Your age, the other medicines and supplements you take, or an existing health condition can also affect who experiences side effects.

MedlinePlus points out that unwanted reactions aren't limited to side effects; drug interactions and drug allergies belong to this group too. In allergic reactions, hives and rashes on the skin are the most common. Telling which one it is, is your doctor's job; your job is to record your observations.

7 things to write down in your notes

A good note is short but complete. For every change you notice, try to write down the following:

1. What did you notice? Write it in your own words, just as it is: something like "I feel dizzy in the afternoons".
2. When did it start? The date and, if possible, the time; how long after taking the medicine it happened.
3. Which medicine, and since when? The name of the medicine, the start date and, if there was one, the date of the last dose change.
4. How long did it last? A few minutes, the whole day, does it come back every day?
5. How much did it affect you? Did it affect your work, your sleep or your eating?
6. What else changed during the same period? A new supplement, a different eating pattern, an illness or a lot of stress, for example.
7. What did you do, and what happened next? For example, "I asked the pharmacist" or "I called the doctor", and what followed.

If you measure your temperature, blood pressure or weight, write the values down with the date, exactly as they are; don't try to interpret what they mean. Keeping your notes in the same place matters too: when you write on paper one day and on your phone the next, putting the pieces together gets harder. Write down even a change that seems small; an observation that looks unimportant on its own can gain meaning next to the others.

In your notes, writing "a change I noticed" instead of "side effect" may be more accurate. That way you record your observation without jumping to a conclusion and leave the assessment to the experts. If you also keep track of how you take your medicines, the medication log checklist post may help.

How do you explain it to your doctor and pharmacist?

Even if you think something is caused by the medicine, don't stop it on your own, change the dose or shift the time you take it. The FDA stresses that adjusting the dose or switching to a different medicine after a side effect should be considered together with a health professional. If you're not sure what to do, call your doctor or ask your pharmacist.

The FDA suggests asking your health professional about possible side effects when a medicine is prescribed, and reading the patient information that comes with the medicine and the pharmacy label. If you notice an effect listed in the leaflet, add it to your notes; but don't skip telling your doctor because you think "it's in the leaflet, so it must be normal".

Time can be short at the appointment. Reviewing your notes beforehand and putting the two or three most important observations first makes things easier. Giving dates and durations tells far more than saying "I haven't been feeling great lately". These questions may also help:

• Could this change I noticed be related to the medicine?
• Will this go away with time, or do I need to do something?
• In which situation should I call you without waiting?
• Could the supplements or other medicines I take be affecting this?

If you take more than one medicine, bring an up-to-date list of all of them. If your doctor changes your plan, note that with the date too; we explained how in the updating your record when your medication plan changes post.

When should you get help without waiting?

Some reactions can't wait for a note. The NHS lists among the signs of anaphylaxis, a serious allergic reaction, sudden swelling of the lips, mouth, throat or tongue, difficulty breathing, trouble swallowing, sudden dizziness or confusion, and fainting. If you see this in yourself or someone near you, call your country's emergency number right away.

Even when it isn't an emergency, don't put off calling your doctor about a change that worries you, keeps getting worse or clearly affects your daily life. Keeping notes isn't meant to delay getting help; it's meant to make the help you get more useful.

Recording what you notice in Oveluni

In Oveluni, you can record a change you notice with its date using Symptoms in the Quick Add menu; besides ready-made tags such as Headache or Tiredness, you can add your own with Add custom label. You can write the details with A note, and keep track of the days you took or skipped your medicine with Medication entry. On the Insights screen, you can see your entries side by side for the range you choose and create a PDF report before your appointment; notes are added to the report only if you turn on "Include notes". In Oveluni's own words: "These are personal observations; they do not include a medical assessment." Oveluni doesn't check drug interactions, interpret side effects or suggest medicines or doses; the assessment always belongs to your doctor and pharmacist. For other tracking areas, take a look at the Features page. Oveluni is coming soon to the App Store.

Sources

1. FDA: Finding and Learning about Side Effects
2. MedlinePlus: Drug Reactions
3. NHS: Anaphylaxis