25 Most Commonly Prescribed Medications in the US:

Side Effects and Prevention

All medications have side effects but not all side effects affect everyone. Therefore, use of prescription meds should always be evaluated in terms of risk versus benefit ratio. Following are common side effects of most commonly prescribed groups of medicines and strategies to mitigate these side effects. These side effects occur with more than 10% frequency and less common side effects are not listed here. 

1. Blood pressure medications:

Following are the classes of blood pressure drugs
●    Diuretics: Examples of diuretics include
hydrochlorothiazide, metolazone, chlorthalidone, chlorothiazide, indapamide, furosemide, etc

Common side effects include 
❖    Decreasing minerals like potassium supply to the body because of loss of potassium leg cramps and weakness are the common symptoms.
❖    After taking a long time of diuretics, some people show attacks of gout.
❖    Increases in blood sugar levels are also seen in some patients.
❖    Impotence is seen in some patients.

 

●    Beta-blockers: Examples include acebutolol, carvedilol, atenolol, Propranolol, betaxolol, nadolol, metoprolol succinate, etc.

Common side effects include
❖    Symptoms of asthma
❖    Slow heartbeat
❖    Insomnia
❖    Tiredness or depression
❖    Cold hands and feet

●    ACE inhibitors: Examples include Lisinopril, captopril, benazepril hydrochloride, etc

Common side effects include
❖    Loss of taste
❖    Skin rash
❖    Some patients have kidney damage.
❖    Chronic dry, hacking cough

●    Angiotensin II receptor blockers: Examples include Losartan, valsartan, irbesartan candesartan etc
Common side effects include

❖    Some patients have dizziness.
❖    Contraindicated in pregnancy because it causes the death of the fetus.

●    Calcium channel blockers: Examples include Amlodipine, bepridil, felodipine, isradipine, etc

Common side effects include
❖    Dizziness
❖    Headache
❖    Constipation
❖    Swollen ankles
❖    Palpitations

●    Alpha-2 Receptor Agonists: Examples include methyldopa etc.

Common side effects include 
❖    drowsiness or dizziness


●    Alpha-blockers: Examples include tamsulosin, prazosin hydrochloride, doxazosin mesylate, etc

Common side effects include
❖    Dizziness
❖    Fast heart rate

●    Combined alpha and beta-blockers: Example include carvedilol, labetalol hydrochloride, etc

Common side effects include
❖    In a stand-up position, patients feel a drop in blood pressure.

●    Peripheral adrenergic inhibitors: Example includes guanadrel, reserpine, etc.

Common side effects include 
❖    Stuffy nose
❖    Diarrhea 
❖    Heartburn

●    Central agonists: Example includes alpha methyldopa, clonidine hydrochloride, etc

Common side effects include
❖    Anemia
❖    Fever  
❖    Dryness of the mouth
❖    Drowsiness or sluggishness

●    Vasodilators: Examples includes minoxidil, hydralazine hydrochloride, etc

Common side effects include 
❖    Pains in the joints.
❖    Heart palpitations 
❖    Swelling around the eyes
❖    Headaches

 

How to prevent side-effects of Blood pressure medications?

Side effects can be subtle and often body gets used to them. However, any noticeable side effect must be addressed appropriately. One of the best ways to manage side effects is to get recommended lab tests and blood pressure checks done one a regular basis. A home blood pressure monitor is a good way of monitoring and managing excessive fluctuations in blood pressure readings.  

Fluids and electrolyte balance can be maintained by making sure that daily recommended fluids are consumed. 

In order to prevent gout attack which can occur with thiazide type diuretics, animal products should be avoided. 

Sexual dysfunction can be prevented by maintaining a robust vascular system and by making sure that additional causes of sexual dysfunction are addressed. These include hormonal, neurological and psychological causes. 

If a rash appears after taking a blood pressure medicine, medicine should be discontinued. 

2. Diabetes Medications:

Following are the classes of anti-diabetic drugs

●    Biguanides: Metformin is the most common example of this class.

Common side effects include
❖    Long term use causes decreased absorption of vitamin B12
❖    Increased flatulence
❖    Vomiting
❖    Nausea
❖    Cramps
❖    Diarrhea

●    Sulfonylureas: Examples include glyburide, glipizide,  etc 

Common side effects include
❖    Confusion
❖    Dizziness
❖    Nervousness
❖    Hunger
❖    Dark-colored urine
❖    Skin reactions
❖    Upset stomach
❖    Weight gain
❖    Sweating

●    Meglitinide derivatives: Examples include nateglinide, repaglinide etc

Common side effects include 
❖    Back pain
❖    Diarrhea
❖    Nausea
❖    Joint pain
❖    Headache
❖    Runny or stuffy nose
❖    Hypoglycemia

●    Alpha-glucosidase inhibitors: Examples include Miglitol, Acarbose, etc

Common side effects include
❖    Diarrhea
❖    Flatulence


●    Thiazolidinediones (TZDs): Examples include Rosiglitazone, Pioglitazone etc

Common side effects include
❖    Weight gain
❖    Eyesight problems
❖    Chest pain and infections
❖    Allergic skin reactions
❖    Reduced sense of touch
❖    Water retention

●    Glucagon-Like peptide–1 (GLP-1) agonists: Examples include lixisenatide, liraglutide, etc 

Common side effects include
❖    Nasopharyngitis
❖    Headache
❖    Nausea

 

●    Selective sodium-glucose transporter-2 (SGLT-2) inhibitors: Examples include canagliflozin, empagliflozin, dapagliflozin, etc

Common side effects include
❖    Thirst
❖    Nausea
❖    Joint pain
❖    Dyslipidemia (increase in cholesterol)
❖    Increased urination
❖    Upper respiratory tract infections
❖    Female and male genital yeast infections

●    Dipeptidyl peptidase IV (DPP-4) Inhibitors: Examples include linagliptin, saxagliptin, sitagliptin, etc

Common side effects include
❖    Nasopharyngitis
❖    Vomiting
❖    Upper respiratory tract infection
❖    Nausea
❖    Headache 
❖    Urinary tract infection

●    Injectable: Examples include Insulin glargine, etc.

Common side effects include
❖    Edema
❖    Lipoatrophy
❖    Weight gain

 

How to prevent side effects of Diabetes medications?

  • Take your medications with meals to prevent hypoglycemia.

  • Monitor blood glucose on a regular basis to prevent excessive fluctuations. 

  • Stay on a well balanced diabetic diet.

  • Be very careful with supplements and dietary changes.

  • Supplement if necessary for any nutritional deficiencies

  • Get regular lab work to monitor for deficiencies

3. Thyroid medications:

The most commonly prescribed antithyroid drug is levothyroxine

Common side effects include
❖    Weight changes
❖    Loss of appetite
❖    Menstrual cycle changes
❖    Pounding heartbeats
❖    Sweating
❖    Fever
❖    Nervousness
❖    insomnia
❖    Headache

How to prevent side effects of thyroid medications?

Thyroid medication doses often need to be changed based upon labs and clinical picture. Therefore, make sure to get routine labs done as advised. 

Maintain an overall healthy lifestyle to prevent additional complications. 

4. Cholesterol Lowering Medicines - HMG-CoA reductase inhibitors:

 

Examples include Pravastatin, Atorvastatin, Simvastatin, Rosuvastatin, etc

Common side effects include 
❖    Nausea
❖    Joint pain
❖    Diarrhea
❖    Stomach pain and discomfort 

 

How to prevent side effects of HMG-CoA reductase inhibitors?

To prevent side effects, take the medication with proper diet and avoid alcohol, smoking, and tobacco use.

Often Co-Q 10 supplement is needed because statins lower Co-Q 10 levels.  

5. Asthma Inhalers - Albuterol:

This medication is used as a bronchodilator. 

Common side effects include
❖    Muscle aches
❖    Nasal irritation
❖    Headache
❖    Nervousness 

 

How to prevent side effects of Albuterol?
Take it as directed. The best way to avoid side effects from albuterol is to use it as directed. 
In order to prevent palpitations, make sure that the inhaler is not used excessively. In case of shortness of breath or wheezing where repeated use is needed, consider adding a controller such as symbicort, advair etc.  

6. Neuropathy Medicine - Gabapentin:

 

This medication is used to treat neuropathic pain and partial seizures.

Common side effects include
❖    Dry mouth
❖    Mood changes
❖    Diarrhea
❖    Nausea
❖    Blurred vision

How to prevent side effects of Gabapentin?
Harmful effects can also include problems with breathing and mental status changes. 
Do not take gabapentin with medications which work on the nervous system unless supervised by a medical practitioner. Some examples include opioids, seizure meds etc. 
Antacids with aluminum and magnesium like Maalox and Mylanta can reduce gabapentin's effects

7.    Narcotics / Pain Medicine / Hydrocodone etc. 

 

This medication is used for moderate to severe pain.

Common side effects include
❖    Drowsiness 
❖    Dizziness
❖    Lightheadedness
❖    Constipation
❖    Vomiting
❖    Nausea

How to prevent side effects of Hydrocodone/acetaminophen?

Hydrocodone is an opioid and a controlled substance. It's use is highly regulated due to the severity of side effects and risk of death associated with this and similar medication. In addition, perceived benefits of the medicine, including pain control do not provide long term cure. Studies after studies have shown that patients on long term opioids continue to have long term pain regardless of dose adjustment. Therefore, opioid use must be minimized and alternative, more effective treatment options must be considered. 

Specific side effects can be prevented by using following strategies;

Constipation can be avoided by increasing fiber intake. Dizziness, lightheadedness and drowsiness can be mitigated by dose adjustment and by appropriate amount of fluid intake. In case of nausea and vomiting, medication must be discontinued and alternate options must be considered. 

8. Anti - Depressants - Selective serotonin reuptake inhibitors (SSRIs):

Examples include Fluoxetine, Bupropion, Escitalopram, Citalopram, Sertraline, etc.

Common side effects include
       ❖ Loss of appetite
       ❖ Heartburn
       ❖ Dry mouth
       ❖ Nausea

       ❖ Vomiting
 

How to prevent side effects of SSRIs?

To prevent side effects, one must take medications with water and around 30-60 minutes before drinking any beverages or eating food.

9. Allergy Meds - Nasal Sprays - Fluticasone:

This medication is used to relieve rhinitis.

Common side effects include
❖    Dizziness
❖    Bloody mucus in the nose
❖    Diarrhea.
❖    Vomiting.
❖    Nausea.
❖    Headache

 

How to prevent side effects of fluticasone?
Side effects of fluticasone are subtle as your body adjusts to the medicine. Side effects must be monitored and dose should be adjusted accordingly.

10. Acetaminophen:

This medication is used to treat fever and pain.

Common side effects include
❖    Itching
❖    Loss of appetite
❖    Stomach pain
❖    Nausea

 

How to prevent side effects of acetaminophen?

To prevent side effects, one must take medications with water and around 30-60 minutes before drinking any beverages or eating food.

11. Common Antibiotics - Amoxicillin:

This is an antibiotic. 

Common side effects include
❖    Rash
❖    Headache
❖    Stomach pain
❖    Diarrhea
❖    Vomiting
❖    Nausea

 

How to prevent side effects of Amoxicillin?
Take amoxicillin with a meal may prevent many side effects. Eat foods that are easy to digest like toast, crackles, soups help to cope with an upset stomach.

12. Sleep and/or Anxiety Meds - Benzodiazepines:

Examples include Alprazolam, Clonazepam etc.

Common side effects include
❖    Difficulty concentrating
❖    Talkativeness
❖    Irritability
❖    Dizziness
❖    Tiredness

How to prevent side effects of Benzodiazepines?
To prevent side effects of benzodiazepines, dose must be adjusted. Additionally, flumazenil injection is used for the reversal of the sedative effects of benzodiazepines

13. Allergy Medicine - Montelukast (Singulair):

This medication is used to treat asthma.
 
Common side effects include
❖    Runny nose
❖    Flu
❖    Earache
❖    Diarrhea
❖    Cough
❖    Headache

How to prevent side effects of Montelukast?
Take Montelukast around he same time every day and it is recommended to take these medications at night because it helps keep levels of Montelukast in your body consistent. Consistent drug levels help keep the drug working the way it should. Moreover, if you miss the dose, do not double up the dose next time.

14. Sleep Medicine - Trazodone:

This medication is used as an antidepressant.

Common side effects include
❖    Diarrhea
❖    Vomiting
❖    Nausea
❖    Headache

 

How to prevent side effects of Trazodone?
To prevent the side effects of this medication, dose adjustment may be needed. In addition, concomitant use of sleep aids may potentiate the side effects of this medicine. Certain medications such as bupropion or wellbutrin lower seizure threshold when taken with this medicine and must be avoided. 

15. Antacid - Pantoprazole/Omeprazole/Nexium:

This medication is used to treat stomach pain.

Common side effects include

  • Dizziness

  • Diarrhea

  • joint pain

  • Gas

  • Headache

How to prevent side effects of antacids / omeprazole / pantoprazole

In order to prevent bone density related side effects of nexium, pantoprazole and similar antacids, it is important to take calcium as calcium citrate and vitamin D supplements. Additional side effects can be prevented by dose adjustment and using alternate options. 

16. Steroids - Prednisone:

This is a corticosteroid.

Common side effects include
❖    Trouble sleeping
❖    Restlessness
❖    Weight gain
❖    Acne
❖    Vomiting
❖    Nausea

How to prevent side effects of Prednisone?

To prevent side effects of prednisone, take this medication early in the morning to prevent side effects like restlessness, insomnia. Taking medication with meals can help reduce gastrointestinal side effects. Antacids can be used as well. Steroids are like credit cards. These provide immediate relief but a hefty price always needs to be paid after some duration. Therefore, steroids should not be used on a long term basis unless absolutely necessary. 

17. Blood Thinner - Clopidogrel (Plavix):

These medications are used as antiplatelet medications.

Common side effects include
❖    Increased bleeding
❖    Nosebleeds
❖    Abdominal pain
❖    Diarrhea 
❖    Headaches 

How to prevent side effects of Clopidogrel?
To prevent side effects of clopidogrel, use proton pump inhibitors like esomeprazole, omeprazole because it helps to reduce the side effects of this medication.

18. Non Steroidal Anti - inflammatory Meds - NSAIDs:

Examples include Meloxicam, Ibuprofen, Aspirin, etc. 

Common side effects include
❖    Difficulty breathing
❖    Feeling tired
❖    stomach pain
❖    Diarrhea
❖    Nausea

How to prevent side effects of NSAIDs?
To prevent side effects of NSAIDs, take this medication with antacids, milk, or food. Reduce intake of alcohol with NSAIDs because it increases the risk of internal bleeding. 

19. Pain Medicine - Tramadol:

This medication is included in the opioid category.

 Common side effects include
❖    Dry mouth
❖    Sweating
❖    Constipation
❖    nausea 
❖    Drowsiness
❖    Headache

How to prevent side effects of Tramadol?
Anti-sickness medications can help to reduce the side effects of this medication. Moreover, taking this medication with food can helps to reduce the side effects related to the stomach.

20. Sleep Medicine - Zolpidem (Ambien):

Zolpidem, also known as Ambien, is a sedative-hypnotic and is used for sleep.

 Common side effects include
❖    Stuffy nose
❖    Tiredness
❖    Lightheadedness
❖    Dizziness
❖    Daytime drowsiness

How to prevent side effects of Zolpidem?

To prevent side effects, dose may need to be adjusted. Day time drowsiness must be managed by considering alternate options for sleep. This medication, like other sedatives must not be combined with other sedatives/hypnotics.

21. Blood Thinners - Warfarin (Coumadin):

This medication is an anticoagulant.

Common side effects include
❖    Stomach pain
❖    Bloody stool
❖    Severe bleeding

How to prevent side effects of Warfarin?
Warfarin must be discontinued if any bleeding related side effects appear. In addition, drug interactions and dose monitoring are needed for long term use of this medicine.

22. CNS Stimulants - Dextroamphetamine/amphetamine (Adderall, Concerta, Ritalin, Focalin etc):

This medication is used for Attention deficit hyperactivity disorder.

Common side effects include
❖    Sleep problems
❖    Cardiovascular side effects
❖    Breathing difficulties , Disorientation

How to prevent side effects of CNS stimulants?

 

Side effects are usually subtle after the body gets used to these medications. Cardiac monitoring is often necessary. High doses can cause breathing problems so it should always be considered a medical emergency.

23. Muscle Relaxers - Cyclobenzaprine:

This medication also known as flexiril, is used as a skeletal muscle relaxant

Common side effects include
❖    Fatigue
❖    Dizziness
❖    Drowsiness
❖    Blurred vision
❖    Dry mouth

24. Anti - Depressants - Duloxetine (Cymbalta):

This medication is known as cymbalta and is a serotonin and norepinephrine reuptake inhibitor.

Common side effects include
❖    Sweating
❖    Dry mouth
❖    Constipation 
❖    Headaches

How to prevent side effects of Duloxetine?
Side effects of Duloxetine are subtle after the body gets used to this medication. If you feel extra side effects then reduce the medication slowly under medical supervision.

25. Antibiotics - Azithromycin:

This medication is known as a macrolide antibiotic. 

Common side effects include
❖    Vomiting
❖    Nausea
❖    Diarrhea

How to prevent side effects of azithromycin?
Take azithromycin with plenty of water. 
Abstain from Alcohol. 
Sometimes, probiotics help mitigate side effects

Important Notice:

This website and its contents are for the purposes of general information and education only and are not to be used for diagnosis or treatment without the supervision of a healthcare provider.

Email drdar@drdarmd.com for general information

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