Can Allopathic drugs in Rheumatology have side effects?
This is a perennial question we are asked by all patients.
- Will we get side effects?
- What are the side effects of the medicines?
- Some patients tell us “Give me mild medicines I am worried about the side effects”.
- Some even say promise me I won’t get any side effects!
Ironically, I have hardly come across any patient who has asked me “Doctor when will I get better?” even though that is what they have actually come for. No one has ever said that “I know I am in competent / safe hands hence it is not my job to worry about anything adverse. My goal is to get better and I need your help I will follow whatever you prescribe…” Funny isn’t it but this is the reality of the matter! Now let us address what we do mean by “Side effect”! Side effect is that “effect” of the medicine which is not suited to our body. This is purely an Individual response to a medication and hence varies from person to person since no two humans are alike. What suits me may not suit you and what suits you may not suit a member of your own family. For that matter you will come across people who are allergic to some kinds of foods as well. You may have heard of people having allergy to certain kinds of fish. Additionally some people will tell you that they have allergy to Chana- dal or even milk at times. When such people consume these foods they also get side effects don’t they? Don’t we accept this phenomenon? Of course there are some general assumptions based on population studies and on the basis of these appropriate advice is given. For e.g. NSAIDS (Non Steroidal Anti Inflammatory drugs commonly addressed as pain killers) can cause acidity and hence should only be consumed after meals and an Antacid should be prescribed along with the same. Side effects can occur in a small percentage of people not the majority. Medicines are called medicines precisely because they cause more good than harm. Any drug which causes more side effects than benefits will not be called a medicine. It would then be called a “poison”. The truth of the matter is this: There is a small chance of side effects with any form of medicine. It is a myth to think that alternative therapies have no side effects at all. We also have patients who could not tolerate alternative therapies and then have come to Allopathy. Let us take one example from Ayurveda. In Ayurveda we know that various “Bhasmas” and “Kaadhas” are used.Some of these even contain heavy metals . For e.g. “Swarna Bhasma” is one of the “Bhasmas” used for treatment of Rheumatoid arthritis since a long time. Now catch this: Even in Allopathy we were using Gold Injections with good results but a lot of side effects such as Kidney failure and muscle inflammation. Hence we ourselves stopped using these medicines almost 20 years ago. Yet these are being used in Ayurveda. Now what do you have to say ?? One patient who took Ayurvedic treatment had to be admitted in the ICU with Arsenic poisoning. She is currently following up with us. This does not mean that Alternative medicines are bad or Allopathy is good or one is inferior and the other is superior etc. All we are saying is that Side effects can occur in any branch of medicine ina small number of people. Even though side effects can occur in a few patients we do not know who these will be and hence we teach all our patients on the possible side effects of drugs if this occurs and also to stop the drug immediately and inform us as soon as this occurs. That is why periodic follow up visits to the clinic are necessary to monitor disease activity along with regular blood tests, to ensure that no side effects occur, on these medications. Medicines are changed at the first sign of Intolerance.The idea is to try and minimize the chances of you getting a side effect. Funnily enough patients want to avoid any possibility of even the smallest side effect but will not follow up regularly even after being advised to do so in writing in the prescription. While you cross the road if you look on both sides of the road and cross then the chances of an accident are very low. However, if a drunken driver loses control of his vehicle and crashes into you but that’s pure simple bad luck. One important point that all patients forget is this. The disease is always much worse than the drug. Not all drugs will cause side effects. Not many patients will get side effects but one thing is certain, if timely treatment is not taken then the disease will certainly cause permanent damaging effects on your body. If a student appears in an exam after studying for the subject then there are good chances that he will do well and a small chance that he may fail despite his preparation. But if he does not appear for the examination itself because of fear of failure then he has failed anyway.