What do you do if you have an adverse reaction to a medication?

According to the World Health Organization, an adverse drug reaction is a harmful and unintended response to a medication, and they are a leading cause of hospital admissions. When considering what do you do if you have an adverse reaction, it's critical to know the proper steps to take, from managing mild symptoms to seeking immediate emergency care for life-threatening issues.

Quick Summary

This guide outlines the critical steps to take when experiencing an adverse medication reaction. It clarifies the difference between side effects and harmful reactions, details the proper response for mild versus severe cases, and explains how to communicate with healthcare providers and report incidents to the FDA.

Key Points

• Differentiate Symptoms: Understand the difference between minor, predictable side effects and serious, harmful adverse reactions.

• Call 911 for Emergencies: Seek immediate medical help for severe symptoms like breathing difficulty, swelling of the throat, rapid pulse, or signs of anaphylaxis.

• Contact Your Doctor for Milder Issues: Report non-emergency symptoms to your healthcare provider or pharmacist, but do not stop medication without their guidance.

• Update Medical Records: Ensure all healthcare providers, including dentists and specialists, are aware of your adverse reaction history.

• Consider a Medical Alert: Wear a medical alert bracelet or carry a card detailing your drug allergy for emergencies.

• Report to the FDA: Voluntarily report serious adverse events to the FDA's MedWatch program to help monitor drug safety.

Understanding Adverse Reactions

An adverse reaction—also known as an adverse drug reaction (ADR)—is a harmful, unintended response to a medication, even when taken correctly. ADRs differ from typical side effects, which are generally more predictable and less severe. Understanding this distinction is the first step toward responding appropriately and effectively to medication-related issues.

Categorizing Adverse Reactions

Medical professionals categorize adverse reactions based on their severity and predictability:

• Minor (Side Effects): These are common, predictable issues that may improve as your body adjusts to a new medication. Examples include mild stomach upset, dry mouth, or drowsiness. Your doctor may recommend adjusting the timing or dosage to manage these.
• Moderate Reactions: These are more significant than typical side effects but are not immediately life-threatening. Symptoms could include a widespread skin rash, persistent or severe nausea, or swelling in a localized area. These symptoms warrant a call to your healthcare provider for guidance.
• Severe Reactions: These are life-threatening or cause significant harm. The most severe type of allergic reaction is anaphylaxis, but other serious reactions can include severe skin conditions like Stevens-Johnson syndrome, kidney inflammation (nephritis), or serious bleeding with blood-thinning medications. These require immediate emergency medical attention.

Allergic vs. Non-Allergic Reactions

Adverse reactions can also be classified by their mechanism:

• Allergic Reactions: Occur when the immune system overreacts, mistaking a drug for a harmful substance. This can happen even after the first exposure. Symptoms typically appear within minutes to hours, but some delayed reactions can take weeks. Antibiotics, such as penicillin, and NSAIDs are common causes.
• Non-Allergic Reactions: Also known as pseudoallergic drug reactions, these can produce allergy-like symptoms without involving the immune system. Examples include flushing from intravenous dyes or a cough and swelling caused by ACE inhibitors.

Immediate Steps to Take

Your response to a potential adverse reaction depends on the severity of your symptoms. A rapid and appropriate response is crucial.

For Severe or Life-Threatening Reactions

If you experience any signs of a severe reaction, it is a medical emergency. Call 911 or your local emergency number immediately. Do not wait to see if symptoms improve.

• Anaphylaxis: Look for tightening of the airways, swelling of the tongue or throat, dizziness, rapid pulse, a severe rash, or a significant drop in blood pressure. If you have an epinephrine auto-injector (EpiPen) for severe allergies, use it as instructed and then call for emergency help.
• Serious Bleeding: If you are on blood-thinning medication and experience a wound that bleeds profusely and doesn't stop within 15 minutes, seek immediate emergency help.
• Severe Skin Reactions: For signs of widespread blistering or painful skin lesions, go to the emergency room.
• Confusion or Altered Mental State: Unexplained confusion, loss of consciousness, or seizures warrant immediate emergency care.

For Milder or Non-Urgent Reactions

If your symptoms are manageable and not life-threatening, follow these steps:

• Contact Your Healthcare Provider: Call your doctor or pharmacist to report the reaction. They will determine if the medication should be stopped, the dosage changed, or an alternative prescribed.
• Do Not Stop Abruptly: Unless specifically told to do so by a medical professional, do not stop taking the medication. Stopping some drugs abruptly can cause a dangerous rebound effect.
• Manage Symptoms (as directed): For mild allergic symptoms like itching or a rash, your doctor may suggest an over-the-counter antihistamine.
• Keep a Symptom Log: Documenting your symptoms, including their onset and severity, can provide valuable information for your healthcare team.

Managing and Preventing Future Adverse Reactions

After an adverse reaction, proactive steps can help prevent future incidents.

Communicate with Your Healthcare Team

• Update Medical Records: Ensure that all healthcare professionals, including your dentist and specialists, are aware of your adverse reaction history. Have it clearly noted in your medical records to prevent future prescriptions of the same or similar drugs.
• Consider a Medical Alert: A medical alert bracelet or wallet card identifying your drug allergy can be a life-saver in an emergency situation where you may be unable to communicate.

Comparing Medication Reactions: Side Effects vs. Adverse Reactions

Feature	Side Effect	Adverse Reaction
Nature of Response	Unintended, but often predictable and may be beneficial, neutral, or harmful	Always harmful and often unforeseen, even when taken correctly
Predictability	Known and extensively documented during clinical trials	Less predictable, can be due to individual susceptibility or an immune response
Severity	Usually mild to moderate and manageable	Ranges from moderate to severe, including life-threatening events
Underlying Cause	Related to the drug's known pharmacological action, potentially dose-dependent	Often an idiosyncratic immune response or a more serious toxicological effect
Action Required	May be managed by adjusting dosage, timing, or waiting for tolerance to develop	Requires prompt medical evaluation and potentially immediate intervention
Examples	Drowsiness from antihistamines, mild stomach upset, dry mouth	Anaphylaxis, significant bleeding, severe skin rashes, tendonitis

Reporting to the FDA

Reporting serious adverse reactions to the Food and Drug Administration (FDA) is a valuable contribution to drug safety. The MedWatch program collects this voluntary information from consumers and health professionals. These reports help the FDA monitor and identify safety issues that might only become apparent after a product is widely available. To report:

• Use the online portal on the FDA's MedWatch website.
• Download and submit Form FDA 3500B (for consumers) or Form FDA 3500 (for health professionals).
• Call 1-800-FDA-1088 for assistance.

Conclusion

Experiencing an adverse reaction to a medication can be alarming, but knowing what do you do if you have an adverse reaction can ensure a safe and effective response. The key is to differentiate between minor side effects and severe or life-threatening events. Always seek immediate emergency care for severe symptoms like breathing difficulty or signs of anaphylaxis. For milder reactions, consult your healthcare provider to safely manage symptoms and determine the next steps. Taking proactive measures like updating medical records and reporting serious events to the FDA contribute to both your safety and broader public health. Stay informed and communicate effectively with your healthcare team to navigate your medication regimen with confidence and prioritize your well-being. For more information, visit the FDA's MedWatch website.

Frequently Asked Questions

What is the difference between a side effect and an adverse reaction?

A side effect is a common, often predictable, and usually less serious unintended effect of a medication. An adverse reaction is a harmful, unintended, and often unforeseen response that can be severe and dangerous, even when the medication is used correctly.

What are the signs of a severe adverse reaction?

Signs of a severe reaction include difficulty breathing, swelling of the tongue or throat, dizziness, rapid or weak pulse, confusion, and widespread skin blistering. These symptoms indicate a medical emergency and require immediate care.

When should I call 911 for an adverse reaction?

Call 911 immediately if you or someone else experiences signs of anaphylaxis, such as trouble breathing or swallowing, a swollen throat, or lightheadedness. Also call for severe bleeding or a seizure.

Can I just stop taking the medication if I have a reaction?

No, you should never stop taking a prescribed medication on your own, especially without consulting a healthcare professional. For certain medications, abruptly stopping can cause other health complications.

How do I report an adverse reaction to the FDA?

You can voluntarily report a serious adverse event through the FDA's MedWatch program. This can be done via their online portal or by submitting Form FDA 3500B.

Should I tell all my doctors about my drug reaction?

Yes, it is very important to inform all healthcare professionals you see—including your primary care doctor, specialists, and pharmacist—about any adverse drug reactions you have experienced. This helps prevent future exposure to the same or similar drugs.

How can I prepare for a potential adverse reaction in the future?

If you have a known drug allergy, the best preparation is avoidance. You can also wear a medical alert bracelet or carry a card identifying your allergy, and discuss a written action plan with your healthcare provider.