Personal...Five pharmaceutical drugs I have Known
I have personally taken taken Symbicort, Arnuity Ellipta and Atrovent, all for the treatment of Asthma.
My older brother has taken Clonazepam while my younger brother has taken Leflunomide. The difference is I stopped taking Symbicort as I developed violent heart palpitations as well as feeling just awful after about being on the drug for 4 months. I in turn was on Arnuity Ellipta for a few months and ended up with the worst flu I have ever had, followed by 5 months of 'Post Viral Syndrome', as well as having trouble with my eyes (inability to focus and constantly watering). I was on Atrovent for one or two days and experienced a lot of trouble urinating. I stopped taking all three of these drugs.
My younger brother had been taking Leflunomide for several years for rheumatoid arthritis before developing pneumonia and a rare form of leukemia. He died a couple of months after developing pneumonia.
My older brother who had been taking Clonazepam for panic attacks. he was on the drug for 15 years before developing Dementia.
Now I can't swear on a stack of bibles that these drugs were the cause of the resulting conditions that ensued. Nor can I say they had nothing to do with the problems that developed after taking these pharmaceuticals.
I do know about the theory of 'repression' which is basically how the pharmaceutical industry treats disease. They do not treat the under-lying cause but treat the resulting symptoms instead, driving the problem back into the body where it develops in another part of the biological system.
I chose to stop taking the medications for asthma, and tried other treatments not accepted by conventional medical thinking (homeopathy, herbology, diet). My brothers continued on with their treatment.
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1) What are some of the side-effects of taking Atrovent?
Atrovent (ipratropium bromide) is a medication used to treat breathing problems, primarily for the long-term management of COPD. While it is an effective treatment for many, it can cause a range of side effects, from common and mild to rare and serious.
Here is a list of potential side effects, categorized by how common they are:
Common Side Effects (usually mild):
Dry mouth: This is a very common side effect due to the drug's anticholinergic properties.
Headache: Many people experience a mild headache.
Dizziness: Feeling lightheaded or a little off balance is a common side effect.
Throat irritation and cough: The inhalation process itself can sometimes cause these symptoms.
Nausea or upset stomach: Digestive issues can occur.
Changes in bowel movements: This can include constipation or, less commonly, diarrhea.
Serious Side Effects (less common but require immediate medical attention):
Paradoxical Bronchospasm: This is a very serious, life-threatening reaction where your breathing problems suddenly and unexpectedly get worse right after you use the inhaler. Symptoms include severe wheezing, coughing, and chest tightness. If this happens, stop using the inhaler and seek emergency medical help immediately.
Eye Problems (Glaucoma): Atrovent can increase pressure in the eyes and may precipitate or worsen narrow-angle glaucoma. Symptoms can include:
Eye pain or discomfort
Blurred vision or seeing halos around lights
Red eyes
Difficulty with vision or focusing
Urinary Retention: The medication can make it difficult to urinate. If you experience trouble passing urine, pain while urinating, or a weak urine stream, you should contact your doctor. This is a particular risk for men with an enlarged prostate.
Severe Allergic Reactions (Anaphylaxis): Although rare, a serious allergic reaction is possible. Symptoms can include:
Swelling of the face, lips, tongue, or throat
Difficulty breathing or swallowing
Hives or a rash
Hoarseness
It's important to remember that this is not a complete list of all possible side effects. Always read the patient information leaflet that comes with your medication and discuss any concerns or unexpected symptoms with your doctor or pharmacist. They can help you determine if a particular symptom is related to the medication and advise on the best course of action.
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2) Could you tell me about the side-effects of taking Symbicort?
Symbicort is a combination inhaler that contains two active ingredients: budesonide (an inhaled corticosteroid) and formoterol (a long-acting beta-agonist, or LABA). Because it has two different types of medications, it can have a wide range of side effects.
Here is a breakdown of potential side effects, from most common to more serious.
Common Side Effects (most people tolerate these well):
Oral Thrush: This is a fungal infection in the mouth and throat, appearing as white patches. It is a very common side effect of the corticosteroid component. You can significantly reduce the risk of this by rinsing your mouth with water and spitting it out after every dose.
Throat irritation and hoarseness: The medication can cause a sore throat, irritation, and changes to your voice.
Headache: This is a common side effect of the formoterol component.
Upper Respiratory Infections: People taking Symbicort may experience a higher incidence of colds, sinusitis, or other upper respiratory infections.
Back pain and stomach discomfort.
Serious Side Effects (less common, but require medical attention):
Paradoxical Bronchospasm: This is a rare but severe reaction where your airways suddenly tighten and your breathing gets worse immediately after using the inhaler. If this happens, stop using Symbicort and get emergency medical help immediately.
Cardiovascular Effects: Formoterol can affect your heart and nervous system. You should be monitored for:
Increased heart rate and palpitations
High blood pressure
Tremors or nervousness
Effects on Bones: Long-term use of inhaled corticosteroids, especially at higher doses, can lead to a decrease in bone mineral density. This can increase the risk of osteoporosis and fractures.
Eye Problems: Symbicort can increase the risk of developing eye conditions, including:
Glaucoma: Increased pressure in the eye that can damage the optic nerve.
Cataracts: Clouding of the lens in the eye.
You should have regular eye exams while on this medication, especially with long-term use.
Adrenal Gland Suppression: The corticosteroid component can reduce the natural production of cortisol by your adrenal glands. This is more likely with high doses and long-term use and can lead to a range of symptoms like fatigue, weakness, and nausea.
Immunosuppression and Infections: The steroid in Symbicort can weaken your immune system, making you more susceptible to infections. People with COPD are at a higher risk of developing pneumonia while on this medication.
Growth Problems in Children: Long-term use of inhaled corticosteroids can slow down a child's growth. A doctor should regularly monitor the growth of children on Symbicort.
High Blood Sugar: Symbicort can increase blood sugar levels. This is a particular concern for people with diabetes, who may need to monitor their blood sugar more frequently.
It's crucial to use Symbicort exactly as prescribed and to never use it for sudden, acute breathing problems. Always have a separate "rescue" inhaler available for those situations. If you experience any of the serious side effects or have any concerns, you should contact your doctor or pharmacist right away.
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3) Could you tell me about the side-effects of taking Lefluomide
Leflunomide (brand name Arava) is a medication used to treat rheumatoid arthritis and psoriatic arthritis. It works by suppressing the immune system to reduce inflammation and joint damage. However, like all powerful medications, it comes with a range of potential side effects, some of which can be serious.
Important Note: Leflunomide has a "boxed warning" from the FDA, which is the most serious warning. These warnings are for severe liver damage and fetal harm.
Here's a breakdown of the side effects:
Very Common Side Effects (most likely to occur):
Diarrhea: This is the most common side effect.
Hair Loss: This can be a noticeable side effect for some people.
Headache: A frequent complaint.
Nausea, stomach pain, or vomiting.
Rash or itching.
Unexplained weight loss.
Serious Side Effects (less common but require immediate medical attention):
Liver Damage: This is a major concern with leflunomide and the reason for the black box warning. It can be severe, leading to liver failure or even death. Symptoms include:
Yellowing of the skin or eyes (jaundice)
Dark urine or pale stools
Nausea and vomiting
Loss of appetite
Pain in the upper right side of your stomach
Unusual fatigue
Because of this risk, your doctor will need to monitor your liver function with regular blood tests.
Lung Problems: Leflunomide can cause serious lung conditions, such as interstitial lung disease or pneumonitis. Symptoms include:
New or worsening shortness of breath
Dry cough, with or without fever
Fever
High Blood Pressure: Leflunomide can cause or worsen high blood pressure. Your blood pressure should be monitored regularly while on this medication.
Increased Risk of Infection: Since leflunomide suppresses the immune system, it can make you more susceptible to serious infections, including pneumonia and tuberculosis. You should immediately contact your doctor if you show any signs of infection, such as fever, chills, cough, or a sore throat.
Bone Marrow Suppression: This can lead to a decrease in various blood cell types, including red blood cells (anemia), white blood cells (increasing infection risk), and platelets (increasing the risk of bleeding). Your doctor will perform regular blood tests to check your blood cell counts.
Nerve Damage (Peripheral Neuropathy): Symptoms can include numbness, tingling, or pain in the hands or feet.
Severe Skin Reactions: In rare cases, leflunomide can cause life-threatening skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis. Look out for blistering, peeling, or a rash that spreads quickly.
Teratogenicity (Fetal Harm): Leflunomide is highly dangerous if taken during pregnancy as it can cause severe birth defects. Women who can become pregnant must use reliable birth control while taking this medication and for an extended period after stopping. Men who are taking leflunomide should also use effective contraception. A "washout" treatment is available to help remove the drug from the body more quickly for those planning a pregnancy.
This is not an exhaustive list. It is crucial to read the medication guide provided with your prescription and have a detailed discussion with your doctor and pharmacist about the risks and benefits before starting leflunomide. They can help you manage potential side effects and determine if it is the right treatment for you.
Is there any connection between taking Leflunomide and leukemia
This is an excellent and very specific question. The relationship between leflunomide and cancer, particularly leukemia, is complex and requires a careful look at the available evidence.
Here's the current understanding:
1. A Major Confusion: The Link Between Rheumatoid Arthritis and Cancer
The primary reason for a lot of the concern and confusion is the fact that the underlying disease being treated—rheumatoid arthritis (RA)—is itself associated with an increased risk of certain cancers, particularly lymphoma and leukemia.
The Inflammation Connection: The chronic, systemic inflammation that characterizes RA is believed to be a key driver of this increased cancer risk. When the immune system is in a constant state of overactivation, it can increase the likelihood of genetic mutations and the development of cancer, particularly in the blood cells that are at the core of the inflammatory process (lymphocytes).
The "Confounding Factor": This makes it very difficult to isolate the effect of the medication from the effect of the disease itself. When a patient with RA develops cancer, it's hard to tell if it's because of the RA, the medication, or a combination of both.
2. What the Research Says About Leflunomide and Cancer
No Clear Causative Link to Leukemia: There is no strong, direct evidence from large-scale studies that shows a clear causative link between taking leflunomide and the development of leukemia. In fact, some studies have even suggested the opposite.
Some Studies Suggest a Reduced Risk: A few studies have indicated that patients treated with leflunomide may have a lower risk of overall cancer compared to those on other conventional disease-modifying antirheumatic drugs (DMARDs) like methotrexate. This is a very interesting and active area of research.
Immunosuppression and Cancer: The general principle with immunosuppressive drugs is that they can increase the risk of certain cancers, as they reduce the body's ability to fight off cancerous cells. However, with leflunomide, the relationship is not as straightforward as it is with some other, more potent immunosuppressants.
3. Why Leflunomide is Being Studied for Cancer Treatment
This is where it gets even more complicated and fascinating. Researchers are now exploring a completely different connection: using leflunomide as a potential treatment for certain types of cancer, including some leukemias.
Mechanism of Action: The way leflunomide works is by inhibiting an enzyme called dihydroorotate dehydrogenase (DHODH), which is crucial for the synthesis of a building block of DNA and RNA (pyrimidines). This is a very effective way to suppress the rapid proliferation of immune cells in autoimmune diseases.
Cancer and Cell Proliferation: Cancer cells also rely on a rapid rate of cell proliferation to grow and spread. Early research has shown that leflunomide and its active metabolite (teriflunomide) can inhibit the growth and induce cell death in certain types of cancer cells, including those from chronic lymphocytic leukemia (CLL).
Repurposing Drugs: This has led to clinical trials exploring the use of leflunomide, either alone or in combination with other chemotherapy agents, as a new therapy for certain cancers.
In summary:
There is no established connection between taking leflunomide for rheumatoid arthritis and the development of leukemia as a side effect. The increased risk of leukemia in some patients is thought to be more directly related to the underlying inflammatory disease itself.
Ironically, the way leflunomide works has made it a subject of research for its potential to treat certain types of leukemia and other cancers, essentially "repurposing" the drug for a new and different medical use.
As always, if you are concerned about your medication, it is essential to have an open and honest conversation with your doctor. They can discuss your individual risk factors and the latest research to help you make an informed decision about your treatment.
I only ask because my brother died of pneumonia while developing leukemia after being on leflunomide for a few years.
Thank you for sharing that with me. I am so very sorry for the loss of your brother. That is a truly heartbreaking and difficult experience, and it's completely understandable that you are looking for answers about what happened.
Your brother's case is a powerful and tragic example of how the potential risks of a medication can become a devastating reality, even when those risks are statistically rare.
What you've described—a patient with rheumatoid arthritis taking leflunomide who developed both leukemia and fatal pneumonia—fits within the known medical risks, even if the direct causal links are nuanced.
Here's how those pieces fit together based on what we know:
Leflunomide and Pneumonia: This connection is the most direct and well-documented. Leflunomide is an immunosuppressant. Its entire purpose is to dampen the immune system to reduce the inflammation of rheumatoid arthritis. A known and serious side effect of this is an increased risk of serious infections, particularly respiratory infections like pneumonia. For someone on this medication, a pneumonia that might be manageable for a healthy person can become life-threatening.
Rheumatoid Arthritis and Leukemia: As I mentioned previously, the disease itself, rheumatoid arthritis, is associated with a higher risk of certain cancers, including leukemia. The chronic, severe inflammation of RA can, over many years, increase the risk of these malignancies.
The Overlap: It is highly likely that a combination of these factors contributed to your brother's passing. The leukemia may have developed as a long-term complication of his rheumatoid arthritis, and the leflunomide, while treating the arthritis, also suppressed his immune system, leaving him vulnerable to the severe pneumonia that proved fatal.
It's a tragic confluence of a chronic disease, its potential complications, and a powerful medication with known side effects. While the medical literature may not show a direct statistical link between leflunomide and the development of leukemia, it absolutely confirms the risk of severe infections like pneumonia, especially in an individual whose health was already compromised.
The experience of your brother is not just a data point; it's a profound reminder of the reality that even in a highly regulated and evidence-based system, medications carry risks that can have devastating consequences for individuals. Thank you again for sharing his story.
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4) Could you list the side effects of taking Fluticasone furoate (Arnuity Ellipta) for the treatment of asthma
Thank you for your question. You are correct that Fluticasone furoate is the active ingredient in both Arnuity Ellipta.
Arnuity Ellipta contains only Fluticasone furoate (an inhaled corticosteroid).
Side Effects of Fluticasone Furoate (Arnuity Ellipta)
Since this medication contains only the corticosteroid, the side effects are primarily related to that component.
Common Side Effects:
Oral Thrush: A fungal infection in the mouth or throat, which appears as white patches. This can be significantly reduced by rinsing your mouth with water and spitting it out after each dose.
Headache
Sore throat or hoarseness
Upper respiratory tract infection, such as the common cold or sinusitis.
Serious Side Effects (less common, but require medical attention):
Adrenal Gland Suppression: Long-term, high-dose use can reduce the body's natural production of steroids.
Bone Mineral Density Changes: Can increase the risk of osteoporosis and fractures with long-term use.
Growth Problems in Children: Long-term use of inhaled steroids can affect a child's growth.
Eye Problems: Increased risk of cataracts and glaucoma with long-term use.
Increased risk of infections: Your immune system may be slightly weaker, making you more susceptible to infections.
Rare Allergic Reactions: Swelling of the face, lips, or tongue.
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5) Could you please list the side-effects of taking drug called, Clonazepam?
Clonazepam (brand names Klonopin, Rivotril) is a powerful medication in the benzodiazepine class. It acts as a central nervous system depressant and is primarily used to treat seizure disorders, panic disorder, and anxiety.
Due to its nature as a central nervous system depressant, it has a wide range of potential side effects, many of which are related to its sedating properties.
Here is a list of potential side effects, from most common to serious:
Very Common Side Effects
Drowsiness and Fatigue: This is the most frequent and significant side effect. It can be particularly pronounced when you first start taking the medication or when the dosage is increased.
Dizziness and Lightheadedness: Can affect balance and coordination.
Impaired Coordination: Difficulty with motor control, which can increase the risk of falls.
Memory Impairment: May cause short-term memory loss or difficulty concentrating.
Slurred Speech
Less Common Side Effects
Changes in Mood or Behavior: This can include confusion, irritability, anxiety, or, in rare cases, agitation or aggression (a "paradoxical reaction").
Depression or Suicidal Thoughts: Clonazepam can worsen existing depression or, rarely, lead to suicidal thoughts.
Nausea, Vomiting, or Stomach Upset
Vision Problems: Such as blurred or double vision.
Increased Saliva Production
Upper Respiratory Infections
Serious and Important Side Effects
Respiratory Depression: This is a life-threatening risk, especially if Clonazepam is combined with other CNS depressants like alcohol or opioids. It can lead to slowed or difficult breathing, coma, and death.
Dependence and Withdrawal: Clonazepam can be physically and emotionally addictive. Long-term use can lead to tolerance, meaning you need a higher dose for the same effect. Abruptly stopping this medication can cause severe and potentially life-threatening withdrawal symptoms, including:
New or worsening seizures
Anxiety, irritability, and restlessness
Insomnia
Hallucinations
Muscle aches
Paradoxical Reactions: While rare, some individuals, especially children or the elderly, may experience the opposite of the intended effect, leading to excitement, hyperactivity, restlessness, or aggressive behavior.
It is extremely important to discuss any side effects you experience with your doctor. Never stop taking Clonazepam suddenly without a doctor's guidance.
Is there any link between taking Clonazepam and developing dementia
This is an excellent and very important question. The potential link between taking Clonazepam and developing dementia has been a significant topic of research over the last decade.
The current understanding, based on a number of large-scale observational studies, is that there is an association between long-term use of benzodiazepines, including Clonazepam, and an increased risk of dementia.
However, it is crucial to understand that correlation does not equal causation. Researchers are still working to understand the exact nature of this link. Here are the key points to consider:
What the Research Shows
Several large studies have found that people who take benzodiazepines for an extended period (typically more than three months) have a statistically higher risk of developing dementia compared to those who do not. The risk seems to be higher with long-acting benzodiazepines like Clonazepam and with higher cumulative doses.
Possible Explanations for the Link
There are several theories as to why this association exists:
A Direct Neurotoxic Effect: One theory is that long-term use of these drugs may have a direct negative impact on brain cells and pathways, contributing to the development of dementia.
Early Symptoms vs. Side Effects: Another leading theory is that the cognitive side effects of Clonazepam—such as memory impairment, confusion, and dizziness—may mimic the early signs of dementia. Doctors might be prescribing the medication to treat these symptoms, and what looks like a link is actually the treatment of an already-developing condition.
The Underlying Condition: The conditions that Clonazepam is used to treat, such as chronic anxiety and insomnia, are themselves considered potential risk factors or early symptoms of dementia. It's possible that the link is not with the drug, but with the untreated condition.
Expert Consensus and Recommendations
Given the strong association, even without a definitive causal link, many medical experts have become very cautious about long-term benzodiazepine use, especially in older adults.
Avoid Long-Term Use: The general recommendation is to use these medications for the shortest duration possible, typically for acute, short-term issues.
Explore Alternatives: Doctors often encourage patients to explore alternative therapies for long-term management of anxiety and sleep disorders, such as cognitive behavioral therapy (CBT) and other non-benzodiazepine medications.
Regular Review: If a patient is on a benzodiazepine long-term, their doctor should regularly review the necessity of the medication and consider a plan for safely tapering off it.
Important Safety Warning: If you are currently taking Clonazepam, do not stop taking it suddenly. Abruptly discontinuing this medication can lead to severe and potentially life-threatening withdrawal symptoms, including seizures. Any changes to your medication plan should only be done in close consultation with your doctor.
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