Side effects, and when to get help

Where the authoritative list is

This page is orientation, not a list of side effects. The list for your medicine, with how common each effect is, is in the patient information leaflet in the box and in the Summary of Product Characteristics, both published on the electronic medicines compendium. Those documents are kept up to date by the company that holds the licence and are reviewed by the regulator. An article on a pharmacy’s website is not a substitute for them, and this one is not trying to be.

What this page does is say which category a symptom falls into and what to do about each.

What is commonly reported

The best known effects of this class of medicine are to do with the stomach and bowel: nausea, vomiting, diarrhoea, constipation, indigestion, burping, stomach pain and a feeling of fullness. Headache, tiredness and dizziness are also reported. Injectable treatments can cause reactions at the injection site — redness, itching or a small lump.

Two things are generally true of these early effects, and neither is a promise about you:

• They are commonest when a medicine is started and after each increase in strength.
• For many people they ease over the following weeks at the same strength.

Feeling full sooner and being less interested in food is how these medicines work, not a side effect of them. Eating less is expected; being unable to eat or drink is not.

What usually helps, and what does not

Things people commonly find help with early stomach symptoms: smaller meals more often, stopping when full, going easy on fatty and very rich food, and drinking enough through the day. Constipation responds to fluid, fibre and movement, and a pharmacist can advise on what is safe to take alongside your medicine.

What does not help: skipping doses to avoid feeling rough, halving a dose yourself, or waiting for something to pass that is getting worse. If a side effect is bad enough that you are managing it by not taking your medicine, that is a reason to talk to a prescriber about the strength — reducing or holding are both normal outcomes and neither is a failure.

Symptoms to act on the same day

These are not the common ones. Get medical advice the same day — call 111, or 999 if someone is seriously unwell:

• Severe or persistent abdominal pain, especially if it spreads through to your back, with or without vomiting.
• Vomiting or diarrhoea you cannot keep on top of, or being unable to keep fluids down.
• Signs of dehydration — passing very little urine, dizziness on standing, confusion.
• Yellowing of the skin or the whites of the eyes, or pain under the ribs on the right side.
• Swelling of the face, lips, tongue or throat, a widespread rash, or difficulty breathing.
• Shakiness, sweating, confusion, palpitations or feeling faint, particularly if you also take insulin or another medicine for diabetes.
• A change in your vision, particularly if you have diabetes.
• Any symptom that is getting worse rather than settling, or that frightens you.

No list can be complete. If you are worried and what is happening is not on this page, that is still a reason to ring 111. The fuller version of this, with who to contact when, is on urgent help and out of hours.

Report it — twice

Tell us. Message us from your account so it reaches a clinician with your record attached. It goes into your clinical file with the date, and a prescriber decides whether anything about your treatment should change. Our prescribing rules do not permit an increase in strength in the cycle after a severe reaction has been reported, so telling us has a direct effect on what happens next.

Submit a Yellow Card to the MHRA. The Yellow Card scheme is how suspected side effects are collected in the UK. Anyone can use it — patients, carers, family and healthcare professionals — and you do not need to be sure the medicine caused it. That is the point of it: one person’s uncertain report means little, and thousands of them are how a pattern nobody could see in a single patient becomes visible.

Report known side effects as well as unexpected ones. A report about something already in the leaflet still tells the regulator how often it happens and how badly.

How to do both, and what information helps, is on report a side effect.

Telling other clinicians

If you see a GP, a dentist, a hospital doctor or a pharmacist while you are on treatment, tell them what you are taking and at what strength. It is on your medicine’s label and in your account. It matters particularly before any procedure involving sedation or anaesthesia, and if you are admitted to hospital.

With your consent we write to your GP when you start treatment, which is the other half of the same point: a record of your care that is only in one place is a record that is not there when somebody needs it.