People’s Pharmacy: Useful drug information is hard to find

Pharmaceuticals are among the most tested, analyzed and scrutinized consumer products in the world. Initial laboratory research and preclinical investigations lead to clinical trials and Food and Drug Administration review. The cost of developing a new medication can range from hundreds of millions to several billion dollars.

That’s why it comes as such a disappointment to discover that the end users of medications, patients, get so little practical information about the drugs they are expected to take. It’s very hard to tell how effective they will be to resolve a health issue. Patients also get much less practical information than they need about side effects.

Compare medications with consumer products, for example. Whether it’s a smartphone, a refrigerator, a toaster oven or an automobile, numerous independent organizations test such products and provide quantitative information to assist consumers in making informed decisions.

If you go to Consumer Reports (CR) and look up a popular car category, say compact SUVs, you will be told an overall score. At a glance, you can see how one vehicle compares to more than a dozen other vehicles in the same class.

You will also be told the price, predicted reliability, owner satisfaction, overall miles per gallon, seat comfort, usability, noise, ride comfort, fit and finish, routine handling, acceleration and braking distance in feet from 60-0 mph in feet. For example, the Subaru Forester gets an overall CR rating of 93 compared to the Hyundai Tucson which gets an overall score of 76.

There is no such rating for medications. Rarely are drugs tested against each other. As a result, even health care professionals may find it tricky to compare one blood pressure medicine to another.

Let’s take the most commonly prescribed blood pressure medicine in America, lisinopril (Zestril). Here’s a fundamental question: How much will lisinopril lower blood pressure? If you check the official prescribing information, you will not find a simple answer. You will be told instead that “Zestril was approximately equivalent to atenolol and metoprolol in reducing diastolic blood pressure and had somewhat greater effects on systolic blood pressure.” That’s not very helpful.

What about side effects? If you put “lisinopril side effects” into a search engine, as many people do, you will find several sites, from the Mayo Clinic and GoodRx to Drugs.com and the Cleveland Clinic. The National LIBRAry of Medicine offers MedlinePlus. Many of these databases list common side effects such as dizziness, headache, cough, excessive tiredness and a decrease in sexual ability. Nowhere in such lists are there numbers to give a patient an idea of how likely such complications may be.

Even worse are TV drug commercials. An announcer speeds through a long list of adverse reactions. For example, an ad for Rinvoq to treat rheumatoid arthritis includes these warnings: “Rinvoq can lower your ability to fight infections, including tuberculosis. Serious infections and blood clots, sometimes fatal, have occurred, as have certain cancers, including lymphoma, and tears in the stomach or intestines and changes in lab results.” This scary information is crucial but does not tell patients how common these side effects may be.

One place to find such data is in the official prescribing information. You will find it at dailymed.nlm.nih.gov. Side effect information is listed as Category 6, Adverse Reactions, for most drug entries.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”