Black Hairy Tongue
Halloween costume gone wild? No, it’s a condition termed “black hairy tongue”. The odd, dark growth on the tongue is due to a bacterial or yeast overgrowth in the mouth. Culprits may be antibiotics (such as with erythromycin, doxycycline or tetracycline), poor oral hygiene, open mouth breathing, use of oxidizing mouth washes (hydrogen peroxide), drugs that cause dry mouth (xerostomia), or heavy tobacco use.
Although it may be unpleasant, black hairy tongue doesn’t usually require medical treatment; it’s temporary and harmless. Be sure to practice good oral hygiene and brush your tongue and teeth twice a day. Talk to your doctor to see if any of your medications may be the cause.
Sherlock Holmes you may not be, but hand–foot syndrome, known by the medical term palmar-plantar erythrodysesthesia, is something to watch out for. Hand-foot syndrome may occur when cancer treatment affects the growth of skin cells or blood vessels in the hands and feet. Redness, swelling, loss of fingerprints, and pain have been reported.
Cancer drugs cited to cause this effect include capecitabine, sunitinib, sorafenib, pazopanib and vemurafenib, although it can happen with others. If you develop hand-foot syndrome, talk to your doctor; there are ways to manage it and prevent it from worsening.
Osteonecrosis of the Jaw
Osteonecrosis of the jaw (ONJ) occurs when the jaw bone is exposed and begins to die from a lack of blood. The name of the condition is descriptive – osteo meaning bone and necrosis meaning death.
Several drugs are linked with ONJ, including antiresorptive therapies that are ironically used to help prevent the loss of bone mass in diseases such as osteoporosis. Drugs such as alendronate, risedronate, ibandronate, and denosumab can lead to ONJ; however, ONJ may also occur without any identifiable risk factors. Most cases of ONJ happen after a dental extraction in patients taking these drugs.
Shopaholic? It might not be so far fetched with the use of some medications. In patients with the movement disorder Parkinson’s Disease (PD), dopamine agonist drugs are often used to help stimulate dopamine receptors; examples include ropinirole and pramipexole.
Clinical studies have found dopamine agonist treatment in PD is associated with 2 to 3.5-fold risk of having an impulse control disorder (ICD) such as compulsive gambling, compulsive buying, compulsive sexual behaviors, or binge-eating disorder. Some case reports also suggest that ICD may occur with dopamine agonist treatment in patients with restless leg syndrome or fibromyalgia.
Amnesia and Memory Problems
Fuzzy memory and forgetfulness is not just a sign of old age. Several drugs are associated with forgetfulness, or flat out amnesia.
Benzodiazepines (BZD) used for anxiety or sleep like triazolam, statins used to help lower cholesterol like atorvastatin, and excessive alcohol use can all cause memory loss. Some medicines such as midazolam, also a BZD, are used to purposely induce sedation and memory loss of medical procedures. The amnesia or forgetfulness is usually short-lived and disappears once the drug wears off; however, the events that occurred while the patient was under the effect are usually forgotten.
Nightmares or Night Terrors
If you have ever woken up from a dream in a cold sweat, you know a nightmare or night terror is a horrific event. Many medications, especially those that might work in the brain, can cause abnormal or vivid dreams. For example, medications used to help patients quit smoking like varenicline or bupropion can cause nightmares.
However, Chantix studies have shown that after 12 weeks of use, 44% of users were able to quit smoking, so check with your doctor as you might be able to lower your dose to help with the dream side effect. And don’t forget — the serious side effects from smoking — chronic lung disease, lung cancer and possible death – is permanent.
Dysgeusia (Abnormal Tastes)
That latest bad taste in your mouth might not just be from the cost of your prescription. Dysgeusia is a condition that affects the ability to taste or results in an odd taste. For example, some drugs cause a distorted sense of taste.
Metronidazole is used to treat bacterial infections, but a common side effect is a distinct metallic taste in the mouth that can make treatment intolerable. Taste changes can be frequent among senior patients who take multiple medications, as well.
Captopril for blood pressure control, the antibiotic clarithromycin, and multivitamins, especially those containing metals like calcium or iron, can cause a metallic taste, too. Certain chemotherapy and anesthesia medications can do this, also.
Bizarre Sleep-Related Behaviors
“Things That Go Bump in the Night” just took on a new meaning. Those who take prescription sleep aids such as zolpidem, zaleplon, or ramelteon have been known to get up at night and go for a drive, take a walk, chat on the phone, binge eat, or even have sex and not remember any of it in the morning.
These behaviors may be due to alterations in brain neurotransmitters, but the exact cause is not fully known. Do not drink alcohol or take medicines that can make you drowsy, which can worsen these side effects. It is extremely important to follow dosing instructions for these medications, and be sure you have adequate time to devote to sleep before you must wake up.
Don’t It Make My Brown Eyes Blue
You’ve heard of that little blue pill? It’s sildenafil, the popular erectile dysfunction (ED) drug. There have been reports of Viagra causing a bluish tint (cyanopsia) to vision in about 3 out of every 100 men. Viagra and related drugs like tadalafil and vardenafil work by inhibiting phosphodiesterase 5 (PDE-5) to facilitate erections.
According to the drug maker, the visual blue hue is due to a blockage of the PDE-6 enzyme present on the retinal photoreceptor. The blue vision is temporary; long-term side effects are unknown. Rarely, vision loss and double vision may also occur with higher doses of PDE-5 blockers in men with certain risk factors.
Unexpected Urine Color
Face-painting is fun – but colored urine? Some drugs can lead to odd and alarming urine colors. For example, amitriptyline, indomethacin, and propofol are all drugs that can lead to blue or green urine. Rifampin, an antibiotic used in the treatment of tuberculosis, can turn urine a reddish-orange. The urinary tract analgesic phenazopyridine and the laxative senna can also cause an orange-reddish urine.
Urine discoloration due to these medications is not a serious problem and will clear once the drug is out of the system. More seriously, pink or red urine can be caused by blood from conditions such as urinary tract infections, enlarged prostate, tumors or kidney stones. See your doctor about that one.
Bells ringing in the belfry are a familiar sound on Halloween night, but if you continue to hear this sound day after day, you may have tinnitus.
Tinnitus is a hearing sensation that is often described as a ringing in the ears. Hearing loss due to age or medication side effects can lead to tinnitus. Aspirin taken in high doses, certain diuretics (water pills) such as furosemide, and some antibiotics, like polymyxin B, erythromycin, vancomycin and neomycin, can all cause the side effect of tinnitus. Luckily, once the medication is stopped, the ringing usually goes away; however, contact your doctor before you abruptly discontinue any regularly-prescribed medication or antibiotic.
Can’t You Smell That Smell?
The loss of smell, also known as anosmia, might not be a problem on Halloween, but come Turkey Day, it’s important to have all of your olfactory parts in working order.
Enalapril, a blood pressure medicine, has been rarely associated with anosmia. Other medications that have been linked with loss of smell include: amphetamines, estrogens, naphazoline eye drops, phenothiazines, long-term use of nasal decongestants, and possibly zinc-based products like Zicam. The loss of smell can sometimes be a symptom of a serious condition, but it isn’t always serious itself. Nonetheless, you need to be able to smell to fully taste and enjoy foods.
Hallucinations, sensing or seeing things that appear to be real, but have only been created by the mind, seem to go hand-in-hand with Halloween. However, hallucinations are a serious side effect and require a thorough medical investigation.
Examples of drugs that may trigger a hallucination include amphetamines, estrogens, phenothiazines, and high dose decongestants. Illicit drugs that can lead to hallucinations include LSD, cocaine, crack, PCP, heroin and alcohol. Common hallucinations may include: crawling bugs, hearing sounds or voices, or seeing lights. Hallucinations may also occur with conditions such as schizophrenia or dementia.
This might be the most fearful side effect of all, and for good reason. Priapism is a prolonged, painful erection of the penis. The erection is not due to sexual stimulation, but may be the side effect of a drug.
Luckily, priapism is rare, but if a prolonged erection lasts for longer than 4 hours, seek emergency medical care immediately. Drugs that have been implicated in leading to priapism include the well-known erectile dysfunction (ED) drugs such as sildenafil, tadalafil and vardenafil; some antidepressants such as fluoxetine, trazodone, and bupropion, and the antipsychotic agents risperidone and olanzapine.
Vertigo is the name of the famous Alfred Hitchcock psychological thriller – and it’s also the term given to the extreme dizziness that creates the sense that you or your surroundings are spinning or moving while you are actually at a standstill. Whoa.
Toxic levels of anti-seizure drugs such as phenytoin, phenobarbital and primidone have been reported to cause vertigo. Antibacterial aminoglycoside drugs like gentamicin can be toxic directly to the ear and result in vertigo. Drugs to control high blood pressure such as the water pill furosemide, the antimalarial agent mefloquine, and not surprisingly, excessive alcohol consumption have also been linked to vertigo.
Gynecomastia is breast enlargement in men due to hormonal imbalances, not excess growth of fat tissue.
Some drugs are known for causing gynecomastia due to effects on hormones. Finasteride and dutasteride, both used in the treatment of benign prostatic hypertrophy (BPH), are commonly associated with gynecomastia. Estrogens, digoxin, phenothiazines, or propranolol have also been linked with this condition. Lower doses of finasteride used for male pattern hair loss have also been linked with gynecomastia. The condition is reversible in about 80 percent of cases. Gynecomastia is not a serious condition medically, but may cause anxiety and embarrassment.
Vampires usually hide from the sunlight. Unfortunately, some medicines may keep you out of the sun, too.
Drugs that cause photosensitivity reactions – such as glipizide, amiodarone, diltiazem, tetracycline, doxycycline, ciprofloxacin, NSAIDs, or carbamazepine – may cause an increased skin sensitivity to sunlight or artificial light. The drug absorbs the UV light from the sun and leads to a skin reaction like a rash or blisters. Not everyone who takes an offending drug will develop a photosensitivity reaction, and it may take 1 or 2 days for the reaction to develop. Contact your doctor if you should develop a unusual skin reaction after taking any medicine.
Those Creepy Added Pounds
Weight gain is also one of the most dreaded drug side effects. Let’s face it – keeping weight off is a hard enough task without gaining weight from medications. Aging, lack of exercise, and diet changes are all culprits in the battle to keep weight down.
However, some common medications can also lead to weight gain – drugs used for mood disorders, depression, diabetes, high blood pressure, seizures and the anti-inflammatory corticosteroids can all add on unwanted pounds. Ask your doctor about this side effect. You may be able to switch to a different medication or use a lower dose if one of your meds put you at risk for weight gain. And remember, medications may affect patients differently, so not every patient will gain weight.
Drug Side Effects are Really No Laughing Matter
So there you have it, the top unusual drug side effects, just in time for Halloween. No doubt, some are downright chilling, but this highlights the need to research your drugs before you start taking them.
Ask questions, too. What are the most common or serious side effects you can expect to see? How often do they occur? Are there any rare side effects you should be aware of? Most importantly, do not stop taking any medication without first talking to your doctor — they may be able to prescribe a lower dose or alternate drug. And many drugs need to be stopped slowly – an abrupt discontinuation may lead to even more scary side effects – just exactly what you were trying to get away from!
- Weintraub, D, et al. Impulse control disorders in Parkinson’s disease. A cross-sectional study of 3090 patients. JAMA Neurology 2010;67:589-95. Accessed 9/5/2016 at http://archneur.jamanetwork.com/article.aspx?articleid=800232
- American College of Rheumatology. Osteonecrosis of the Jaw (ONJ). Accessed 9/5/2016 at http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Osteonecrosis_of_the_Jaw_(ONJ)/
- Vision Web. Viagra and Vision. Accessed 9/5/2016 at http://www.visionweb.com/content/consumers/dev_consumerarticles.jsp?RID=85
- Mayo Clinic. Diseases and Conditions. Black Hairy Tongue. Causes. Accessed 9/5/2016 at http://www.mayoclinic.com/health/black-hairy-tongue/DS01134/DSECTION=causes
- Thompson DF, Kessler TL. Drug-Induced Black Hairy Tongue. Pharmacotherapy. 2010;30:585-93. Accessed 9/5/2016.
- Cancer.net. Hand-Foot Syndrome or Palmar-Plantar Erythrodysesthesia. Accessed 9/5/2016 at http://www.cancer.net/all-about-cancer/treating-cancer/managing-side-effects/hand-foot-syndrome-or-palmar-plantar-erythrodysesthesia
- Harmon K. Scientific American. Can You Lose Your Fingerprints? 5/29/2009. Accessed 9/5/2016 at http://www.scientificamerican.com/article.cfm?id=lose-your-fingerprints
- Mayo Clinic. Urine Color. Causes. Accessed 9/5/2016 at http://www.mayoclinic.com/health/urine-color/DS01026/DSECTION=causes
- Vasotec. Product Labeling. Valient. Accessed 9/5/2016.
- MedLine Plus. Smell – Impaired. Accessed 9/5/2016 at http://www.nlm.nih.gov/medlineplus/ency/article/003052.htm
- Viagra. Product Labeling. Pfizer. Revised Jan 2010. Accessed 9/5/2016 at http://www.pfizer.com/files/products/uspi_viagra.pdf
- Mayo Clinic. Tinnitus. Causes. Accessed 9/5/2016 at http://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/dxc-20180362
- FDA. FDA Advises Consumers Not To Use Certain Zicam Cold Remedies Intranasal Zinc Product Linked to Loss of Sense of Smell. 6/16/2009. Accessed 9/5/2016 at http://www.fda.gov/Newsevents/Newsroom/PressAnnouncements/ucm167065.htm
- MedLine Plus. Hallucinations. Updated 3/7/2012. Accessed 9/5/2016 at http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm
- Family Practice Notebook. Vertigo Caused by Medication. Accessed 9/5/2016 at http://www.fpnotebook.com/ent/pharm/VrtgCsdByMdctn.htm
Source: Drugs.com, September 05, 2016