Can I stop a medicine if I feel well?

Why feeling well is not a reason to stop treatment, which medicines should not be stopped suddenly and how to tell your doctor you want to stop one.

Generally, no. If you take a medicine for a long term condition, such as high blood pressure, high cholesterol or diabetes, feeling well does not mean you no longer need it: very often it means it is doing its job. Stopping it on your own can let the condition get out of control again without you noticing, and some medicines can cause withdrawal effects if they are stopped suddenly.

That does not mean you must take everything forever without asking. Reviewing whether each medicine is still needed is part of good treatment, always together with your doctor.

Why is it not a good idea to stop treatment when you feel well?

Because many long term conditions cause no symptoms even when they are not under control. High blood pressure, high cholesterol or high blood sugar can damage the heart, kidneys or blood vessels for years without you noticing, and the medicine is what keeps them in check.

Stopping medication is more common than it seems. In its 2003 report on long term treatments, the World Health Organization (WHO) estimated that in developed countries adherence to treatment for chronic diseases averaged only 50%. The WHO gave an example in high blood pressure: in a study in Sudan, only 18% of people who did not follow their treatment had well controlled blood pressure, compared with 96% of those who did.

If you feel better, that is good news and a good reason to mention it at your next appointment, not to leave the tablets in the drawer.

What can happen if you stop a medicine suddenly?

It depends on the medicine. With some, the problem is that the condition comes back; with others, stopping suddenly causes symptoms of its own, sometimes serious ones. That is why the leaflets of many medicines say explicitly that you should not stop them without talking to your doctor.

If you are being treated for depression or anxiety and are thinking of stopping, you may find it helpful to read keeping up treatment once you feel better.

Are there medicines you can stop?

Yes, but not all of them and not in just any way. Some treatments have a set duration, some medicines are only taken when needed, and others become unnecessary over time or carry more risks than benefits. Withdrawing them in a planned way is called deprescribing, and your doctor decides it with you.

• Treatments with an end date: for example, an antibiotic or a short course of steroids. They end when and how the doctor said.
• "As needed" medicines: such as a painkiller for occasional pain. They are used only if there are symptoms and as the leaflet says.
• Medicines worth reviewing: those started years ago for a reason that no longer applies, or those causing side effects. Your doctor can reduce or withdraw them, sometimes little by little.

If you feel you are taking too many medicines, we explain how to raise it in how to talk to your doctor if you think you take too many.

How do you tell your doctor you want to stop a medicine?

Honestly and with information. Saying "I want to stop this tablet because..." is much more useful than quietly stopping it, because the reason usually has a solution: switching medicine, adjusting the dose or timing, or confirming that you no longer need it.

1. Write down which medicine you want to stop and why: side effects, a feeling that it is not needed, cost or difficulty taking it.
2. If you have measured your blood pressure, blood sugar or other readings at home, bring the records.
3. Ask what would happen if you stopped it and whether there are alternatives.
4. If the doctor decides to withdraw it, ask for written instructions on how to do it and when to review.
5. In the meantime, if a side effect worries you, ask your pharmacist: they can advise you and let your doctor know.

A practical example: Luis and his "perfect" blood pressure

Let us take the example of Luis, 49, an engineer. Two years ago he was diagnosed with high blood pressure and high cholesterol, and he takes two medicines every day. For months, every time he checks his blood pressure at the pharmacy it is fine, so he starts to think he is cured and could stop the tablets.

Instead of stopping, he books an appointment with his GP and brings his readings. She explains that the readings are good precisely because of the treatment and that, without it, they would most likely rise again. Together they check:

• That both tablets are still needed.
• That he could take them together in the morning, which is more convenient for him.
• That if he loses weight and exercises more, they will reassess the treatment at the next review.

Luis leaves the appointment with a plan and without wondering whether he is doing the right thing.

How can IMA Health help you?

Sticking to a long term treatment for years is easier when you do not have to think about it every day. At IMA Health we coordinate with a specialised pharmacy that prepares your medication by day and time of each dose, we deliver it to your home and we provide personalised follow-up. When your doctor changes or withdraws a medicine, we coordinate with the pharmacy so that your preparation is updated.

Sources

• WHO: Failure to take prescribed medicine for chronic diseases is a massive, world wide problem (2003)
• MedlinePlus: Metoprolol (in Spanish)
• MedlinePlus: Prednisone (in Spanish)
• NHS: Antidepressants
• AEMPS: Antibiotics campaign, take them seriously (in Spanish)

This article is for information only and does not replace advice from your doctor or pharmacist.