Can you believe that well over 50% of Americans are currently taking a prescription medication? Nowadays, it seems like you can’t sit through a single commercial break without seeing a medication ad. Some of them can cause side-effects while exercising, so I thought I’d shine a light on some of the most commonly taken medications and their potential effects on the human body while exercising.

 

Medications for Hypertension (high blood pressure) and Heart Disease

Beta Blockers
  • Common Prescriptions: Atenolol and Metoprolol
  • Effect: Decreased resting and exercise heart rate and blood pressure values
  • What To Do: Don’t use heart rate as a way to determine exercise intensity. Instead try the “talk test” – if you can easily have a conversation while exercising, you aren’t working very hard. If you can only say a few words while exercising without ceasing conversation while you catch your breath, you’re working quite hard. If you can’t talk at all while exercising, you’re likely pushing yourself harder than you should (unless you’re an elite athlete).
  • Watch Out For: A decreased heart rate may induce dizziness and fatigue.
  • Additional Concern: Beta blockers can also cause glucose intolerance in people with diabetes by masking the symptoms of hypoglycemia.
ACE Inhibitors
  • Common Prescriptions: Captopril, Enalapril, and Lisinopril
  • Effect: Relaxation of the blood vessels and lower blood-pressure values. The concern for individuals taking ACE inhibitors is that the combination of the reduction in blood pressure from the medication coupled with the naturally occurring post-exercise hypotension can result in excessive reductions in blood pressure.
  • What To Do: Adhere to a gradual cool-down of 5 to 10 minutes following every exercise session, to permit the body to return to homeostasis and prevent excessive reductions in blood pressure.
  • Watch Out For: Dizziness and, in rare instances, syncope (i.e., temporary loss of consciousness).
Diuretics
  • Common Prescriptions: Hydrochlorothiazide (or HCTZ)
  • Effect: Diuretics act on the kidney and lead to increased urine output. An increase in urine excretion in turn leads to a lower plasma volume, which helps lower blood pressure.
  • What To Do: Perform a gradual cool-down after all exercise sessions, without fail.
  • Watch Out For: Dizziness
  • Additional Concern: It’s also a good idea to perform a daily weight check to ensure that the prescribed dosage of diuretic is continuing to have the desired effect. A sudden change in weight of a few pounds can help alert you that something may be amiss and that you should get in touch with your physician.

Medication for Blood Clots

Anticoagulants and Anti-thrombics
  • Common Prescriptions: The most common is Coumadin (Warfarin)
  • Effect: Regular physical activity is associated with higher Warfarin dose requirements.
  • What To Do: Check with your Dr before beginning a new exercise regimen.
  • Watch Out For: Be extra careful not to bump into things while exercising, as these drugs increase the likelihood of bruising.

Medication for Cholesterol

Statins
  • Common Prescriptions: Lipitor, Zocor and Pravachol
  • Effect: Statins are the most commonly prescribed medication for high cholesterol. Statins function by inhibiting a key enzyme involved in the production of cholesterol in the liver.
  • What To Do: Begin with low-intensity exercises and progress gradually. Workout during cooler times of the day if you’ll be outside. Hydrate before, during and after exercise.
  • Watch Out For: Excessive muscle stiffness and/or pain, fatigue, and dark-colored urine.
  • Additional Concern: Although not common, there are occasional instances where statins have been associated with exertional rhabdomyolysis. Rhabdomyolysis is a condition in which damaged skeletal muscle tissue breaks down and releases cellular content into the blood that can be harmful to the kidneys.

Medication for Type-2 Diabetes

Oral Hypogycemics (particularly ß-cell stimulants)
  • Common Prescriptions: Glipizide and Glyburide
  • Effect: ß-cell stimulants function by inciting insulin release from the pancreas.
  • What To Do: Check blood glucose levels pre-exercise, at the mid-point of exercise and post-exercise. Once it has been established how much blood glucose values typically drop for a usual exercise session, and provided these changes in glucose levels are within an acceptable range, less-frequent monitoring will be required.
  • Watch Out For: Symptoms of hypoglycemia (i.e., low blood glucose), such as excess sweating, excessive hunger, fainting, fatigue, lightheadedness, or shakiness.

Medication for Depression

Antidepressants
  • Common Prescriptions: sertraline (Zoloft), fluoxetine (Prozac, Sarafem), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva, Brisdelle), fluvoxamine (Luvox)
  • Effect: Some anti-depressants are known to cause rapid heart rate and dizziness with the onset of exercise.
  • What To Do: A longer warm-up or cool-down may be necessary.
  • Watch Out For: Other side effects may include restlessness, insomnia, headache, tremor, dry mouth, confusion, nausea, bowel problems, and rash.
  • Additional Information: Exercise appears to be an effective treatment for depression on its own, even in moderate amounts, improving depressive symptoms to a comparable extent as drugs.

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