Embodiments of the present invention disclose a method, a computer program product, and a computer system for medication decision support. A computer generates one or more patient profiles detailing one or more patient health conditions and one or more medication profiles detailing one or more medication side effects. The computer then determines an association between the one or more patient health conditions and one or more medication side effects and quantifies the association as a conflict score. In addition, the computer determines whether the conflict score exceeds a threshold and, if so, the computer identifies and recommends an alternative medication having a lower conflict score.