Millions of people worldwide take over-the-counter medications daily to treat a wide range of minor health conditions. OTC medicines are safe for the most part, and there is no doubt about the convenience offered by the wide variety of OTC products. However, we often underestimate the potential health complications and side effects they could cause. Certain OTC products may not be suitable for you if you have certain health conditions. In addition to that, OTC medications can also interact with other medications. Last but not least, not following instructions on the product labels can lead to some unpleasant effects.

Please keep reading to learn about some of the over-the-counter medicines you should take with precaution. We will also give you some quick tips on how to take OTC drugs safely.

What are over-the-counter medicines?

Over-the-counter medicines are medicines that can be purchased without a prescription. OTC products are commonly used for a wide range of health problems and are effective at relieving symptoms such as fever, diarrhea, pain, cough, acne, and many more. It is estimated that more than 300,000 OTC medicines are available in the United States.

What is the greatest danger of taking over-the-counter drugs?

There are several potential risks associated with taking an OTC medicine.

Wrong dosage

It is very important to read the medicine label carefully to ensure you do not take more than the recommended dose of an OTC medication. Remember that older adults 65 years and over may need to take a lower dose of medicine. This also applies to those with kidney or liver disease, as their bodies don’t clear the medication as well as healthy people.

Giving over-the-counter medication to children requires even more caution. Most people think of children as “little humans,” which is not entirely accurate. Certain medications that are safe for adults are not appropriate for small children or teenagers. You should always check dosage instructions carefully before giving children medicines. For example, while Tylenol (acetaminophen) is usually a safe option to treat a young baby’s fever, you should not give aspirin to a child unless the doctor tells you to.

Long-term use

Most OTC medicines are meant to provide short-term relief from minor health problems. Generally, you should not use over-the-counter medications for an extended period of time without consulting a healthcare professional. This is because OTC medicines can sometimes mask the symptoms of a serious illness like asthma or heart disease. If you have a chronic illness or take any medications at home, you should consult your healthcare provider before using over-the-counter medications to ensure these medications are safe and there are no drug interactions.

Pregnant and breastfeeding women

Not only prescription medications but also over-the-counter medicines can move from mothers to their unborn babies. Similarly, medications can get into breast milk and affect nursing infants. That doesn’t mean you can’t take any remedies if you are an expecting or nursing mother. Your family medicine doctor can help you choose a safe treatment for you and your baby.

Drug interactions

Mixing different OTC medications can potentially lead to serious side effects. For instance, St. John’s Wort, a popular herbal supplement used for various mental health conditions, can interact with dextromethorphan to cause high levels of serotonin in the body, known as serotonin syndrome. Dextromethorphan is a cough suppressant, and many OTC cough and cold medicines contain dextromethorphan as an active ingredient. Before starting any new medicine, you should check with your doctor or pharmacist and give them a complete list of all your medicines, including both prescription and non-prescription drugs. This will help lower your risk of potentially dangerous drug interactions.

Overdose

Many OTC products contain the same active ingredient. The amount of OTC cough and cold medicines on the pharmacy shelves can be overwhelming. However, the fact is that many of these products contain the same active ingredient; for example, most of them contain acetaminophen. Tylenol is everyone’s “go-to” fever medicine and an essential item in every household’s medicine cabinet. Therefore, reading product labels can help you avoid doubling the dose of medication by accident.

Which OTC medicines should you take with precaution?

Antihistamines:

Medication names: diphenhydramine (Benadryl, Diphenhist), doxylamine (Unisom).

Used to treat: Allergies, insomnia, motion sickness.

Side effects: Dizziness, drowsiness.

Risks: Falls, accidents, injuries.

Pseudoephedrine:

Medication names: Sudafed; active ingredient of Mucinex DM, Advil Sinus Congestion and Pain

Used to treat: nasal congestion, sinus pressure

Side effects: difficulty sleeping, feeling nervous or shaky, elevated blood pressure

Risks: Dangerously elevated blood pressure, especially for people who already have high blood pressure.

Anti-diarrheal Medicines:

Medication names: loperamide (Imodium A-D, Kao-Paverin, Maalox Anti-Diarrheal, Pepto Diarrhea Control).

Used to treat: Diarrhea.

Side effects: Tiredness, constipation.

Risks: Life-threatening changes in heart rhythm, vision changes, fainting, and euphoria.

Proton Pump Inhibitors:

Medication names: (Prilosec OTC), Zegerid OTC (combination product of omeprazole and sodium bicarbonate).

Used to treat: Heartburn (acid reflux).

Side effects: Nausea, vomiting, diarrhea, gas, constipation, headache.

Risks: Vitamin B12 deficiency, osteoporosis, hip fractures, electrolyte imbalance.

Non-steroidal Anti-inflammatory Drugs (NSAIDs):

Medication names: Ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin (Bayer Aspirin).

Used to treat: Pain and fever.

Side effects: Stomach upset, heartburn, nausea, dizziness, kidney injury.

Risks: Stomach ulcers, stomach bleeding, increased risk of heart attack, serious drug interaction with warfarin increasing bleeding risks.

What are some over-the-counter medicine precautions?

OTC medicines, used at the minimum effective dose, provide the most optimal outcomes when combined with lifestyle changes, especially for sleeping problems or heartburn. When dealing with a cold or flu, don’t forget that fluids and rest are crucial for your recovery. If you decide to take an over-the-counter medicine, take it at the minimum effective dose for the shortest possible time to treat your symptoms or condition. Also, you should not take more than the recommended dose on the product label to feel better quicker, “the more, the merrier” is not the case here. Last but not least, it is vital to seek medical care promptly if your symptoms worsen or your illness does not improve after a few days. Healthcare providers such as your pharmacist, your family medicine doctor, or an internal medicine doctor can provide guidance and treat your illness appropriately.

Here are some safety tips for over-the-counter medicines.

If you are unsure what to take for your symptoms, discuss the medicine's benefits and side effects with your doctor or pharmacist before taking it. This will help you make an informed health decision.
Carefully read and follow the instructions on the product labels. Do not take the medicine in a different way than directed unless your doctor tells you to.
Use the measuring device, such as an oral syringe that comes with liquid medicine, to measure the dose. Do not use a household spoon to measure the dose of a liquid drug, as this can result in inaccurate doses.
Do not take a medication if you have had an allergic reaction to it in the past. Check with your pharmacist for other medicines in the same drug class that may also cause allergic reactions.
If your symptoms do not get better within a few days or get worse after starting treatment with an OTC product, call your doctor.
If you have severe side effects or side effects that last more than a few days after taking an over-the-counter medicine, call your doctor.
If you are pregnant or could be pregnant, call your doctor before taking any OTC product.
Keep an updated list of all your medications, including prescription drugs, over-the-counter medications, and natural health products. Take the list to all your healthcare appointments.

References:

https://www.sciencedirect.com/topics/medicine-and-dentistry/non-prescription-drug#
https://medlineplus.gov/druginfo/meds/a682539.html#
https://medlineplus.gov/druginfo/meds/a682492.html
https://medlineplus.gov/druginfo/meds/a682280.html
https://medlineplus.gov/druginfo/meds/a693050.html#:
https://www.nhs.uk/conditions/nsaids/

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