What You Need To Know About OTC Drugs
First of two parts. About 3 billion trips to the pharmacy are made each year to purchase over-the-counter drugs in the United States, according to the Consumer Healthcare Products Association. The average household spends about $338 per year on these products, and 70 percent of parents have given their child an OTC in the middle of the night for various symptoms. Consumers buy OTC remedies for a variety of ailments: to reduce fevers, ease body aches, soothe sore throats, and alleviate nausea and diarrhea. OTC medications are considered safe if they are used according to the directions on the label. But there is much more to be considered when using these products. OTC medications are readily available, are often less expensive than prescriptions and can be purchased without a visit to the physician’s office. The FDA considers these drugs to be safe for healthy consumers to use if the instructions on the label are followed. These medications have few side effects, low toxicity and a low potential for abuse. Nonetheless, there is the possibility of serious and unpredictable interactions with other drugs that you may be taking. If you’re taking other prescription or OTC medications, a consultation with a doctor or pharmacist before selecting an OTC remedy may be a wise decision. One potential problem with OTC medications: You generally self-diagnose when using them, which may result in mistaking a minor ailment for a more serious illness. For example, “headache” may indicate a brain tumor, or “heartburn” may be a sign of a heart attack. Older people are at greater risk of developing adverse effects and drug interactions from OTC medications because increasing age affects the absorption, distribution, metabolism and excretion of many drugs. Some OTC drugs, such as cold remedies, cough syrups and painkillers contain substances that can produce drowsiness, impair judgment and slow reaction time. People experiencing these side effects are at risk of injury or even death while operating equipment or motor vehicles. There are several other problems that can occur when using OTC medications. Even though the side effects are few, they can be dangerous. Heart attacks and strokes can be side effects of Advil, Aleve and Motrin, which are classified as nonsteroidal anti-inflammatory drugs (NSAIDs). An OTC remedy may worsen a pre-existing condition. NSAIDs can aggravate peptic ulcers, and some decongestants can elevate blood pressure. Because OTC medications are mistaken as harmless, they are often taken more frequently and in higher dosages than recommended, which can cause organ damage and toxicity. An accidental overdose can occur, since some of the actions of OTC medications are similar to those of prescription drugs. For example, OTC aspirin taken with prescription Coumadin, Heparin or Plavix can result in excessive thinning of the blood and increase the risk of bleeding. Rare and unpredictable allergic reactions can be produced by some OTC drugs. Anaphylaxis, a life-threatening allergic reaction, is a possibility after taking aspirin or Advil. The consequences of the prolonged or excessive use of some OTC remedies — including liver and kidney damage or osteoporosis — can take years or decades to develop. You can alleviate the annoying symptoms associated with many common conditions through the use of OTC medications. But the right to purchase these remedies does not come without responsibility. For these drugs to be used safely, here are some important guidelines: ■ Read the label for the active ingredient, correct dose, precautions, and which conditions would make the drug a poor choice. ■ Consult a pharmacist or physician when in doubt about which active ingredient would most appropriately address a particular symptom or to identify drug interactions and side effects. ■ Select an OTC drug that treats your exact symptoms. If you have only a cough, avoid the multisymptom cold remedies. ■ OTC medications are intended for short-term use. Do not exceed the recommended treatment duration. If symptoms persist, consult a physician. ■ Consult a physician before taking any OTC remedy if you have health problems or are taking prescription medications. ■ Use reliable internet resources — such as WebMD or, on iTunes, Epocrates Rx — for information. JANET CAPUTO, P.T., D.P.T., O.C.S., contributed to this column. PAUL J. MACKAREY, P.T., D.H.Sc., O.C.S., is a doctor in health sciences specializing in orthopedic and sports physical therapy. He is in private practice and an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. His column appears every Monday. Email: firstname.lastname@example.org.