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Bitter pill

How safe are over-the-counter drugs?


Editor's note: Unedited video of Becky Bean, PharmD, speaking to this topic is available for media. Download 720p version here. Download the SD version here. Download accompanying b-roll here.

Chances are if you’ve had a cold, a headache, muscle pain, heartburn or allergies, you’ve taken an over-the-counter medication to help you feel better.

Millions of Americans routinely turn to these drugs for relief of minor symptoms. According to the American College of Preventive Medicine, at least 35 percent of adults rely on over-the-counter drugs on a regular basis.

And the reason is simple: They’re easily accessible, convenient and inexpensive, and they work well when taken as directed for minor problems.

“When taken appropriately according to the package labeling, over-the-counter medications are safe and effective,” said Becky Bean, PharmD, director of Novant Health’s population health pharmacy. “Problems arise when patients take excessive doses or medications for extended lengths of time leading to the risk for side effects and a delay in seeking medical care.”

The most commonly purchased medicines at drug stores and supermarkets are, in order: cough, cold and allergy remedies; analgesics such as acetaminophen, ibuprofen and aspirin; antacids; laxatives; and anti-diarrheals.

However, risks are associated with the nonprescription medicines, including:

  • A wrong self-diagnosis that delays an accurate diagnosis and treatment from a health care professional.
  • An increased risk of an adverse effect if the drug is misused, such as when an individual takes too large a dose.
  • An increased risk of a drug interaction if an individual is taking other medications.

Bean said consumers should consult the pharmacist at the drugstore for advice about medication. “The pharmacist can review your current medications and help guide you to make good decisions when it comes to purchasing over-the-counter products,” she said.

Even though they are safe when taken as prescribed, taking over-the-counter drugs can have consequences. “Over-the-counter products have side effects and drug interactions just like prescription medication,” Bean said.

Patients may sometimes be unaware they are taking multiple drugs containing the same ingredient. For example, acetaminophen, or Tylenol, is often contained in prescription drugs, too, Bean said. “Acetaminophen-related adverse effects continue to be a public health problem, as evidenced by the large number of calls to poison control centers, the number of hospitalizations and visits to the emergency department,” she said.

“Overdose with acetaminophen can lead to liver damage and in severe cases even death,” she added.

Even aspirin can be dangerous. Taking too much aspirin can lead to bleeding, stomach ulcers, ringing in the ears and bronchospasm, a contraction of the airways leading to the lungs, Bean said.

Some over-the-counter medicine is not safe for certain groups of people.” Nonsteroidal anti-inflammatory drugs (NSAIDS) should not be used by people with a history of gastrointestinal bleeding or  kidney disease or by anyone taking blood thinners,” Bean said. Common NSAIDS are sold under the brand names of Motrin, Aleve and Advil.

Individuals with heart disease, high blood pressure, diabetes, asthma and kidney and liver problems are at an increased risk of adverse side effects from over-the-counter medicines.

Of particular concern are older people who may be on multiple prescription drugs. People who are taking medications to control chronic conditions, such as high blood pressure, may not be aware of dangerous drug interactions with common over-the-counter products. Decongestants in cold medicine can raise blood pressure.

When using common cold and cough medicines, consumers need to be aware that these products contain multiple ingredients, including decongestants, antihistamines, analgesics and cough suppressants, Bean said. “Only take medication for the symptoms you are experiencing,” she added. “These medications can increase blood pressure and cause sedation. They’re also risky for patients with glaucoma and prostate disease.” 

The Food and Drug Administration is responsible for regulating nonprescription medicine. It offers the following tips about taking these common drugs safely.

  • Keep an up-to-date record of all the prescription medicines, vitamins and other supplements you take and share it with your doctor.
  • Before you start taking something new, talk to your doctor or pharmacist.
  • Read the label completely each time before you take your medicine. Double-check that you know what it is, what it treats and how to use it.
  • Choose a medicine that only treats the condition you want treated. Extra medicine could cause harmful side effects.
  • Check for the active ingredient in all medicines and don’t take medicines with the same active ingredients.
  • Take only the dose directed on the label.
  • Follow label instructions on dosage and duration. Don’t take medicines for longer than what is recommended on the label.

Bean said consumers should discuss their symptoms with their pharmacist to seek out the best product. “Formulations of over-the-counter products frequently change and your pharmacist will be able to point you in the right direction,” she said.

Also, if a problem persists, go see your doctor.





Published: 1/27/2016