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What you need to know about OTC drugs: Part 1 of 2

Dr. Mackarey's Health & Exercise ForumOVER THE COUNTER DRUGS…What You Need to Know

PART 1 of 2

According to the Consumer Healthcare Products Association, approximately 3 billion trips to the pharmacy are made each year to purchase over-the-counter (OTC) drugs in the United States. The average household spends about $338. per year on these products and seven out of 10 parents have given their child an OTC in the middle of the night for various symptoms. Consumers purchase 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 printed on the label. However, 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 printed 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 the consumer may be taking. Therefore, if the consumer is taking other prescription or OTC medications, a consultation with a doctor or pharmacist before selecting an OTC remedy may be a wise decision. Furthermore, the consumer must “self-diagnose” when using OTC medications 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! Moreover, older individuals 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. Finally, some OTC drugs such as cold remedies, cough syrups, and pain killers contain substances that can produce drowsiness, impair judgment, and slow reaction times. Individuals 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 of OTC drugs are few, they can be dangerous. Heart attacks and strokes can be side effects of Advil, Aleve, and Motrin which are classified as non-steroidal 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 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 can require years or decades to develop: liver and kidney damage or osteoporosis.

The consumer has the ability to alleviate the annoying symptoms associated with many common conditions through the use of OTC medications. However, the right to purchase OTC medications does not come without responsibility. In order for these drugs to be used safely, the consumer is advised to follow these guidelines: (1) Read the label for the active ingredient, correct dose, precautions, and which conditions would make the drug a poor choice. (2) 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. (3) Select an OTC drug that treats your exact symptoms. If you only have a cough, avoid the multi-symptom remedies. (4) OTC medications are intended for short-term use. Do not exceed the recommended treatment duration. If symptoms persist, consult a physician. (5) Consult a physician before taking any OTC remedy if you have health problems or are taking prescription medications. (6) Use reliable internet resources for more information such as WebMD or Epocrates Rx on iTunes App Store.

CONTRIBUTIONS: Janet Caputo, PT, DPT, OCS

Read “Health and Exercise Forum” by Dr. Paul J. Mackarey every Monday in The Scranton Times-Tribune. Next week read, Part II of II OTC Drug Safety. Dr. Mackarey is a doctor of orthopedic and sports physical therapy with offices in downtown Scranton. Dr. Mackarey is an associate professor of clinical medicine at GCSOM.