Families spend over $143 billion (about $440 per household in the US) annually on over-the-counter (OTC) medications that you can purchase at stores. OTC products treat or manage a wide variety of conditions related to colds, allergies, itching, constipation, fever, aches, and pains. Generally, people consider OTC medications to be safe and effective when taken as directed, but they can have serious side effects or even lead to death.
OTC medications can be harmful in certain patient populations when combined with prescription medication, taken in excessive amounts, and/or used along with alcohol. Taking more than the recommended dose can lead to overdose and other harmful side effects. Alcohol can multiply the negative side effects and possible overdose of OTC decongestants, cough/cold remedies, Acetaminophen, laxatives, anti-nausea/motion sickness, and antihistamines.
Non-steroidal anti-inflammatory drugs (NSAIDs) are used to reduce inflammation and relieve pain. NSAIDs (e.g., Ibuprofen, Motrin, Aleve, Advil) can increase the risk of gastrointestinal bleeding. Antidepressants and Warfarin (e.g., Coumadin) when taken with an NSAID can also increase your bleeding risk. Your bleeding risk is significantly increased in those who are older than 65, have a stomach ulcer history, taking blood thinners, or corticosteroids. Taking NSAIDs can raise your blood pressure and increase your risk for heart attack or stroke.
Acetaminophen (e.g., Tylenol) may also be in your OTC cold medications. As you reach for the bottle of Tylenol for a headache along with OTC cold medication, you could receive more than the recommended dose, which is less than 4,000 mg per day. This excessive dose could increase the risk of liver damage. Mixing alcohol with Acetaminophen also increases the risk of liver damage.
Some people take antihistamines regularly for allergy symptoms. Did you know that Diphenhydramine (e.g., Benadryl) is also in many OTC sleep and cold medications? An overdose of antihistamines can increase your risk of significant drowsiness, low blood pressure, rapid heart rate, nausea/vomiting, confusion, falls, seizures, and hallucinations.
Laxatives that are used for constipation can cause severe dehydration leading to kidney damage. Laxatives can also cause electrolyte imbalances due to a loss of sodium and potassium. These imbalances can lead to heart rhythm changes, weakness, confusion, and seizures.
Dextromethorphan may be listed as D or DM in OTC cough and cold medicines such as Mucinex DM, Nyquil/Dayquil, Theraflu, Tylenol Cold, and more. High doses and intentional misuse can increase blood pressure and cause shallow breathing, heart palpitations, extreme drowsiness, dizziness, paranoia, hallucinations, and seizures.
Some OTC medications can also be harmful to pregnant women and their babies. A few of the most common OTC medications that pregnant women should avoid include Aspirin, Bismuth subsalicylate (e.g., Pepto), Ibuprofen, Naproxen (e.g., Aleve), Phenylephrine (e.g., Neo-Synephrine), Pseudoephedrine (e.g., Sudafed) and Chlorpheniramine (e.g., Chlor-Trimeton). If you are pregnant or trying to conceive, you should consult your health care provider before using OTC medications.
Education about the potential risks of OTC medication is key to your safety. Consultation with your Woodlawn Health provider is crucial to navigating and reducing your risks. Your Woodlawn Health provider can offer specific advice for your individual medical needs and help avoid possible harmful interactions and side effects to guide your treatment regimen.
