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What Are the Health Risks Associated with Popular Over-The-Counter Medications?

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We’ve all played doctor at some point, battling common colds, pains, and itches with over the counter (OTC) medication. While OTC drugs can be an easy and convenient option to treat unexpected mild ailments, they can pose severe health risks – when we use them indiscriminately, in inappropriate doses or intervals, or on vulnerable/high-risk individuals like children or the elderly. To minimize the risk, read the labels carefully, follow instructions that come with the package, and ensure the right dosage. You can also opt for safer natural alternatives where possible.

Minor ailments that get in the way of our daily lives usually mean a trip to the supermarket’s pharmacy aisle. Over-the-counter (OTC) medication can be bought without a prescription from any drugstore and often provide quick relief from aches, pains, itches, and allergies. When used in moderation, OTC medicines can prove to be a godsend, especially when you don’t have easy access to a healthcare specialist. In the United States, the Food and Drug Administration (FDA) decides which medicines are safe enough to be OTC drugs. But even then there is a risk we run – when we use OTC drugs indiscriminately, in inappropriate doses or intervals, or on vulnerable/high-risk individuals like children or the elderly.

Adult Woes

So what exactly are the risks you run with the abuse of OTCs?

OTC Misuse

One major risk would be abuse itself. Cold and cough remedies that contain dextromethorphan are often abused severely because they can cause a side effect similar to euphoria. According to a 2006 National Survey on Drug Use and Health report, over 3 million young people had used OTC cold/cough drugs to get high.1 It’s not just accessibility or lower costs that make OTC medication enticing options. Because these medicines are considered “legal,” substance abusers often assume they are not as harmful as street drugs. But, in reality, excessive doses can cause dizziness, vomiting, accelerated heart rate, lethargy, seizures, brain damage, and even death.

Dosage Damage

Using OTC meds for longer than indicated can be detrimental. For example, treating a persistent cough with an OTC syrup for more than ten days could work to mask a potentially serious respiratory infection. If overused, they can also cause serious side effects. Non-steroidal anti-inflammatory drugs (NSAIDs) used commonly in cough, cold, and pain medications can cause side effects like diarrhea, dizziness, headaches, and stomach pain.2 On the other side, using antimicrobial and antifungal creams for a shorter period than directed can be equally bad. We often dab on an antifungal cream for an itch or rash, only to stop as soon as we feel the irritation subside. But if you have an infection you’re not aware of, not following through on the recommended dosage could cause the infection to come back with a vengeance.3

Long-Term Risks

Some OTC drugs are dangerous even when taken judiciously over a long period of time depending on factors such as age, food habits, alcohol interactions, and consumption of other medicines. Aging adults face a far greater risk with OTC medicines. According to a University of Indiana study, older people who took OTC medication for cold or pain showed higher chances of cognitive impairment, including the risk of delirium and even Alzheimer’s. This was attributed to the chemical diphenhydramine which is commonly found in OTC drugs. This tends to block the neurotransmitter acetylcholine that helps the central and peripheral nervous systems function smoothly.4

Conflict With Other Medication And Conditions

OTCs can often clash with other medicines, affecting the efficacy or potency of a prescribed dose of medication. Some decongestants tend to interfere with blood pressure medication. Many OTC drugs are also high in sodium, compromising the sodium levels in your body and raising blood pressure. The American Heart Association, in fact, recommends that people on blood pressure medication consult their physicians before taking any OTC drug.5 OTC cold or allergy drugs can intensify the effect of the blood thinners taken by people on anti-coagulation medicines. Some pain relievers may also cause blood to thicken.6 People with thyroid, kidney, liver, immune system, or cardiovascular problems are at higher risk of an adverse reaction to an OTC medicine.

Check with the pharmacist to make sure an OTC drug doesn’t clash with your existing medication. Or better still, consult your physician and find out what OTC medicines you should avoid.

Health Risk In Children

Every parent knows the panic of a midnight puke or fever and the scurrying around for medical help. OTC drugs naturally become a viable option at these times. According to a Consumer Healthcare Products Association survey, 7 out of 10 parents have resorted to OTC medicines to treat their sick child for a late-night, unexpected illness.7 Some parents even conceded to using adult doses of acetaminophen when a pediatric dose wasn’t available. They may seem like an easy option, but steer clear of giving unprescribed OTC drugs to children as much as possible. Children under the age of 2 especially should not be given any non-prescription medication. Aspirin should not be given to anyone below 19 years as it can cause a fatal condition called Reye’s Syndrome.8 Children could also be allergic to a drug or its components, and these reactions can be very severe.

Safe Practices

While it may not be possible to completely avoid OTC medication, caution and a bit of restrain are advised every time you gear up to pop an OTC pill. According to the FDA OTC guidelines, reading the “Drug Facts” label carefully, keeping tabs on the active ingredients, and following dosage and other instructions meticulously can avert many potential health problems.9

Cabinet Versus Kitchen

Before you head to the medicine cabinet for an OTC drug, try a safer natural alternative from your kitchen.

  • Chicken soup is grandma’s sureshot cold remedy for a reason – it is proven to have mild anti-inflammatory properties and can give relief in upper respiratory illnesses.10
  • Turmeric is a time-tested antiseptic and can be used on scrapes, cuts, and bruises.11
  • Honey has antibacterial qualities and can work on skin conditions such as acne.12
  • Ginger, fenugreek, and fennel can help cure indigestion.1314

References   [ + ]

1.Ford, Jason A. “Misuse of over-the-counter cough or cold medications among adolescents: prevalence and correlates in a national sample.” Journal of Adolescent Health 44, no. 5 (2009): 505-507.
2.Medications – non-steroidal anti-inflammatory drugs, Victoria State Government.
3.Kyle, Amber A., and Mark V. Dahl. “Topical therapy for fungal infections.” American journal of clinical dermatology 5, no. 6 (2004): 443-451.
4.Boustani, Malaz, Noll Campbell, Stephanie Munger, Ian Maidment, and Chris Fox. “Impact of anticholinergics on the aging brain: a review and practical application.” (2008): 311-320.
5.Over-the-Counter Medications, American Heart Association.
6.Medication Interactions: Food, Supplements and Other Drugs, American Heart Association.
7.Statistics on OTC Use, Consumer Healthcare Products Association.
8.Over-The-Counter Medicines for Infants and Children, University of Rochester Medical Center.
9.FDA issues final guidance for liquid OTC drug products with dispensing devices, U.S. Food and Drug Administration.
10.Rennard, Barbara O., Ronald F. Ertl, Gail L. Gossman, Richard A. Robbins, and Stephen I. Rennard. “Chicken soup inhibits neutrophil chemotaxis in vitro.” Chest Journal 118, no. 4 (2000): 1150-1157.
11.Prasad, Sahdeo, and Bharat B. Aggarwal. “Turmeric, the golden spice.” (2011).
12.Chowdhury, M. M. “Honey: is it worth rubbing it in?.” Journal of the Royal Society of Medicine 92, no. 12 (1999): 663.
13.Sengupta, Archana, Samit Ghosh, Shamee Bhattacharjee, and Sukta Das. “Indian food ingredients and cancer prevention-an experimental evaluation of anticarcinogenic effects of garlic in rat colon.” Asian Pacific journal of cancer prevention 5, no. 2 (2004): 126-132.
14.Ulbricht, Catherine, Ethan Basch, Dilys Burke, Lisa Cheung, Edzard Ernst, Nicole Giese, Ivo Foppa et al. “Fenugreek (Trigonella foenum-graecum L. Leguminosae): an evidence-based systematic review by the natural standard research collaboration.” Journal of herbal pharmacotherapy 7, no. 3-4 (2008): 143-177.
CureJoy Editorial

The CureJoy Editorial team digs up credible information from multiple sources, both academic and experiential, to stitch a holistic health perspective on topics that pique our readers' interest.

CureJoy Editorial

The CureJoy Editorial team digs up credible information from multiple sources, both academic and experiential, to stitch a holistic health perspective on topics that pique our readers' interest.