A dose of wisdom about over-the-counter medications
Americans are taking an active role in their health care today, thanks to the growing number of over-the-counter (OTC) medicines hitting pharmacy shelves. But with so many choices, how do you know which are best? "Ask your pharmacist if you're not sure about a product, especially if you're taking prescription medicine as well," says Virtua Health family physician
Ronald Willoughby, DO. "Otherwise, the drugs that are widely used have generally proven themselves as good, safe drugs when taken properly."
But don't assume the term "over-the-counter" automatically means harmless. Many nonprescription medicines use ingredients and dosages that 30 years ago were available only by prescription. That's why it's critical to follow dosage instructions. Many prescription drugs — including those you wouldn't expect — contain the same ingredients as OTC drugs. To avoid an accidental overdose, check your medications for overlapping ingredients, or talk to your pharmacist about possible drug interactions.
Here's what you need to know about the most common types of nonprescription drugs:
Pain relievers/fever reducers
Hay fever/allergies
Asthma
Colds and coughs
Skin rashes and infections
Gastrointestinal
Heartburn
Pain relievers/fever reducers
"Acetaminophen is recommended for all ages, even newborns," says Dr. Willoughby. However, he advises following dosage instructions explicitly: "Acetaminophen overdose is common and can be fatal." Ibuprofen is another choice for muscle inflammation or high fevers, but it's not recommended for babies less than six months or people with asthma. Call your doctor if pain persists after a few days, if fever is higher than 104 degrees or lasts more than 24 hours, or if other symptoms are present.
Hay fever/allergies
There are sedating drugs, like diphenhydramine (Benadryl) and chlorpheniramine (Chlor Trimeton), that are short acting, but effective. And, there are non-sedating drugs, like loratidine and cromolyn sodium (NasalCrom) spray, that are long lasting and effective, but more costly. "It's a personal choice," says Dr. Willoughby.
Asthma
Among the most improperly used OTC drugs are non-prescription inhalers for asthma. "These can be dangerous," warns Dr. Willoughby. "If you use them regularly, ask your doctor for a prescription inhaler, which is far safer."
Colds and coughs
Dr. Willoughby frequently recommends cold formulas that treat multiple symptoms. "They're generally safe, but if you have a condition listed under the warnings, check with your doctor before taking it." Also, check ingredients against any other cold, cough or pain relief medicines you're taking because many contain the same ingredients.
Since coughs help the lungs clear out germs, look for medicines containing an expectorant — like guaifenesin, which helps clear out mucus — rather than a suppressant. Call your doctor if symptoms hang on longer than a week.
Skin rashes and infections
Consider using an anti-fungal cream for itchy rashes between fingers, toes, folds of skin, or in moist areas. Hydrocortisone creams are best for treating contact rashes, poison ivy, mild skin irritation or inflammations, but keep it away from moist areas or diaper rash. Use triple antibiotic ointment for any open, weeping sores or scabbing skin. If you have a rash that hurts, spreads or is accompanied by fever, call your doctor.
Gastrointestinal
"As a general rule, most people need more fiber in their diet," says Dr. Willoughby. For constipation, he recommends fiber supplements to enhance bowel function. For diarrhea, loperamide is effective for the short-term. If you have no relief after a few doses, or your stools are dark, mucousy, bloody or accompanied by other symptoms, call your doctor.
Heartburn
When it comes to heartburn, there are two types of non-prescription medicines. There are antacids like calcium carbonate (Maalox and Tums), which work quickly, but don't last long. Then there are acid-blockers like omeprazole (Prilosec), ranitidine (Zantac), and lansoprazole (Prevacid). These can take up to two days to take effect, but can work for up to 24 hours. "If you frequently suffer from heartburn or indigestion, you should see your doctor as these may be symptoms of more serious gastrointestinal disease or even heart disease," advises Dr. Willoughby.
Over-the-counter drugs aren't one-size-fits-all. When it comes to children, the elderly, or women who are pregnant or nursing, safety and dosage may vary. If drug labels don't provide information specific to your needs, check with your doctor.