Do you use over-the-counter drugs “as directed?” If not, you could be headed for trouble each time you reach into your medicine cabinet for relief.
Americans diagnose and treat themselves for common health problems four times more often then they turn to their physicians for help. When hay fever season rolls around, millions of us reach for an antihistamine. For the discomfort of a winter cold, droves more seek relief with a decongestant, cough syrup or painkiller. Laxatives are readily available for occasional bouts of constipation, as are first-aid sprays for minor cuts and burns, antacids for heartburn, or sleep aids for restless nights.
Even though over-the-counter (OTC) preparations are readily available without a doctor’s prescription, they should only be used according to the label instructions. OTC medications are often as powerful and can have the same potentially harmful side effects as their prescription counterparts. In fact, many once were prescription drugs that the Food and Drug Administration (FDA) has determined can be used safely without a doctor’s Rx. When medicines make the crossover to OTC status, drug companies must provide clear, detailed labels, but it’s up to consumers to use the drugs as directed.
Ignoring label instructions on an OTC drug can cause a health problem that’s even worse than the one you originally attempted to treat. For example, taking high doses of nonsteroidal antiinflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, etc.) and naproxen sodium (Aleve), for long periods of time put you at risk for stomach pain, bleeding from gastritis or ulcers, and even kidney failure. And, while acetaminophen does not cause stomach upset, research suggest that taking just one pill daily for a year doubles the risk of kidney disease. It has also been found that the risk of liver damage is higher in people who drink alcohol and don’t eat before taking acetaminophen (four grams equal eight extra-strength tablets).
While it is the FDA’s responsibility to ensure that OTC medications are safe and effective, it’s up to you to use them correctly. Here are some points to keep in mind:
• Over-the-counter drugs should be used primarily for the temporary relief of minor symptoms.
• Inappropriate use of any medication may aggravate symptoms or cover up a serious condition that needs a doctor’s attention. Don’t take OTC drugs longer than is recommended on the label. If symptoms persist or if new symptoms occur, see a doctor.
• If you are pregnant or nursing, check with your doctor before taking any medication–even “natural” ones. Drugs pass from a pregnant woman to her unborn baby and a safe concentration of medication for the mother may be too high for her baby. And although most drugs pass into breast milk in concentrations too low to have unwanted effects on the child, some drugs should be avoided altogether.
• Consumers who have allergies or chronic health problems should read ingredient, warning and caution statements carefully and check with a doctor or pharmacist if any questions remain about taking a product.
• Read the label on the drug container carefully before you start to take on over-the-counter drug product. Check it again each time you buy a new package because there could be important changes in indications, warnings or directions.
What’s in a Label?
Here is some of the information you’ll find on labels of nonprescription medications:
1) The name of the product and the type of drug it is. This information lets you know the products brand name and if it is an antacid, a pain reliever, cough suppressant, antiinflammatory, etc.
2) A list of the active ingredients. If you are taking two over-the-counter products at once, check to see that both don’t contain the same ingredient to avoid over-dosing. Also, if you are allergic to any medications, make sure the products you buy do not have that ingredient.
| Time for a Medicine Cabinet Check-up? • Be sure to look through your medicine supply at least once a year. • Always store medicines in a cool, dry place. • Discard any medicines that are past the expiration date. • To make sure no one takes the wrong medicine, keep all of them in their original containers. |
3) Warnings. These are special precautions associated with proper use of that drug, including who shouldn’t take it (i.e., people with medical conditions, such as high blood pressure), possible side effects (like drowsiness), when to discontinue using the product, and whether the drug can be used by young children. Also included are such universal precautions as: “Keep this and all drugs out of the reach of children,” and “If you are pregnant or nursing a baby, seek the advice of a health professional before using this product.”
4) Declaration of the dye Yellow No. 5. According to FDA regulations, any product that contains this dye (foods and cosmetics, as well as drugs), has to note that fact on its label. That is because people who are allergic to aspirin also have allergic reactions to Yellow Dye No. 5.
5) The symptoms or conditions for which the product should be used. Since consumers can buy these products without consulting a physician, this type of information is particularly helpful. For instance, you don’t want to buy a decongestant when what you really need is an antihistamine.
6) Instructions for use. Sometimes described under “dosage,” this tells you how much medicine to take and when and, sometimes, how to take it (“Tablet should be chewed,” or “Take with water”).
7) Drug interaction precautions. If you’re taking two medications at once (prescriptions or OTCs), the ingredients in one may interact or interfere with the ingredients in the other. Some common combinations to avoid:
• Do not use antihistamines, nasal decongestants or bronchodilators (drugs that treat asthma) if you are taking a prescription drug for high blood pressure or depression.
• Don’t use drugs that treat sleeplessness if you are taking prescription sedatives or tranquilizers, or if you have asthma, glaucoma, emphysema, chronic pulmonary disease, shortness of breath, difficulty breathing. Men who have difficulty urinating due to an enlarged prostate should also avoid sleep aids.
• Do not use antacids if you have any type of kidney problems.
• Do not use drugs with the ingredient phenylpropanolanine (PPA), used in many cough-cold and weight control medicines, if you’re being treated for high blood pressure or depression, or if you have heart disease, diabetes or thyroid disease.
8) Description of tamper-resistant features will tell you what to look for to ensure the product hasn’t been tampered with. You might be instructed: “Do not use if the Sealed For Your Protection band around cap and neck is broken or missing.”
9) Expiration date. This is the month and year beyond which a drug is no longer effective. Not all OTCs have one, but take it seriously when they do. Outdated drugs may not only be ineffective but harmful.
OTCs and Your Child
You need to be especially careful when giving OTC medications to a child. Here are some tips to ensure your child is helped and not hurt by nonprescription drugs:
• Children aren’t just small adults. Their bodies process drugs differently than an adult’s, so don’t guess about the dose based on the child’s size. Follow the instructions on the label.
| SPECIAL ALERT: Giving aspirin to a child with a viral infection, such as chicken pox or the flu, can be deadly. This combination may lead to Reye’s syndrome, a serious condition that affects the brain. Symptoms usually occur near the end of the original illness and include a skin rash, exhaustion, vomiting, violent headache and confusion. Later there may be extreme disorientation, followed by coma, seizures and death. Mortality rates vary from 20 to 80 percent depending on the severity of symptoms. When buying medications to ease your child’s symptoms, read the ingredients and warnings carefully. Some products do not have aspirin in the name, but do contain aspirin or other salicylates (the type of amino acid that aspirin is made of). Acetaminophen (sold under brand names such as Tylenol or Datril) is not associated with Reye’s syndrome and can be used to relieve pain and reduce fever. |
• When giving liquid medications, use precise measuring spoons or containers marked for the correct dosage. TBS or TBSP stands for tablespoon and TSP for teaspoon. They are very different doses.
• Before you give your child two medicines at the same time, talk to your doctor or pharmacist.
• Note the age limits on the label. If it says not to give the drug to a child under 12, don’t.
• Never let children take medicines by themselves.
• Keep all drugs out of the reach of children. Remember that even vitamin-mineral supplements can be dangerous. Iron, for instance, is the number one cause of fatal ingestion poisoning in children under three. And some common medications, such as diet pills, decongestant tablets, antidepressant drugs and high blood pressure medications, are potentially lethal to children. In some cases, as little as one pill can be fatal.
• Never describe medicine as candy to coax your kids to take it. If they come across it on their own, they might think it’s a harmless treat.
• Know the difference between tamper-resistant caps (which indicate if the package has been opened) and child-resistant caps (designed to make it difficult for children to open the package). Be sure to “re-lock” the cap after each use. If you don’t, the child-resistant device will be useless.
• Child-resistant does not mean child-proof. The legal definition is that it must take more than five minutes for 80 percent of five-year-olds to get into it. That means 20 percent can do it in less time, so don’t solely rely on them to keep your child safe.
