Be Smart About Over-the-Counter Medicines

You really can have too much of a good thing. Over-the-counter (OTC) medicines — in other words, medications sold without a prescription — are a case in point. Some people don’t take these medicines as seriously as prescription ones. As a result, they might feel free to use more than the recommended dose. “If the box says to take one pill, some people think two must be better. Or if it says to take the medicine every four to six hours, they may feel every two to three hours is fine,” says Linda Garrelts MacLean, R.Ph., a spokesperson for the American Pharmacists Association.

Yet OTC products are strong medicine. In fact, many of today’s most popular OTCs were sold by prescription not long ago. And when you overuse OTC medications, you risk doing more harm than good. That’s why it’s so important to use them with care. Here’s what you should know.

Too Much Painkilling

It’s easy to slip into the habit of taking OTC medicines often. They’re easy to buy, and they offer much relief. Consider pain relievers, including aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and naproxen (Aleve). A recent study looked at how people use these medications. Of 546 people seeking care in an emergency room, about 6 percent said they had taken more than the recommended daily dose of an OTC pain reliever within the past three days. Many were also getting a double dose or more of painkiller by taking not only the OTC pain reliever but also a multisymptom product (such as a coldand- flu preparation) that contained the same active ingredient.

The problem:

“OTC medications like pain relievers are considered safe and effective at the recommended dose. But when you go over that dose, they’re not always as safe as you might think,” says the study’s author, Kennon Heard, M.D., assistant professor of surgery at the University of Colorado School of Medicine. Used in excess, pain relievers can cause serious side effects. For example, taking too much ibuprofen or naproxen increases the risk for ulcers. Combining these drugs with aspirin just adds to the risk for bleeding inside the digestive tract. In addition, heavy use of acetaminophen can lead to liver damage. The risk is especially high with products containing a mix of painkilling ingredients, such as acetaminophen plus aspirin.

Overdoing Other OTCs

Overuse of many other OTC medicines can also lead to side effects or mask more serious health problems:

Laxatives.

Some people overuse laxatives due to a mistaken belief that it’s vital to have a bowel movement every day. Others abuse these medicines in an effort to lose weight. Over time, they can become dependent on laxatives, with ever-larger doses needed to stimulate a bowel movement. Eventually, the intestine may stop working properly on its own. Laxatives are meant to be used for only a short while. If you have constipation often, talk with your doctor. It could be a side effect of another medication or a symptom of a condition such as irritable bowel syndrome, a hormonal disorder or nerve damage.

Nasal decongestant sprays.

They can help relieve a stuffy nose caused by a cold, the flu, allergies or sinusitis. However, they shouldn’t be used for more than three or four days in a row. When used for longer, a rebound effect may occur, making the congestion worse than before. If your nose is still stuffy after a few days, stop using the spray and talk with your doctor. You may need treatment for an underlying condition.

Heartburn remedies.

OTC antacids and acid reducers can help relieve the discomfort of occasional heartburn. But people with severe or frequent symptoms may have a more serious problem that could get worse if not properly treated. Talk with your doctor if you’re using an OTC medication for heartburn more than twice a week. Also stop the treatment and call your doctor if you have stomach pain that stays the same or gets worse after you take the medicine.

Sleep aids.

OTC sleep aids are meant to help with only an occasional sleepless night. Side effects may include daytime drowsiness, reduced alertness, headaches and dizziness. “For older people in particular, they can increase the risk for falls,” says MacLean. If you often have trouble getting the rest you need, talk with your doctor. He or she may suggest other ways to improve your sleep, such as cutting out caffeine, following a regular sleep schedule and exercising regularly.

A Dose of Caution

Be sure to give OTC medicines the respect they deserve. Always read product labels completely and follow the instructions exactly. When in doubt about whether a product is right for you or safe to take with your other medicines, talk with your doctor or pharmacist. “And if you’re not getting adequate relief at the recommended dose, it’s time to see your doctor,” says Dr. Heard. Protect your health — don’t go overboard with OTC medicines.

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