A nonprescription medicine-sometimes called an over-the-counter, or
OTC, medicine-is any drug that you can buy without a doctor's prescription. But
don't assume that all nonprescription drugs are safe for you. These drugs can
interact with other medicines and can sometimes cause serious health
problems.
Some medicines should only be used by adults or older
children. Be sure to read the package instructions carefully, or ask a
pharmacist before giving any product to an infant or
young child. If you are pregnant, always check with your pharmacist or doctor
before using any nonprescription medicine, to make sure it is safe to use
during pregnancy.
Carefully read the label of any nonprescription
drug you use, especially if you also take prescription medicines for other
health problems. Ask your pharmacist for help in finding a nonprescription drug
best suited to your needs. See the
medication guidelines for tips on how to avoid common
medicine problems.
Some common nonprescription medicines
include:
Antacids and acid reducers.
Bulking
agents, laxatives, and stool
softeners.
Antidiarrheals.
Cold and allergy
remedies.
Pain relievers.
These drugs can be very helpful when used properly but can
cause serious problems if used incorrectly. The following tips will help you
use common nonprescription drugs wisely and safely. In some cases, you may find
that you don't need to take them at all.
Antacids and Acid Reducers
Antacids are taken to
relieve
heartburn or
indigestion caused by excess stomach acid. While they
are safe if used occasionally, antacids may cause problems if taken regularly.
There are several kinds of antacids. Learn what ingredients are in each type so
that you can avoid any adverse effects.
Sodium bicarbonate antacids (such as
Alka-Seltzer and Bromo Seltzer) contain baking soda. Avoid these antacids if
you have high blood pressure or are on a salt-restricted diet. Alka-Seltzer
contains aspirin, which is linked to
Reye's syndrome, a rare but serious illness in
children.
Calcium carbonate antacids (such as Tums and Alka-Mints) are
sometimes used as calcium supplements. These products may cause
constipation.
Aluminum-based antacids (such as Amphojel) are less
potent and work more slowly than other products do. They may also cause
constipation. Some may cause calcium loss and should not be taken by
postmenopausal women. If you have kidney problems, check with your doctor
before using aluminum-based antacids.
Magnesium compounds (such as
Phillips' Milk of Magnesia) may cause diarrhea.
Aluminum-magnesium
antacids (such as Maalox, Di-Gel, Mylanta, and Riopan) are less likely to cause
constipation or diarrhea than are aluminum-only or magnesium-only
antacids.
Acid reducers decrease the amount of acid produced by the
stomach. There are several types of nonprescription acid reducers on the
market. Each has slightly different cautions for use. Read and carefully follow
the instructions included with the package.
Antacid and acid reducer precautions
Try to eliminate the cause of frequent heartburn instead of
taking antacids regularly. For more information, see the topic
Heartburn.
Consult your doctor or
pharmacist before taking an antacid if you take other
medicines. Antacids may interfere with the absorption and action of some
prescription medicines. Also consult your doctor if you have ulcers or kidney
problems.
If you have a problem with the function of your kidneys
or liver, you should be careful in using acid reducers. All drugs are broken
down and removed from the body by the combined action of the liver and kidneys.
If your liver or kidneys are not working correctly, it is possible that too
much of the acid-reducing drug will build up in your body.
Bulking Agents, Stool Softeners, and Laxatives
There
are three types of products used to prevent or treat constipation: bulking
agents, stool softeners, and laxatives.
Bulking agents, such as bran or psyllium (found in Metamucil, for example) ease
constipation by increasing the volume of stool and making it easier to pass.
Regular use of bulking agents is safe and helps make them more
effective.
Stool softeners (such as Colace
and Docusate Calcium) soften the stool, making it easier to pass. Stool
softeners can be most effective if you drink plenty of water throughout the
day.
Laxatives (such as Correctol, Ex-Lax,
Senokot, and Dulcolax) speed up the passage of stool by irritating the lining
of the intestines. Regular laxative use is not recommended.
There
are many other ways to treat constipation, such as drinking more water. For
more information, see the topic
Constipation, Age 12 and Older.
Precautions
Take any laxative or bulking agent with plenty
of water or other liquids.
Do not take laxatives regularly. Overuse
of laxatives decreases tone and sensation in the large intestine, causing
laxative dependence. If you need help keeping your bowels regular, use a
bulking agent.
Regular use of some laxatives (such as Correctol,
Ex-Lax, and Feen-a-Mint) may interfere with your body's ability to absorb
vitamin D and
calcium. This can lead to weakened bones.
Antidiarrheals
There are two types of antidiarrheal
drugs, those that thicken the stool and those that slow intestinal
spasms.
The thickening mixtures (such as
psyllium) contain clay or fruit pectin and absorb the bacteria and toxins in
the intestine. They are safe because they do not go into the blood, but these
products also absorb the bacteria needed for digestion. Long-term use is not
advised.
Antispasmodic antidiarrheal
products slow the spasms of the intestine. Loperamide (the active ingredient in
products such as Imodium A-D and Pepto Diarrhea Control) is an example of this
type of preparation. Some products contain both thickening and antispasmodic
ingredients.
Antidiarrheal precautions
Diarrhea helps rid your body of an infection,
so try to avoid using antidiarrheal medicines for the first 24 hours. After
that, use them only if cramping and pain continue and there are no other signs
of illness, such as fever or blood in the stool.
Be sure to take a
large enough dose. Take antidiarrheal preparations until your stools thicken,
then stop immediately to avoid constipation.
Replace lost body
fluids. Dehydration can develop when someone, especially an infant, child, or
older adult, has diarrhea. To help avoid dehydration, you can make a
rehydration drink at home.
If your child
or teen gets
chickenpox or
flu, do not treat the symptoms with over-the-counter
medicines that contain bismuth subsalicylate (such as Pepto-Bismol and
Kaopectate). If your child has taken this kind of medicine and he or she has
changes in behavior with nausea and vomiting, call your doctor. These symptoms
could be an early sign of
Reye's syndrome, a rare but serious illness. Ask your
doctor if your child younger than 12 should take these medicines.
Cold and Allergy Remedies
In general, whether you
take medicines for your cold or not, you'll get better in about a week. Rest
and liquids are the best treatment for a cold. Antibiotics will not help. But
nonprescription medicines help relieve some cold
symptoms, such as nasal congestion and cough.
Allergy symptoms,
especially runny nose, often respond to antihistamines. Antihistamines are also
found in many cold medicines, often together with a decongestant. But the value
of antihistamines in treating cold symptoms is under debate.
Decongestants
Decongestants make breathing easier
by shrinking swollen
mucous membranes in the nose, allowing air to pass
through. They also help relieve runny nose and postnasal drip, which can cause
a sore throat.
Decongestants can be taken orally or used as nose
drops or sprays. Oral decongestants (pills) are probably more effective and
provide longer relief, but they cause more side effects. Pseudoephedrine (the
active ingredient in products such as Sudafed) is an oral decongestant. In some
states, medicines containing pseudoephedrine (such as Sudafed) are kept behind
the pharmacist's counter or require a prescription. You may need to ask the
pharmacist for it or have a prescription from your
doctor to buy the medicine.
Sprays and drops provide rapid but
temporary relief. Nasal sprays containing phenylephrine (such as
Neo-Synephrine) are effective. Sprays and drops are less likely to interact
with other drugs than oral decongestants are.
Saline nose drops are not decongestants but may help
keep nasal tissues moist so the tissues can filter air.
Decongestant precautions
Don't give cold medicines or oral decongestants
to a child younger than 2 unless you've checked with the doctor first. If your
child's doctor tells you to give a medicine, be sure to follow what he or she
tells you to do. Nonprescription cold medicines have not been proved effective
for preschool children.
Don't use medicated nasal sprays or drops more than 3 times a day
or for more than 3 days in a row. Continued use will cause a "rebound effect,"
in which your mucous membranes swell up more than before you used the
spray.
Drink extra fluids when taking cold
medicines.
Decongestants can cause problems for people who have
certain health problems, such as heart disease, high blood pressure,
glaucoma, diabetes, or an overactive
thyroid. Decongestants may also interact with some
drugs, such as certain antidepressants and high blood pressure medicines. Read
the package carefully or ask your pharmacist or doctor to help you choose the
best decongestant for you.
If you are pregnant, check with your
doctor or pharmacist before using a decongestant.
Cough preparations
Coughing is your body's way of getting foreign substances and
mucus out of your respiratory tract. Coughs are often
useful, and you shouldn't try to stop them. Sometimes, though, coughs are
severe enough to impair breathing or prevent rest.
Water and other
liquids, such as fruit juices, are probably the best cough syrups. They help
soothe the throat and also moisten and thin mucus so it can be coughed up more
easily.
You can make a simple and soothing cough syrup at home by
mixing 1 part lemon juice with 2 parts honey. Use as often as needed. This can
be given to children older than 1 year of age.
There are two kinds
of cough medicines: expectorants and suppressants.
Expectorants help thin the mucus and make it easier to cough
mucus up when you have a productive cough. Look for expectorants containing
guaifenesin, such as Robitussin, Mucinex, and Vicks 44E.
Suppressants control or suppress the cough reflex and work
best for a dry, hacking cough that keeps you awake. Look for suppressant
medicines containing dextromethorphan, such as Robitussin-DM and Vicks Dry
Hacking Cough. Don't suppress a productive cough too much (unless it is keeping
you from getting enough rest).
Cough preparation precautions
Cough preparations can cause problems for
people with certain health problems, such as asthma, heart disease, high blood
pressure, or an
enlarged prostate (BPH). Cough preparations may also
interact with sedatives, certain antidepressants, and other medicines. Read the
package carefully or ask your pharmacist or doctor to help you choose
one.
Cough suppressants can stifle breathing. Use them with caution
if you give them to someone who is very old or frail or if you have chronic
respiratory problems.
Read the label so you know what the
ingredients are. Some cough preparations contain a large percentage of alcohol,
and others contain codeine. There are many choices. Ask your pharmacist to
advise you.
Don't give cough and cold medicines to a child younger than 2
unless you've checked with the doctor first. If your child's doctor tells you
to give a medicine, be sure to follow what he or she tells you to do.
If you are pregnant, check with your doctor or pharmacist before
using a cough preparation.
Antihistamines
Antihistamines dry up nasal secretions and are
commonly used to treat allergy symptoms and itching.
If your runny
nose is caused by allergies, an antihistamine will help. For cold symptoms,
home treatment and perhaps a decongestant will probably be more helpful. It is
usually best to take only single-ingredient allergy or cold preparations,
instead of those containing many active ingredients.
Products such
as Chlor-Trimeton (chlorpheniramine) and Benadryl (diphenhydramine) are
single-ingredient antihistamine products.
Products such as
Dristan, Coricidin, and Triaminic contain both a decongestant and an
antihistamine.
Antihistamine precautions
Don't give antihistamines to your child unless
you've checked with the doctor first.
Use of antihistamines to
treat the stuffiness of a cold will often thicken the mucus, making it harder
to get rid of.
Drink extra fluids when taking
antihistamines.
Antihistamines can cause problems for some people
with health problems such as asthma, glaucoma, epilepsy, or an enlarged
prostate. Antihistamines may also interact with certain antidepressants,
sedatives, and tranquilizers. Read the package carefully or ask your pharmacist
or doctor to help you choose one that will not cause problems.
If
you are pregnant, check with your doctor or pharmacist before using an
antihistamine.
The drowsiness that antihistamines often cause
usually decreases with continued use. If drowsiness continues, or if the
medicine isn't helping your allergies after 1 week, call your doctor for
advice.
Antihistamines that don't cause drowsiness are available by
prescription. Ask your doctor if these are appropriate for you.
Pain Relievers
There are dozens of pain-relief
products. Most contain either aspirin, ibuprofen, or acetaminophen. These three
drugs, as well as naproxen sodium, relieve pain and reduce fever. Aspirin,
ibuprofen, and naproxen sodium also relieve inflammation. They belong to a
class of drugs called
nonsteroidal anti-inflammatory drugs (NSAIDs).
When you buy pain relievers, keep in mind that generic products are
chemically equivalent to more expensive brand-name products, and they usually
work equally well.
Aspirin
Aspirin is widely used for relieving
pain and reducing fever in adults. It also relieves minor itching and reduces
swelling and inflammation. Most tablets contain 325 mg of aspirin. Although it
seems familiar and safe, aspirin is a very powerful drug.
Aspirin precautions
Keep all aspirin, especially baby aspirin,
out of children's reach.
Aspirin increases the risk of
Reye's syndrome in children. Do not give aspirin to anyone younger than 20 unless your doctor tells you to
do so.
Aspirin can irritate the stomach lining, causing bleeding or
ulcers. If aspirin upsets your stomach, try a coated brand, such as Ecotrin.
Talk with your doctor or
pharmacist to determine what will work best for
you.
Some people are allergic to aspirin. They may also be allergic
to ibuprofen.
Throw aspirin away if it starts to smell like
vinegar.
Do not take aspirin if you have gout or if you take blood
thinners (anticoagulants).
If you are pregnant, check with your
doctor or pharmacist before taking aspirin.
Do not take aspirin for
a hangover. Aspirin used with alcohol increases your risk for stomach
irritation.
High doses may result in aspirin poisoning
(salicylism). Stop taking aspirin and call a doctor if any of these symptoms
occur:
Ringing in the ears
Visual
disturbances
Nausea
Dizziness
Rapid, deep
breathing
Other aspirin uses
In
addition to relieving pain and inflammation, aspirin is effective against many
other ailments. Because of the danger of side effects and the interactions
aspirin may have with other medicines, do not try these uses of aspirin without
a doctor's supervision.
Heart attack and stroke: Aspirin in low but regular doses helps prevent heart attacks and
strokes in certain people, including people with diabetes. For more
information, see the topics
Chest Pain and
Heart Attack and Unstable Angina.
Migraines: Regular, low-dose aspirin use may reduce the
frequency of migraine headaches.
Other pain relievers
Ibuprofen (the active ingredient in products such as Advil and
Nuprin) and naproxen sodium (in products such as Aleve)
are other
nonsteroidal anti-inflammatory drugs (NSAIDs). Like
aspirin, these drugs relieve pain and reduce fever and inflammation. Also like
aspirin, they can cause nausea, stomach irritation, and heartburn. People who
take blood thinners (anticoagulants) should use these drugs with
caution.
Acetaminophen (the active ingredient in products such
as Tylenol) reduces fever and relieves pain. It does not have the
anti-inflammatory effect of NSAIDS, such as aspirin and ibuprofen, but it also
does not cause stomach upset and other side effects.
The product's
package label will tell you how many milligrams (mg) of medicine are in each
pill, how much you should take; and how often you should take it. Do not exceed
the dosage limits, and follow the instructions on the package if you have
health problems that may make it unsafe for you to take the usual dosage of a
product.
If you are pregnant, check with your doctor or pharmacist
before taking any kind of pain reliever.
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