Four out of five American adults commonly take over-the-counter medications, most often to treat ailments like aches and pain, coughs and colds, fever, allergies, skin disorders, and heartburn and other digestive problems. O.T.C.s are convenient, readily available in groceries and big box stores as well as pharmacies, and they are less expensive than going to th
e doctor and possibly paying for an expensive prescription.
According to the FDA, there are more than 300,000 over-the-counter drug products on the market, a number that continues to grow as an increasing number of medications move from prescription to O.T.C. status. According to the Consumer Healthcare Products Association, more than 100 ingredients, indications or dosage strengths have transitioned from prescription to O.T.C. status.
Last year, Americans spent about $44 billion on O.T.C. drugs which, the industry claims, saved the health care system about $102 billion in doctor visits, diagnostic tests and prescription medications.
That’s all to the good if O.T.C. drugs are used appropriately, for an indicated condition in the proper dosage and for no longer than the recommended time. However, one in 5 adults who self-medicate admit to taking more than the recommended dose or using the medication more frequently than the label indicates.
Even if O.T.C.s are used correctly, there can be problems. Some drugs should not be taken with certain health conditions, or be combined with other drugs – prescribed or over the counter – because of the possibility of adverse interactions.
Acetaminophen, for example, the active ingredient in Tylenol and its many competitors, is the most widely used O.T.C., commonly taken to relieve pain or fever. But acetaminophen is also a frequent ingredient in other often-used O.T.C. products, including many cough, cold and allergy remedies, and prescribed pain relievers like Percocet and Vicodin. In excessive amounts, acetaminophen can cause severe liver damage.
A study of 500 people published in 2012 in The Journal of General Internal Medicine revealed that 24% would unwittingly exceed the safe limit of 4,000 milligrams of acetaminophen over a 24-hour period when taking a single product containing the drug. About 46% would overdose when taking two products at the same time that contain this pain reliever.
About 40% of O.T.C. drugs are used by people older than 65, who are most likely to have health issues that may contraindicate the use of certain over-the-counter medications. Because of chronic health problems, age-related changes in how well the body processes drugs, and the sheer number of prescription medications many older people tend to take, they face the greatest risk of adverse side effects and drug interactions
When Nsaids, or non steroidal anti-inflammatory drugs, like aspirin, ibuprofen and naproxen are taken too long, they can likewise pose dangers, including bleeding ulcers, kidney or liver damage and an increased risk of a heart attack or stroke.
People who have underlying health problems or who routinely take one or more prescription drugs should consult their doctors before taking an O.T.C. drug. At the very least, check with the pharmacist. If you fill all your prescriptions at the same pharmacy, potential adverse drug interactions are easier to pick up. Failing that, carry with you a list of all the prescription and O.T.C. medications you take to show the pharmacist.
November 30, 2015
My college track teammates and I took much more Aleve than the recommended dosage and for much longer periods of time to treat injures. It was part of the culture on my team and I believe is common with many athletes. My headache condition started when I was taking Aleve and always wondered if that had something to do with the development of my headache condition as I have seen it listed as a risk factor for the development of chronic daily headache and new daily persistent headache.