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University Health Services Manoa
Over-the-Counter Drugs are Serious Medicine
In January, the Food and Drug Administration began a campaign to educate consumers
about safe use of over-the-counter pain relief medications. This effort is based
on research indicating that many people do not follow directions and warnings
on these and other classes of OTC drugs. Although misuse can have serious consequences,
people often do not treat these medications as seriously as they would prescription
drugs.
In 2002, the National Council on Patient Information and Education conducted
a survey of consumers and health professionals, to study attitudes and behaviors
associated with use of OTC products. When using a medication for the first time,
only 20 percent of consumers indicated that they read the label to determine
proper dosage, use or even the active ingredient. Only 10 percent read the label
for warnings and side effects. Only 34 percent of those that took pain relievers
could correctly identify the active ingredient in the medicine. About one-third
had misused their OTC product, taking it too often or taking too much.
There are many reasons why one should read and follow the instructions on OTC
labels.
• Misuse may
lead to delay or failure to identify a serious condition that should
be treated by a medical provider. An example is the use of pain
killers for undiagnosed painful conditions. The use of pain medicines
for longer than the recommended time may mask the problem, preventing
timely diagnosis.
• Some OTC
medications should not be taken by people with other medical conditions.
For example, some ingredients in decongestants should not be taken
by people with heart problems or high blood pressure because they
increase the chance of stroke or heart attack.
• If OCT medicines
are used beyond maximum doses and time period, the risk of side
effects may outweigh any benefits. More is not always better.
• Some people
use OTC products to substitute for changes in lifestyle. For example,
nicotine replacement products are to be used to withdraw from smoking,
not as long-term substitutes, and diet aids should be used only
while one is developing a healthy diet and exercise plan.
• Some OTC
products can cause addiction. If nasal decongestion sprays are
used for longer than the stated time limit, attempts to stop can
cause a “rebound” effect and excessive congestion.
If sleep aids are used over a long period of time, the person may
find it even more difficult to sleep when they stop taking the
medication.
• Overuse or
overdosing with pain medications can cause serious problems such
as stomach bleeding and kidney problems. Although some people intentionally
take more than the recommended dose of these medications, many
people do not realize that they are taking two or more medications
with the same active ingredient.
For example, acetaminophen is the ingredient in Tylenol. However, it is also
found in cough suppressants and cold medications…in fact, more than 600
OTC and prescription medications contain this drug. Taking too much can cause
liver damage and even death, especially if the patient is consuming alcohol at
the same time. Yet many people don’t read labels carefully enough to realize
they are overdosing.
Another class of pain relievers, NSAIDS (non-steroidal anti-inflammatory drugs)
includes aspirin, ibuprofen and naproxen sodium. Overuse of these products or
use of the product combined with other drugs can cause stomach bleeding, especially
in those over 60.
• OTC products
for children should be treated just as seriously as for adults.
Medications for infants are not necessarily less concentrated,
and directions for children’s use of adult medications should
be followed carefully, for all of the reasons listed above.
The safe use of OTC medications involves taking them seriously. A new “Drug
Facts” label on these products makes it easy to determine the active ingredient,
the approved uses, warnings and side effects, and directions for use. In addition
to reading the label and following directions, someone taking several OTC medications,
or OTC plus prescription or herbal products, should ask their medical provider
about possible interactions and side effects.
For more information, see the Web site for the National
Council on Patient Information and Education, the Food
and Drug Administration or Medscape.
University Health Services
Manoa serves UH Manoa students, faculty and staff. The health
service provides walk-in medical services and referrals for specialty
care to in-house or community physicians.
This
article is for educational purposes only. Do not rely on this information
for diagnosis or treatment and/or in place of personal medical
attention. If you feel you have a medical problem, you should consult
with a health care professional as soon as possible.
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