Saroja, a 66 year old woman with widespread rash is admitted into the hospital. The rash initially began on the back of her hands and spread very rapidly to the arms, abdomen, neck, and face. The lesions consist of circular rings with blistering in some areas. Lesions have begun to appear on her lips and also inside her mouth. She gives the history that she took an over the counter drug for cold, the rashes appeared after that. The physician said that it could be the side effects of Over-the-counter drug she took.
“Over-the-counter” medicines are called OTC medicines. OTC medicines are sold without a doctor’s prescription and may be used to relieve pain, reduce fever or to ease symptoms of cold or flu.
Adverse effects
At times, OTC medicines can cause adverse reactions. Adverse reactions are subdivided into side effects, drug-drug interactions and drug-food interactions. You need to be aware of the adverse effects the OTC drugs may cause so that you can avoid them when you use OTC medicines.
Side effects are the reactions the drugs cause in addition to the therapeutic effects the medicines are supposed to produce. At times they may be bad. For example, antibiotic amoxicillin can cause diarrhea, dizziness, and heartburn. Sometimes these side effects may be useful. For example, when you take antihistamine for cold, you may feel drowsy. This may help you to get a good sleep, if the cold is not allowing you to sleep.
Drug-drug interaction is the alteration of the effect of one drug when administered along with another drug. The outcome can be duplication of the dose, reduction in the effectiveness of one or both drugs, or modification in the action of either of the medicines.
For example, OTC cough medication taken along with prescription antihistamines may result in double dose as both may contain the same ingredient. OTC decongestants may oppose the action of certain antihypertensive medications, as decongestants tend to reduce blood pressure. Aspirin when taken along with certain blood thinning medications may modify the effect of both the drugs.
Some food items when taken along with medications may modify the way in which the medication works. For example, dairy products taken with the antibiotic tetracycline may interfere with the infection fighting ability of tetracycline.
People can be allergic to medicines including OTC medicines. Allergic reactions may include skin rash, itching, irritation or breathing problems. If you had an allergic reaction to a drug, ensure to avoid drugs containing same active ingredient. If you think you are having an allergic reaction, call for medical help right away.
Signs of adverse drug reactions
It is very essential to be aware of any changes that may take place when you take any medicine. Sometimes it may not be easy to distinguish the symptoms of your illness from the adverse effects of the medicine. If you observe any new symptoms appearing since you have taken the medicines, you should bring it to the notice of your doctor immediately. Some of the adverse reactions you may notice are rash, getting bruised easily, bleeding, uneasy feeling in the stomach, vomiting, digestion problems including diarrhea and constipation, state of confusion, and breathing problems.
OTC drugs and supplements
Nutritional supplements consist of vitamins, minerals, medicinal herbs or amino acids and are meant to compliment the food we take. Once again these nutrients too must be absorbed from the intestines and processed. Supplements are regulated by FDA as foods and not as Drugs. These nutrients compete with drugs for absorption and may hinder proper metabolism and therefore with the effect of drugs. Hence, drugs need not be taken together with these nutritional supplements and avoided. For example, vitamin E taken along with blood-thinning medication may increase the risk of bleeding.
Consumption of alcohol with certain medicines may cause adverse reactions and should be avoided. For example, taking antibiotic metronidazole with alcohol can cause redness in the face, headache, irregular heart beatings, uneasiness in the stomach and vomiting.
Avoiding adverse effects
Most of the adverse effects arise out of the misconceptions that OTC drugs are safe because they can be purchased without doctor’s prescription, and secondly that vitamins and herbal supplements are safe because they are natural. Some of the tips to avoid adverse effects include:
- Avoid consuming alcohol and medicines for example antibiotic metronidazole
- Avoid taking more than the prescribed dose, frequency, and duration
- Avoid mixing your medicine with other foods unless your doctor advises you to do so
- Avoid taking prescription and OTC medicines together unless your doctor advises you so
- Avoid mixing medicines with hot drinks, as it decreases the effectiveness of the drug
- Avoid taking pills of vitamins and herbal supplements at the same time as the effect of either may get modified
- Ensure that you know the active ingredients the product and understand any warnings or possible adverse effects.
- Inform your doctor about all the medicines including vitamins, minerals, herbal medicines and OTC drugs you are taking and discuss the possible adverse effects.
- Ensure to have updated consumer information regarding all the products you take and make sure to go through them carefully and follow the instructions.
- Read the label carefully and give more attention to the warnings section
Knowing your medicines
You need to be proactive to know the details of the medicines you are taking over the counter. Whenever you take medicines, you should keep in mind to know certain details of the medicine you take.
You should know the active ingredient of the medicine, the brand name or generic name to know the active contents of the medicine. You should know as to why you are asked to take this medicine. If you are buying the medicine from a pharmacist, make it a point to ask the pharmacist why the medicine needs to be taken. If you are buying an OTC medicine, carefully read the label and the indications before you buy.
Ensure to know the quantity of the medicine you have to take and the frequency at which you need to take the medicine. You should also keep in mind as to the period you need to take the medicine. Some medicines need to be taken for short periods and some for longer periods. You must know the possible side effects of the medicine so that you are aware of them and if when they occur you may need to seek medical help. Certain special instructions such as whether the medicine needs to be taken with or without food or before or after food or at bedtime need to be known and followed.
Activities to avoid
The best way to know which activities you can undertake and which ones to avoid is by talking to your doctor. Some drugs may cause upset stomachs if taken with some foods and some foods also may cause upset stomachs. Hence it is advised to consult your doctor which activities to be avoided. Some medicines may make you more sensitive to the sun and hence you need to avoid any outdoor activities during day time. Some medicines may make you drowsy and sleepy. Be well informed about the activities that are permissible or to be avoided, before you take any over the counter medication.
Conclusion
OTC medicines have number of adverse reactions due to interaction with other medicines, diets and food supplements that are taken together. You should read the consumer information or package insert carefully before you take OTC medicine. Follow simple tips like reading the label carefully, avoiding mixing two medicines or food items, to reduce the adverse affects of OTC medicines. Multiple medicines should not be given to children, elderly people or pregnant or lactating females unless the doctor advises so.
