Just because you can purchase a medication over-the-counter (OTC), does not mean that it is safer than a prescription drug, and it definitely does not mean it is harmless. We have discussed the safety issues surrounding OTC drugs previously in the Inside Tract® newsletter, issues 136 and 153, and it is very important that everyone be aware of the risks and benefits of these medicines.

When you take an OTC product in the manner stated on the label for the ailment indicated, you can expect a good result; however, if you misuse the medication, even inadvertently, then you could be setting yourself up for potentially harmful side effects.

Acetaminophen (Tylenol®), an effective pain reliever, is a common active ingredient in many compound OTC medicines. This can lead to inadvertent overdose. For instance, imagine if you habitually take a prescription medication for chronic tension headaches, you are also recovering from a minor knee injury, and then you develop a cold. You would likely take your regular prescription medication, shortly followed by an OTC medication for joint pain relief, and then you might take an OTC cold medicine. You might not realize that it is likely all of them contain the same pain relief ingredient, typically acetaminophen, and you have now consumed three times the recommended dose.

Acetaminophen is safe if you use it as directed, but can cause acute liver failure, among other symptoms, if you exceed the standard dose. It is very important that you follow the dosing instructions on the packaging of OTC medications, as these drugs go through stringent testing to find the best doses for safety and efficacy. Another common way that people end up accidently taking too much is by increasing the dosage, hoping that it will make the medicine work more quickly or better. Paradoxically, increasing dosage beyond the recommendation on the package is more likely to make you feel worse, through an increase in side effects, than it is likely for the medicine to work more efficiently or take effect more quickly.

To help make sure you are taking your medications safely, the makers of Tylenol® have designed a website called getreliefresponsibly.ca with Medicine Checker, a helpful tool where you can enter all the names of the medicines you are taking, with an option to print the list, whether OTC or prescribed, irrespective of the brand. It alerts you if any of the medicines you are currently taking contain acetaminophen, so you can safely decide which medications to prioritize, in cases where the same ingredient is in multiple products.

Other common pain relievers that might also be compounded in OTC products include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil®, Motrin®), aspirin, and naproxen (Aleve®, Naprosyn®). When taking any of these NSAID products, be careful to only take one at a time, and at the standard dose.

Knowledge is the Best Medicine (KiBM) helps patients take control of their health by working with their physician, pharmacist, and the rest of their health care team to ensure the safe and effective use of medicines. At the KiBM website, knowledgeisthebestmedicine.org, you can create your own medication records through a free downloadable app called MyMedRec or through a program that constructs a printable medications record. This can be helpful in managing many types of medications or for those helping to manage the medication of others. As members of the Best Medicines Coalition, the GI Society and CSIR support this initiative and agree that an educated patient is a healthier patient.

Every medication has risks and benefits, so it is important to monitor your intake carefully to ensure that you are safely getting the most out of them.

First published in the Inside Tract® newsletter issue 192 – 2014