Your Home Health Centre

A nonprescription medication (sometimes called an over-the-counter or OTC medication) is any drug that you can buy without a doctor's prescription. However, don't assume that all nonprescription drugs are safe for you. These drugs can interact with other medications and can sometimes cause serious health problems.

Some medications 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.

Carefully read the label of any nonprescription drug you use, especially if you also take prescription medications for other health problems. Ask your pharmacist for help in finding a nonprescription drug best suited to your needs.

Some common nonprescription medications include:

• Antacids and acid blockers.

• Bulking agents and laxatives.

• Antidiarrheals.

• Cold and allergy remedies.

• Pain relievers.

These drugs can be very helpful when used properly but can also 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 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 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.

Calcium carbonate antacids (such as Tums, Caltrate, and Os-Cal) are sometimes used as calcium supplements (See Calcium). However, 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 Milk of Magnesia) may cause diarrhea.

Aluminum-magnesium antacids (such as Maalox, Diovol, Mylanta, and Gelusil) are less likely to cause constipation or diarrhea than are aluminum-only or magnesium-only antacids.

Acid blockers reduce the amount of acid produced by the stomach. There are several types of acid blockers (such as Pepcid AC and Zantac 75) on the market. Each has slightly different cautions for use. Read and carefully follow the instructions included with the package.

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Antacid and Acid Blocker Precautions

• Try to eliminate the cause of frequent heartburn instead of taking antacids regularly. See Heartburn on See Heartburn.

• Consult your doctor or pharmacist before taking an antacid if you take other medications. Antacids may interfere with the absorption and action of some prescription medications. 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 blockers. 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 high a dose of the acid-blocking drug will build up in your body.

There are 2 types of products to prevent or treat constipation: bulking agents and laxatives.

Bulking agents , such as bran or psyllium (found in Metamucil, for example), are not laxatives, but they 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.

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. See Constipation.

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Laxative 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 regular, use a bulking agent.

• Regular use of some laxatives (such as Correctol, Ex-Lax, Senokot, and Dulcolax) may interfere with your body's ability to absorb vitamin D and calcium; this can lead to weakened bones.

There are 2 types of antidiarrheal drugs: those that thicken the stool and those that slow intestinal spasms.

The thickening mixtures (such as Kaopectate) contain clay or fruit pectin and absorb 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) is an example of this type of preparation. Some products (such as Donnagel) contain both thickening and antispasmodic ingredients.

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Antidiarrheal Precautions

• Diarrhea helps rid your body of an infection, so try to avoid using antidiarrheal medications for the first 24 hours. After that, use them only if cramping and pain continue but there are no other signs of illness, such as fever.

• 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. See Rehydration Drinks for a recipe for a rehydration drink you can make at home.

In general, whether you take drugs or not for your cold, you'll get better in about 1 week. Rest and liquids are probably the best treatment for a cold (See Colds). Antibiotics will not help. However, medications 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 medications, often together with a decongestant. However, the value of antihistamines in treating cold symptoms is under debate.

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.

Sprays and drops provide rapid but temporary relief. Nasal sprays containing xylometazoline (such as Otrivin) are effective. Sprays and drops are less likely to interact with other drugs than oral decongestants are.

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Decongestant Precautions

• Do not give cold medicines or oral decongestants to infants under 6 months of age. Nonprescription cold medicines have not been proven effective for preschool children.

• Do not 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": after you stop using the spray, your mucous membranes will swell up more than they did before you used the spray.

• Drink extra fluids when taking cold medications.

• 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 medications. Read the package carefully or ask your pharmacist or doctor to help you choose one.

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 eliminate 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. Also See Pneumonia.

There are 2 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, Benylin-E, 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 medications containing dextro-methorphan, such as Delsym, Robitussin-DM, or Benylin-DM.

Don't suppress a productive cough too much (unless it is keeping you from getting enough rest).

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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. Cough preparations may also interact with some drugs, such as sedatives and certain antidepressants. 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; others contain codeine. There are many choices. Ask your pharmacist to advise you.

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 (See Decongestants) 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-Tripolon (chlorpheniramine) and Benadryl (diphenhydramine) are single- ingredient antihistamine products.

Products such as Dristan, Coricidin, and Triaminic contain both a decongestant and an antihistamine.

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Antihistamine Precautions

• Do not give antihistamines to infants younger than 4 months of age. For children between 4 months and 1 year, ask your 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 some drugs, such as 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.

• The drowsiness that antihistamines often cause usually lessens with continued use. If it continues, or if the medication isn't helping your allergies after 1 week, call your doctor for advice.

• Antihistamines that don't cause drowsiness are also available (such as Claritin, Reactine, and Allegra). These drugs carry some additional risks. Ask your doctor.

There are dozens of pain reliever products. Most contain either aspirin, ibuprofen, or acetaminophen. These 3 drugs relieve pain and reduce fever. Aspirin and ibuprofen also relieve inflammation. They belong to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs).

When purchasing pain relievers, keep in mind that generic products are chemically equivalent to more expensive brand-name products, and they usually work equally well.

Aspirin (ASA) 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

Aspirin causes more childhood poisonings than does any other drug. Keep all aspirin, including baby aspirin, out of children's reach.

Aspirin can irritate the stomach lining, causing bleeding or ulcers. If aspirin upsets your stomach, try a coated brand, such as Entrophen. Talk with your doctor or pharmacist to determine what will work best for you.

Aspirin increases the risk of Reye syndrome in children. See Reye Syndrome. Do not give aspirin to anyone younger than 20 unless your doctor tells you to do so.

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).

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 health professional if any one of these symptoms occurs:

• 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 medications, do not try these uses of aspirin without a doctor's supervision.

• Heart attacks and strokes : Aspirin in low but regular doses helps prevent heart attacks and strokes in certain people. Doses as low as 30 mg per day have helped. Aspirin may also help as a first aid measure for heart attacks. Chewing tablet may be enough to help.

• Stomach and colon cancer : Some studies have shown that taking 1 aspirin tablet per day can reduce the risk of cancers in the digestive system.

• Migraines : Regular, low-dose aspirin use may reduce the frequency of migraines.

Other Pain Relievers

Ibuprofen, the active ingredient in products such as Advil and Motrin, is another nonsteroidal anti-inflammatory drug (NSAID). Like aspirin, ibuprofen relieves pain and reduces fever and inflammation. Also like aspirin, it can cause nausea, stomach irritation, and heartburn. People who take blood thinners (anticoagulants) should not use ibuprofen unless their doctor advises them to do so.

Acetaminophen (the active ingredient in products such as Tylenol, Tempra, and Panadol) 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.

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