Taking These (and Supplements) Safely
Over-the-counter medications (OTC) are easy to find at the store. They offer relief from common health problems like stuffy noses, seasonal allergies and achy muscles. They also can help prevent problems like constipation and nausea. You may feel empowered to solve a health issue without having to see your primary care provider for advice or a prescription. But, is it safe for you, given your medical conditions and other medications? For some, it may be, but for others, the use of OTC medications and supplements can cause unpleasant or dangerous effects.
Sometimes OTC medicines and supplements cause negative effects or create new problems. Adverse effects from OTC medications include:
Side effects are results that medicines have on the body that don’t have anything to do with the symptoms. Side effects can be helpful, for example, taking diphenhydramine (Benadryl) for an allergic reaction can help you sleep. This is good if it’s bedtime, but not if you are at work or need to drive.
Drug-drug interactions can happen in three ways: duplication, opposition and alteration. When you take two medicines that have similar ingredients, you can get more medicine than you need; this is called duplication. For example, taking the OTC pain reliever ibuprofen (Advil, Motrin) at the same time as a prescription anti-inflammatory medicine can give you too much, which can hurt the kidneys or liver. Duplication also happens when people who take blood thinning medications (Plavix, Eliquis, Xarelto) also take aspirin, ibuprofen, fish oil and/or vitamin E; the combination of medicines and supplements can increase the risk of bleeding. If you take supplements like vitamin D, calcium and magnesium, along with a multi-vitamin, be sure to add up the totals for each so that you don’t get too much.
Some medicines can have an opposite effect, an interaction called opposition. For example, decongestants to relieve stuffy noses are known to raise blood pressure. If you take medicine for high blood pressure (HBP) and then take a decongestant, you run the risk of reducing the effectiveness of the HBP medication. The medicines work against each other (cause opposition).
One medicine may change the way your body absorbs another medicine. This interaction is called alteration. For example, aspirin can change the ways some prescription blood-thinning medicines work. This alteration may mean the medicine won’t provide the intended benefit.
Drug-food interactions can happen with some medications. Most medicines are absorbed into the body through the lining of the stomach. If you take a medicine with food but the directions say to take on an empty stomach, your body might not absorb the medicine in the right way. Zinc (Zicam), an OTC homeopathic remedy thought to prevent or shorten the length of a cold, is best taken when the stomach is not empty (to avoid minor upset) and to wait 15 minutes before eating or drinking after taking it.
Discussing your OTC medications with your provider, especially if you take prescription medications, can help you avoid potential problems.
My Friend Suggested…
Sometimes people take vitamin supplements or OTC medications because a friend suggested it or because a family member takes them. Keep in mind that because a medication or supplement helps one person, it doesn’t mean that it’s safe for another. Read more about adverse events on the right. Be sure to review your health history and medications with your provider, pharmacist or KnovaSolutions clinician before starting a new supplement or OTC medication.
You Are Your Best Advocate
What can you do to avoid adverse effects from prescription and OTC medications and supplements?
- Keep a current list of your prescription and OTC medications, supplements and herbs. Include the dose and when you take each. Keep it in your wallet so it is available for doctor’s appointments or emergencies. Use this handy form.
- Know what condition you take each medicine for.
- Discuss with your provider if there are any medications or supplements that are unsafe for you.
- If possible, buy your medications from one pharmacy so your pharmacist can oversee your medications and look for potential risks.
- Ask your KnovaSolutions clinician to perform a medication review.
A Word About Supplements
The Food and Drug Administration (FDA) has established good manufacturing practices for dietary supplements to help ensure that they contain what the bottle says they contain. While supplements are not regulated by the government like prescription medications are, the FDA periodically inspects facilities where supplements are made.
Independent organizations (U.S. Pharmacopeia, ConsumerLab.com, NSF International) test supplements and allow their seals of approval to be used if manufacturers pass quality tests. The seals don’t guarantee that a product is safe or effective, but they may be recommended more often by a provider than a supplement made by a company that hasn’t met the criteria.
Too Much Can Be A Bad Thing
Dietary supplements are those OTC vitamins, minerals and herbs that are used to add nutrients to a poor diet or to lower the risk of health problems (like calcium to reduce bone loss). Eating a variety of healthy foods is the best way to get the nutrients that your body needs. But your provider may recommend supplements if you can’t get enough vitamins and minerals from your food or if supplements or herbs may benefit you without interacting poorly with conditions you have or medications you take.
People with conditions ranging from heart disease and thyroid problems to Parkinson’s disease and epilepsy, probably have a list of OTC medications/supplements to avoid. If you are not sure, talk with your provider or pharmacist before you start a new one. Here are a few examples that show how important it is to make medication decisions carefully.
- Aspirin and ibuprofen (and other non-steroidal anti-inflammatory drugs) can trigger asthma symptoms. Certain high blood pressure medications can too.
- Decongestants not only raise blood pressure, but they can raise blood sugar levels, a concern for diabetics.
- St. John’s wort, an herb to improve mood, can cause fever, tremors and heart problems when taken with anti-depressants.
- Ginkgo biloba, an herb marketed to improve memory, can increase bleeding risk if taken with blood thinners.
- Antacids, used for indigestion or heartburn, can be harmful for people with kidney disorders.
- Acetaminophen (Tylenol and a common ingredient in cold medicines) is the most common cause of drug-related liver injury when used in excess.
- Alcohol interacts with many medicines, and can be particularly dangerous to use with sleeping pills and prescription painkillers.
Taking OTC medications and supplements can be tricky business. Depending upon your conditions and the prescriptions you take, some medicines aren’t safe. If you have questions about your current medications or potential new ones, check with your provider, pharmacist or KnovaSolutions clinician. Let us perform a medication review for you. Call us weekdays from 8 am to 5 pm (Mountain time) at 800/355-0885. We’d be happy to help you avoid adverse effects!
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The information contained in this newsletter is for general, educational purposes. It should not be considered a replacement for consultation with your healthcare provider. If you have concerns about your health, please contact your healthcare provider.