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Tips to Navigate Through the OTC and Prescription Drug Jungle

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editors: Melissa Conrad Stoppler, MD

Choice is often a wonderful thing for the consumer. But sometimes too many options can make shopping tough, and it may even be deadly as far as medications are concerned.

Walking into a supermarket or pharmacy, you are confronted with shelf upon shelf of medications advertised to cure everything from cold symptoms to warts. There are the nationally advertised brands, the stores' own label, and generic products, all packaged to confuse even the most savvy shopper. Advertisements in magazines and on television tout the latest and greatest advances in products to help treat you and your family. Need advice? Join the crowd.

Headlines are made when medication errors happen in hospitals. Dennis Quaid's twins were accidentally given an overdose of heparin, a blood-thinning drug. The Institute of Medicine reports that thousands of people die each year in hospitals because medications were given inappropriately:

  • the wrong drug was given to the patient,

  • the wrong dose was administered to the patient, or

  • drug interactions occurred.

Imagine that these errors happened in a place where professionals - nurses, doctors and pharmacists - do this for a living. What chance does the average person have, wandering through the nonprescription aisles of the local store?

The salvation lies with the professional behind the counter. Aside from filling prescriptions, the pharmacist can guide any customer through the risks and rewards of over-the-counter medications. With a little background knowledge, the pharmacist can inform a patient with high blood pressure that OTC cold medications containing pseudoephedrine are not a good choice. Pseudoephedrine acts like adrenaline, and can increase the patient's blood pressure.

If you are taking warfarin (Coumadin) for blood thinning, then ibuprofen may not be the right drug for you; it can increase the risk of bleeding from the stomach. Remember that antihistamines shouldn't be used if you have glaucoma. Fever control in a child? No aspirin please, it may cause Reye's Syndrome. Who can remember all these things?

OTC medications make up a tough jungle to navigate. Many products contain more than one medication, and sometimes the print is too small to read. And then there are the supposed "nonactive" ingredients that can also cause issues in some people. Alcohol is listed as a nonactive ingredient in NyQuil. Remember that if you have a drink with dinner, and are taking NyQuil.

Just because a drug is available OTC doesn't mean it is safe for everybody. Prescription and non-prescription drugs should be taken with care. Anytime we put things in our body we enter into a risk-reward relationship. It's important to use the resources available to make the right choices. The pharmacist is a professional who is available to answer questions, and no question is too minor. All you have to do is walk up to the counter and ask.


Last Editorial Review: 6/25/2008







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