OTC Medicines – Are They Safe?

Dr-Vikram Sharma Neurologist

Medically Reviewed by Dr. Vikram Sharma (MBBS, MD)
September 9, 2020


Over-the-Counter Medicines are the drugs that are available at the drug store or pharmacy or supermarkets. These medicines do not require prescription to buy as they are considered as relatively safe.

Nagging pain, cough, cold, headaches, body pains, muscle pain, allergies and migraines are quite disgusting to manage. For instant relief OTC medicines are
always available at our disposal. They don’t require doctors’ prescription and we often use them whenever the need arises.

They are relatively safe at recommended dose, but excess dose and lack of awareness regarding their interaction with foods, drinks and other medicines can cause severe complications and side effects.

Prior to using them we must know the correct answer to the following few questions about OTC Medicines:

Are OTC medicines always safe to use?

OTC medicines are not always safe to use. You must have to be very careful while using them for recurrent health issues.

Are there any contraindications in their use?

Dr. Moazzam, a renowned general physician and diabetologist from Hyderabad says that those who have liver problems, kidney issues, diabetes, high blood
pressure, asthma and any pre-existing heart disease must consult their family physician prior to using OTC medicines. Individuals with any of these
conditions are at increased risk of side effects from the use of OTC medicines.

Dr Moazzam goes ahead a step further and says, “If you get sick, then ask your doctor what medicines are safe for me to use.”

He further adds, ask your doctor this: “Doctor I have cold and fever.” What medicines should I take? What is safe for me”

The final words from the doctor: “As a rule of thumb, I recommend you to keenly read the labels on the drugs and follow the instructions carefully.”

Do these medicines interact with foods, drinks and other drugs?

Food does not affect all OTC medicines. Doctors instruct you to take some
medicines with food and certain others on an empty stomach. The reason, what
you eat and when you eat does matter with certain medicines. Which means, the food you eat may impact the way the medicines are processed and absorbed.

Certain medicines absorb and process better if they are taken on an empty stomach.

See the labels for specific instructions. If there are no instructions, then it doesn’t matter when you take it. Your family physician is the best person to answer any queries you may have.

Drug-drug interactions

If you use two or three medicines together, then the ways in which they affect the body can change. It is due to drug-drug interaction. Therefore, one must
become careful while taking two to three OTC medicines together. Even the chances of augmenting the side effects could also increase.

Duplication: When you take two different medicines with similar active ingredients, this is what you see. The dose obviously increases. Dr Moazzam has explained us this in the preceding paragraphs. This is known as drug duplication. Excess dose of an OTC medicine can damage liver and kidneys.

Sometimes a combination of two OTC medicines can reduce the effectiveness of one or both the medicines. This may be due to the interaction of the two active ingredients that cause opposing effects on the body (opposition). For instance, if you use decongestants with blood pressure lowering medicines
neither of the two medicines can work efficiently because decongestants increase blood pressure – whereas the other medicine is used to lower blood pressure.

Alteration: When you take two medicines together – one of the medicines can alter the way in which the other medicine goes in the system, gets absorb and process. This is known as alteration. Be careful here as well. While using OTC medicines be aware of these three – duplication, opposition and alteration. Remember “DOA”

What dose is considered as safe?

This is an interesting question. Sometimes, many of us unknowingly increase the dose by taking several medicines with the same main active ingredient. For instance, several cold, flu and fever medicines may have paracetamol or acetaminophen. By taking several drugs or a combination drug, the dose can become a toxic dose – which can cause havoc in the body. Overdose of medicines can lead to kidney failure, liver damage and even death as well.

Prior to taking several drugs in combination, that have same active ingredient, it is better to talk to your doctor.

See the labels for the recommended dose and frequency of use.

How long can they be used?

Don’t take OTC medicines longer than recommended. Ask your doctor clearly about how long can you take the medicine without undergoing any undue side effects. Never use OTC medicines at a stretch for around 15 to 20 days and for months together. First of all, get a better understanding of the frequency of usage of all the OTC medicines from your doctor whenever you consult them.

For instance, if you are using an OTC medicine for more than three weeks (considering three doses per week) for your headache – you may get rebound headaches. As long as you take the medicine your headaches remain under control, but once you stop the medicine, headache comes back. To stop it you may get prompted to use one more dose. In this way, you may keep on increasing the frequency of dose and the time as well. The dose, frequency and duration of use increases leading to addiction and severe side effects. Prolong use of OTC medicines can cause liver and kidney damage and problems related to gastrointestinal tract.

Bottom Line
  • All OTC medicines are not safe for all.
  • The risks associated with one OTC medicine may differ from another.
  • OTC medicine could interact with drinks, foods, supplements or other medicines.
  • Excessive use of OTC medicine is dangerous for the liver.
  • Certain OTC can cause allergic reactions in some people.
  • There are some OTC medicines that are not safe during pregnancy.
  • Some OTC medicines are not recommended for children. Be careful while giving such medicines to children.

Beware of using OTC medicines as many people are not aware of the risks that are associated with their improper dose, frequency of use and duration. Correct dose is important – especially when the medicines are for children. Don’t use kitchen spoon for giving medicines to children. Measuring cup can be used instead.


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