OTCs: Don’t shop till you drop

Here’s what you need to know about taking medicines without a prescription

pocket full of medicines

What do you do when you have a headache or toothache? If you’re like most, you’ll simply walk over to the chemist and buy some over-the-counter [OTC] tablets, without a prescription. OTC medicines are a convenient, inexpensive and relatively safe way to treat minor illnesses. They bring relief and save you a trip to the doctor [not to mention the consultation fees].

Remember, though, that OTC medications are meant for simple conditions that resolve in a short time. Illnesses that can be safely tackled with OTC medicines are mild-to-moderate fevers, aches and pains, minor colds, coughs, acidity, vomiting or loose motions, nose block, ear and eye pain, oral ulcers, dandruff, lice, simple skin ailments, and minor injuries like cuts, wounds and burns.

OTC medications are safe, if used in proper dosages and for a few days. But since they can have occasional adverse effects, a clear understanding and knowledge of these is required. When you purchase and consume OTC medications, the responsibility automatically shifts to you; and not your doctor. Hence, being informed about the dosage and side-effects of these medications becomes all the more important. Here is a list of 10 of the most commonly used OTC medications with their uses and occasional problems that might crop up.

Paracetamol: By and far, this is considered a safe medicine for fever or pain, if you stick to the dosages mentioned on the packaging, which varies for infants, children and adults. Paracetamol is used to control fever, but if the fever is too high or does not show signs of subsiding within a couple of days, you must visit your doctor. Paracetamol does not cure the disease; it only takes away the symptom of fever, irrespective of what underlying disease is producing the fever. In rare cases, an overdose of this drug may lead to liver damage. Hence, take care to not exceed the recommended dosage.

Ibuprofen: This medicine is popular for its fast-acting and efficient pain-relieving abilities. Ibuprofen is taken for head, muscle, bone, joint, tooth, and body pains. It also has a good effect on high fevers and is safe for those above the age of one year. In some people, it can irritate the stomach and cause heartburn and acidity. If you’re prone to bleeding or you’re on anti-clotting medicines, be cautious because ibuprofen might prolong the bleeding time. When used for long periods of time without medical supervision, ibuprofen can affect kidney function.

Aspirin: This is another popular fever and pain medicine. It has the same advantages and disadvantages as ibuprofen. Because of its blood-thinning and anti-clotting effect, it is often prescribed to patients of stroke or heart attack. Avoid giving aspirin to children as, once in a while, it can cause a dangerous condition in the liver called Reye’s syndrome, which can be fatal.

Cough syrups: These usually have a combination of an anti-cough medicine, a decongestant, an anti-allergic, and paracetamol. Some of the anti-cough preparations like codeine are derived from narcotic sources. Generally, cough syrups are safe, and are consumed by millions of people around the world. Since they contain anti-allergic medications or codeine, in rare cases, if there is an overdose, cough syrups can cause drowsiness and disorientation, and might make it risky to drive a vehicle, or to operate heavy machinery.

Nose drops: These are effective in relieving a blocked nose, and can bring instant relief to children as well as adults who cannot breathe or sleep because of a nose block. They are available in separate strengths for infants, older children and adults. Nose drops don’t have serious side-effects, but may occasionally cause rebound congestion and may also become addictive. Prolong, unsupervised use may also cause drying of the mucus membranes of the nose.

Eye drops: Whenever the eye is red or painful, we tend to use eye drops based on the recommendations of the chemist. Most eye drops contain antibiotics or an antibiotic and-steroid combination. They are effective in minor eye irritations. But if they don’t provide relief within a day or two, or if the irritation or pain is severe, consult an eye doctor. Eye drops can be used for children and adults, and there are no separate strengths available for different age groups.

Laxatives: These are used frequently by people who are constipated. They are safe and work well in those who experience sudden constipation due to illness, other medications or fever, but have normal motions otherwise. There are also those who use laxatives for years on end, without suffering major side-effects. However, laxatives can be addictive and you might need to keep increasing the dose as time goes by to achieve the same effect. Some traditional laxatives like castor oil can irritate the stomach and intestine in an unpredictable manner and are better avoided. Since the intestines of children are more sensitive than those of adults, consult the doctor before using these for children.

Antibiotics: Technically, antibiotics are not considered OTC products. But since they are available without prescription, it is a common practice with many people to take a course of antibiotics themselves, often using the previous prescription of the doctor. Antibiotics are chosen by your doctor after examining you, asking for tests and keeping in mind the common infections that are prevalent at that point of time. What was given to you the last time may not work this time.

Also, antibiotics have many side-effects. They also are to be taken over a specific period, and if taken haphazardly, can lead to antibiotic resistance. If you go wrong in your choice of antibiotic, or if you are suffering from any infection that is not a bacterial one, then the infection will progress and you will eventually get yourself into a serious condition, often needing hospitalisation. Antibiotics should be strictly taken only under the prescription and supervision of a doctor, even though they are available as OTC products.

Anti-spasmodics: Stomach cramps and aches have a variety of causes from indigestion, stomach infections to menstrual pain and worm infestation. Anti-spasmodic medications bring relief from pain by relaxing the smooth muscle of the intestine. They are available as drops for small babies, syrups for older children and as tablets for adults. Taking an anti-spasmodic often gets rid of minor cause of stomach pain. If, however, stomach pain persists, or is accompanied by more severe symptoms like fever, vomiting or loose motions, it is better to consult a doctor.

Anti-acidity medications: All of us suffer from mild indigestion or heartburn at times, and have found relief by consuming antacids. These medicines are safe, and even an overdose does not do much harm. However, if there is not much relief, or if the pain seems to be worsening, it is better to consult your doctor to identify the exact cause. Occasionally, some serious condition like a heart attack can be mistaken for acidity, and one must be alert to worsening symptoms, or if the pain of acidity is accompanied by sweating, giddiness and weakness.

The safest policy to adopt when you’re self medicating with OTC products is to be alert to the changes of your body, and to report to the doctor when symptoms are not improving for more than two or three days.

This was first published in the March 2012 issue of Complete Wellbeing.

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P V Vaidyanathan
Dr P V Vaidyanathan, MD, DCH, is a Mumbai-based paediatrician in private practice, hobbyist writer, and author of a book on childhood stress management.


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