Dr. Rebecca Brightman spoke with us about which common over-the-counter medications could have dire consequences when taken incorrectly.
In mid-May, Michigan Representative Debbie Dingell was admitted to the emergency room for intense stomach pain. Rep. Dingell explained in a radio interview that she felt like she “was on fire,” and that a perforated ulcer, which required emergency surgery, was the cause of her sudden pain. The ulcer was likely caused by a high dose of Motrin, a common over-the-counter non‐steroidal anti-inflammatory, or NSAID, which Rep. Dingell was taking for a jaw infection. Luckily, the surgery was successful.
While a story like Rep. Dingell’s is rare, it’s not impossible. “Just because a drug or supplement can be purchased over-the-counter (or OTC), it doesn’t mean that it can be used without any concerns,” says Dr. Rebecca Brightman, our resident women’s health expert. “All OTC drugs contain instructions, warnings, and drug interactions, and it’s important to read through all of these categories before using an OTC.” She warns, “The amount recommended for daily use should not be exceeded and if the symptoms one is trying to treat are not alleviated by an OTC, it’s imperative that one reach out to their healthcare provider.”
This led us to wonder — what else is in our medicine cabinet that we should be wary of? We asked Dr. Brightman to share her expertise on which seemingly harmless OTC medicines have risks we should know about
Over the Counter Medicine and Drug Side Effects
NSAIDS Side Effects
This includes Motrin, the pain reliever taken by Rep. Dingell, but it also includes a number of other common meds like ibuprofen (like Advil) and naproxen (Aleve). “NSAIDs can irritate the stomach lining and cause heartburn, gastritis, and occasionally ulcers. Sometimes these ulcers can bleed and even perforate, which requires surgical intervention,” Dr. Brightman says. “In order to avoid this, when I recommend NSAIDS, I tell patients to take them with food. While most individuals do not have GI symptoms when using NSAIDS, their use should not be taken lightly. If they are needed on a regular basis to control symptoms, one should discuss options for potentially safer alternatives.”
Acetaminophen Side Effects
This is another popular OTC pain reliever, and comes under the brand name Tylenol. Dr. Brightman warns, “Acetaminophen should not be taken in excess, as it has been shown to cause liver damage with extensive use.”
Antihistamine Side Effects
These are found in allergy medications used to relieve symptoms like congestion or a runny nose. They come under brand names like Claritin, Zyrtec, and Benadryl. “Some people are allergic to them, and common signs include tongue swelling or shortness of breath after use,” Dr. Brightman says. “Reach out to your healthcare provider if you’re unsure before taking one, because a severe allergic reaction should be managed in an ER setting.”
Supplement Side Effects
“In excess, many OTC supplements can be detrimental,” Dr. Brightman warns. “Magnesium for example may cause nausea, cramping, and diarrhea. Excessive amounts can cause an irregular heartbeat and sedation.” She continues, “Biotin, which is a supplement frequently taken for hair and nail health, can affect certain lab test results such as thyroid function tests and troponin levels, which are important in diagnosing heart attacks. Creatine, a popular sports supplement used to increase muscle mass, may cause an elevation in serum creatinine, leading one to erroneously suspect kidney disease.”
Should I be worried about OTC drug side effects?
The bottom line, says Dr. Brightman, is to ask your healthcare provider if you’re concerned about any OTC medications. When asked at the doctor to provide a list of medications, be sure to include any OTCs, vitamins, or other nutritional supplements. If you decide to use an OTC to treat symptoms, review the uses for the medication and appropriate dosing, and make sure that the OTC will not interact with any other medication you’re currently taking.
