What You Need to Know About OTC Medication Dangers

Just because over-the-counter medications don't require a prescription, doesn't mean they are harmless. Here, some tips to keep you safe.

Stomach pain is one of the unpleasant side effects of taking too much non-steroidal anti-inflammatory medication.Over-the-counter (OTC) medications may seem completely safe. After all, you don’t need a prescription to pick up some pills at the drugstore to treat your headache, backache, or sore muscles. But popping too much of certain OTC medications can have a terrible effect on your tummy, according to experts.

"We are talking about common household brands, like Motrin, Aleve, and Advil,” said Byron Cryer, MD, a gastroenterologist who is working to raise awareness about OTC dangers through a campaign developed by the American Gastroenterological Association called “The Gut Check: Know Your Medicine.” “These are medications that everyone has taken at one time or another, and the principle side effect is stomach problems.”

What are NSAIDs?

OTC pain medications generally fall into one of two categories: acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAIDs) like aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). More than 500 OTC and prescription medications contain acetaminophen, while close to 550 OTC and prescription medications contain an NSAID like aspirin or naproxen.1

While too much acetaminophen can cause liver problems, it is the NSAIDs that  are associated with more worrisome risks—intestinal problems as well as heart attacks and stroke.

Despite the huge volume of pain medications used in the US, many people don’t understand the risks associated with NSAIDs, which work by reducing hormones that cause inflammation and pain in the body.

One nationwide survey of more than 1,000 adults found that nearly half the participants admitted to a lack of basic understanding about NSAIDs and didn’t know that long-term use or high doses can not only wreak havoc on the stomach but, on rare occasions, be fatal.

While about half of medication users (58%) acknowledge that there are risks associated with taking NSAIDs, only 27% are aware of the Food and Drug Administration (FDA) recommendations to use the lowest effective dose for the shortest possible duration, the survey found.2

According to Dr. Cryer, at least 50% of individuals who use NSAIDs for pain will experience some type of adverse abdominal effect and the discomfort can range from a mild tummy upset to intense pain. While an upset stomach is the most common symptom, 1 in 5 individuals will actually develop an ulcer, Dr. Cryer explained.3 “And about 1 in 100 will develop a bleeding ulcer in the stomach along with pain,” he said. “And a bleed is what I am most concerned about.”

Some 95% of the patients who are hospitalized due to an overdose of OTC meds could have avoided the hospital if they had educated themselves about the potential hazards of these medications, Dr. Cryer said. To learn more about safe pain management, Dr. Cryer recommends a free, online resource known as the “Gut Check Journey,” developed by the American Gastroenterological Association. This interactive activity takes the user through a series of quizzes designed to provide education about the potentially dnagerous side effects of OTC medications. 4

5 Helpful Tips to Reduce Stomach Pain

In recent years, tolerability has improved as the formulations of these medicines have been changed, Dr. Cryer admitted.  “Today you can find enteric-coated aspirin, which is far easier on the stomach, for example.”

If you are experiencing unpleasant stomach symptoms while taking OTC medications, try these 5 helpful tips:

  • Take the medication with food. “Food serves as a buffer against potential problems,” Dr. Cryer said.
  • Take a formulation of the medication specifically designed to be easier on your intestines. Liquids are more gentle than pills; while soft gels, or enteric-coated medicines are other stomach-friendly options recommended by Dr. Cryer.  
  • Reduce the dose to lessen chance of stomach bleeding and other related problems. For best results, take the medication at the lowest effective dose for the shortest possible time. Some conditions, including arthritis, may not respond immediately to OTC medication and may take up to 2 weeks before patients reap the full benefit of the pills. It’s also important to realize that OTC pain medications often work best when taken at the first sign of pain. Waiting until the pain has become worse, can weaken the effect.
  • Be mindful of the ingredients in other medications you may be taking. If you are taking cold or allergy medication, be sure to read the label as many contain aspirin or other NSAIDs that could combine to give you too much if you are also taking OTC medication to treat pain. Never take more of a medication than what is recommended on the container or a higher dose than your health care provider recommends.
  • Try a different product that promises the same results. Acetaminophen, which is not an NSAID like ibuprofen, and which relieves common aches and pains as well as fever, doesn’t cause as many stomach problems as other pain medications, according to the National Institutes of Health (NIH).5 “Each person needs to have their own trial to see what will take care of their pain,” Dr. Cryer pointed out. “We often find a person who doesn’t respond well to one medication responding very well to another. The responses are personalized.”

If you take a pain reliever most days, NIH urges you to inform your doctor as you may need to be watched for side effects. If you experience any serious side effects such as chest pain, shortness of breath, weakness, slurred speech and/or severe stomach pain, let your doctor or pharmacist know right away.


Updated on: 09/28/16
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