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“НАШЕ ЖИТТЯ”, БЕРЕЗЕНЬ 2018 WWW.UNWLA.ORG 33 Some Thoughts On Over-The-Counter Medications by Ihor Magun, MD, FACP Over the past few years, the pharmaceutical indus- try (with the blessing of the proper authorities) has brought to market numerous new medications— including medications that were previously availa- ble only with prescriptions issued by physicians. These medications fall into the category generally referred to as “over-the-counter meds” or OTCs. They are sold in actual prescription strength or in lower-dose versions. As an added convenience, they can now be purchased not just at your local pharmacy but at your local Target or Walmart, and even at wholesale clubs that generously stock large quantities of OTCs and sell them at attractive prices. What could be better? Easy access and lower prices are often a good thing; in fact, this trend has generally been extremely helpful, effective and safe. But, as with anything that looks good at face value, there are several important points to consider and keep in mind. Our society is very “medication oriented.” What this means is that many medical conditions or medical situations may not actually need any medications but are treated with medications any- way. One can even go so far as to state that our so- ciety has become conditioned to ingest some pill or tonic for every conceivable ache, pain, discomfort or ailment. The advertising agencies deserve some of the credit for promoting this concept and the be- havior it leads to. The most popular OTC medications add- ress digestive issues, primarily heartburn and the like. (My article on GERD, published in the Feb- ruary 2017 issue of OL addresses this topic.) There are numerous products available, some that prom- ise to work immediately and others that claim things will improve within a day or two. Products in this category include Zantac, Pepcid, Prilosec and Nexium. Two issues to consider here are the duration of treatment and whether the treatment is appropriate. Among things to consider is that long-term use of these OTCs, if used more than the recommended time, can result in magnesium and/or vitamin B12 deficiencies, problems that can go undetected without appropriate blood tests. In other words, taking these OTCs can address the in- tended ailment but may provoke or promote a completely different condition or health concern. Another new OTC market choice is allergy medications, including nasal sprays that contain steroids. These medications should be used cor- rectly; users should be particularly wary about the danger of duplication of medications and take care not to combine the sprays with any oral OTC al- lergy medications. Pain and anti-inflammatory products, such as ibuprofen (marketed as Advil or Motrin) and naproxen (marketed as Aleve) are also availa- ble OTC. Both work well for mild to moderate pain and inflammation. Ibuprofen is available in 200 mg doses. Higher doses (up to 800 mg) are availa- ble in prescription strength. Unfortunately, long- term use and overuse can lead to gastrointestinal hemorrhage, gastrointestinal ulcers and even kid- ney failure. From these few examples the reader can easily figure out that taking higher or more fre- quent OTC doses can provide good relief and cure without a prescription or medical advice. But the flip-side of this convenience factor is a cautionary note: What is readily available and convenient is not always the correct choice, and easy access to a medication does not justify indiscriminant use, in- cluding prolonged treatment. The golden rule is to read the dosing instructions and pay attention to what the label says about length of time for treat- ment response. Above all, pay attention to any “caution” or “warning” notes on the box or bottle, especially anything that mentions drug-to-drug in- teractions. Do not assume that no harm will be done. Use caution when considering using any OTC products in combination, especially those containing acetaminophen (Tylenol). There have been many issues with liver failure with high and frequent doses. Read all labels carefully before us- ing any of these products. This column is not intended to frighten readers or give dire warnings to avoid OTCs. In fact, the availability of OTC medications is quite beneficial. The emphasis here is that all medica- tions (whether prescription or OTC) are medica- tions and should be treated as such. Proper judg- ment means that periodic medical consultations with your physician are warranted and that you should inform your physician about all OTC medi- cations you are using. On a final note it might be best to consider a broader view of health and well-being. Do we re- ally need all these pills and potions? We’ve all heard the old adage about an ounce of prevention being worth more than a pound of cure. A healthy lifestyle, diet, exercise and practicing mindfulness may be the best “pill” to swallow.
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