Top 10 OTC drugs to keep at home

There are many over-the-counter (OTC) medications available without a prescription, which are used to treat the symptoms of many illnesses that don’t usually require the help of a physician or health care practitioner. A few of these medications that can help treat;

• Minor aches and pains,
• Fever,
• Diarrhoea,
• Cold symptoms,
• Sore throat, and
• Allergies

OTC medications have brand names as well as generic and store brand names (similar to prescription medications). Generic, store, and brand names contain the same active ingredients and are identical in their action on the body if the concentration of the active ingredients is the same. Because some OTC pills and liquids contain multiple medications, it is important to read the fine print on the label to know exactly what ingredients are in the product. There are three major medication categories available OTC to treat pain and fever;

1. Acetaminophen,

2. Nonsteroidal anti-inflammatory drugs (NSAIDs), and

3. Aspirin.

Although the three major categories of drugs listed below are also used to treat the pain of minor trauma, rest, ice, compression, and elevation (RICE) are easy first steps in the treatment of minor injuries, especially the pain associated with sprains and strains.

Acetaminophen

Acetaminophen is the most commonly recommended OTC medication for fever. It works well for minor aches and pains, especially for people who cannot tolerate anti-inflammatory medications such as ibuprofen or aspirin. It is important to read the labels in regard to the recommended dosing of each medication to prevent accidental overdose. This is especially true with infants and children where the proper dosage depends upon the weight of the infant or child.

For an adult, the maximum dose of acetaminophen per day is 4 grams to prevent the complications of liver damage. Many cold medications contain acetaminophen as one of several other ingredients and it is important to read the labels carefully to prevent overdose. Because of the possibility of liver toxicity, acetaminophen should be avoided in patients with liver diseases such as cirrhosis and hepatitis. There are several brand and generic names for acetaminophen. Common brand names include Tylenol, Panadol, and Tempra.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Many nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat inflammation, fever, and pain are available over-the-counter. OTC ibuprofen (for example, Motrin, or Advil) is often recommended by healthcare practitioners to decrease pain and inflammation from minor orthopedic injuries. It can also be used effectively as part of the treatment for kidney stones and gallstones, where inflammation is part of the process causing pain. Ibuprofen is also frequently recommended for the treatment of fever in all age groups. 

Naproxen (for example, Naprosyn, Anaprox, and Aleve) is another NSAID available over-the-counter. The benefit of OTC naproxen is that it is longer lasting than ibuprofen and only needs to be taken twice a day instead of every 4 hours. NSAIDs should not be taken by individuals with kidney disease, or those who have a history of bleeding from the stomach and bowels because NSAIDS are removed from the body by the kidneys and may increase bleeding in the stomach or bowels. These medications are relatively contraindicated in individuals taking blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), and prasugrel (Effient) because the NSAIDS may increase the chance of inappropriate bleeding.

Salicylic Acid or Aspirin

Salicylic acid or aspirin is a well-known medication that has been recommended for generations as a treatment for pain, inflammation, and fever. It is also a first-line treatment in the prevention of heart attack and stroke because of its anti-blood clotting properties by making platelets in the bloodstream less sticky. Because of the many side effects associated with aspirin, other medications such as acetaminophen (Tylenol and others) or ibuprofen may be recommended instead of aspirin. Aspirin may cause Reye’s syndrome in infants and children, which can lead to fatal brain swelling. Therefore, aspirin should not be taken by children younger than 14 years of age. Some individuals may need to take large amounts of aspirin to manage pain from arthritis, but high doses of aspirin can cause major complications such as tinnitus (ringing in the ears), pulmonary edema (fluid buildup in the lungs) and kidney failure. Aspirin can cause irritation of the stomach and may lead to ulcers and bleeding. Individuals with a history of ulcers or other stomach problems should not take aspirin, and those who take blood thinners should use caution when taking aspirin at the same time, as the probability of inappropriate bleeding is increased. There are several brand and generic names for aspirin. Common brand names include Bayer aspirin, St. Joseph’s aspirin, and Anacin. A cold is an upper respiratory tract infection (URI) caused by a virus. Since most people with a viral illness (viral upper respiratory infection) generally recover in approximately 7 to 14 days, treatment is focused on symptom control. Symptoms of a cold are:

• Runny nose,
• Stuffiness,
• Possibly a sore throat, and
• Hoarseness.

The symptoms of the flu (influenza) are different. Influenza (flu) has more systemic symptoms such as fever, chills, coughs, and muscle/body aches. OTC medications including herbal remedies may be of benefit in controlling symptoms but cannot cure a cold; instead, they can potentially minimize the symptoms that cause people to suffer. Herbs have been used for centuries to help relieve cold symptoms but scientific studies have not yet proven their effectiveness. While herbal remedies may be of benefit to some people, it is important to remember that they are not harmless and may interact with prescription medications. Your pharmacist or health care practitioner can give advice as to the safety of a specific treatment plan. Drugstore and grocery shelves are lined with numerous types of drugs used to treat the symptoms of a cold; listed below are some of the treatments for cold symptoms and precautions about their use.

OTC Medications for Sore Throat, Headache, Earache, and Body Aches

Many sore throats are caused by viruses but others may be due to a strep or other bacterial infection. It is reasonable to treat the symptoms of a sore throat for a few days but if symptoms don’t resolve, a strep screen or throat swab may be necessary to determine if antibiotics are needed. Acetaminophen and ibuprofen are helpful in treating the pain associated with colds and influenza. Benzocaine (Cepacol) is the active ingredient in cough drops and sprays that helps to control the symptoms of a sore throat. It is also available as an eardrop antipyrine (A/B Otic, Aurodex, Rx-Otic), benzocaine (Oticaine); as a dehydrated glycerin (Auralgan) for temporary relief of ear pain; and as a pain reliever for oral ulcers toothache pain (Anbesol).

OTC Medications for Upset Stomach

Classic heartburn is described as a burning sensation in the upper abdomen that may radiate to the upper chest and may be associated with a bad taste in the back of the throat. It is important to note that many of these symptoms also are associated with heart attack or angina. Unless the diagnosis of heartburn is well established, individuals with chest pain should consider seeking emergent medical care. This is especially true in those with significant risk factors for heart disease including smoking, high blood pressure, high cholesterol, diabetes, and a family history of heart disease or stroke. Bismuth subsalicylate (Pepto-Bismol) is an OTC liquid medication recommended by many for the treatment of indigestion, nausea, and diarrhoea. The bismuth often will cause black stools (usually this is not a concern). The compound has anti-secretory, antibacterial, and anti-acid properties, but should not be used in infants, young children, or women who are breastfeeding to avoid the chance of causing Reye syndrome. Bicarbonate tablets (for example, Alka-Seltzer, and Bromo-Seltzer) are recommended to relieve heartburn and indigestion because they reduce stomach acidity. Simethicone (Gas-X, Phazyme) is an OTC medication used to reduce/relieve gas and the feeling of stomach bloating.

Dimenhydrinate (Dramamine) may be taken to control nausea and vomiting. It is also recommended for motion sickness and dizziness. It should not be used with sedatives as it may increase drowsiness. Emetrol is an OTC medication that relieves nausea and vomiting. It is a mixture of carbohydrate-rich sugars that is also relatively safe for children and pregnant women (with a doctor’s approval). People with diabetes should not use this medication because of the high sugar content. Continued nausea and vomiting may result in dehydration, and these symptoms may signal a more serious illness. If the symptoms persist, it is reasonable to contact your healthcare practitioner. A variety of OTC medications are now available to help treat indigestion. They include H2 blockers (a type of antihistamine that helps control acid secretion in the stomach) such as cimetidine (Tagamet) and ranitidine (Zantac). Proton pump inhibitors (PPIs) decrease acid production through a different pathway and include medications such as omeprazole (Prilosec) and lansoprazole (Prevacid). Calcium carbonate (for example, Caltrate 600, Os-Cal 500, Rolaids, Tums), aluminium hydroxide (for example, ALternaGEL, Dialume), and magnesium hydroxide (Phillips Milk of Magnesia) are antacids that work immediately to relieve acid indigestion and heartburn. They are available in both chewable tablets and liquid forms. Aluminium-based antacids may cause constipation, and magnesium-based products may cause diarrhoea. Maalox is a combination of the two types of antacids.

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