Show 1385: The Dangers of Overdosing on OTC Meds

This week, Joe and Terry Graedon welcome your questions and stories about the dangers of overdosing on OTC meds. Dr. Lisa Sanders, an acknowledged expert on medical diagnosis, starts us off with a story about a patient’s mysterious illness. How was it linked to the medicine he was taking? 

The Dangers of Overdosing on OTC Meds:

For most of us, the first thing we turn to when we notice a minor medical problem is a nonprescription medicine. Why wouldn’t we? Drugstores, quick marts, vending machines and other places offer as many as 300,000 such products for a wide range of symptoms. According to the FDA, these drugs can be used for self-diagnosed conditions, don’t need a healthcare practitioner to supervise their use and have a low likelihood of abuse or misuse. OTC drugs are usually affordable and don’t require seeing a prescriber.

That might not mean they are completely safe, though. About 95% of the products that are currently sold over the counter once required a prescription. The FDA decided that they were safe enough not to need expert monitoring. Presumably, patients/consumers are undertaking the necessary monitoring themselves. How do they know what to watch for?

Consumer Information on OTC Meds:

Do you read the Drug Facts on the label of your over-the-counter meds? Generally, this will tell you about the active ingredient and may also include a list of inactive ingredients. It should list its use. For example, the label for Prilosec OTC states: “treats frequent heartburn (occurs 2 or more days a week)” and cautions that it will not provide immediate relief.

Drug Facts also include important warnings. These may be somewhat esoteric, as in the warning about glucose-6-phosphate dehydrogenase deficiency on a box of phenazopyridine for urinary pain relief. If you have G6PD deficiency, you’ll know the warning is important. Those who do not may well wonder about it briefly and then forget it. Other warnings appear more generally. Products containing salicylates, including aspirin and Pepto-Bismol, caution against giving them to children or teenagers with chickenpox or the flu. That could result in Reye’s syndrome, “a rare but serious illness.”

Prescription to OTC:

You are probably aware that prescription drugs generally come with a lengthy list of side effects. Take Prilosec (omeprazole) as just one example. The prescribing information for this important medication used to treat ulcers, erosive esophagitis, Zollinger-Ellison syndrome and GERD lists more than 100 adverse reactions. Some of them are extremely serious, such as anaphylactic shock, angioedema, pancreatitis and liver failure. The package containing Prilosec OTC does not list any side effects directly. It does suggest you stop use and see your doctor if you get diarrhea or develop a rash or joint pain. What happened to the side effects from prescription omeprazole? Presumably, the maker and the FDA figure that using the OTC drug for just two weeks at a time makes serious reactions unlikely. But what if you took it for longer than two weeks? Are you in danger of overdosing on these OTC meds?

How to Stay Safe:

We will discuss reading labels and finding other important sources of information about your OTC meds. We welcome your questions about these drugs and your stories about problems you may have had.

Please share your inquiries and anecdotes. You can email us: radio@peoplespharmacy.com or call 888-472-3366 between 7:00 and 7:50 am EDT on Saturday, May 18, 2024.

This Week's Guests:

Stefanie Ferreri, Pharm.D., is the Henry L. Smith and James L. Olsen, Ph.D., Distinguished Professor in Pharmacy Practice and Chair of the Division of Practice Advancement and Clinical Education at the UNC Eshelman School of Pharmacy. Her main research interests include advancing clinical practice in the community-pharmacy setting.
https://pharmacy.unc.edu/directory/ferreri/

[caption id="attachment_127984" align="alignnone" width="768"] Stefanie Ferreri, PharmD[/caption]

Dr. Lisa Sanders is the Medical Director of Yale's Long Covid Multidisciplinary Care Center. In addition to her work as a physician and teacher, she writes the popular Diagnosis column for the New York Times Magazine. In 2019 Dr. Sanders collaborated with the New York Times on an eight-hour documentary series on the process of diagnosis for Netflix. Dr. Sanders is the author of Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis and Diagnosis: Solving the Most Baffling Medical Mysteries.

[caption id="attachment_130686" align="alignnone" width="768"] Dr. Lisa Sanders[/caption]