In my last post, I began analyzing over-the-counter drugs. Should you take these kinds of drugs, considering the risk of the damaging effects they can have, or should you try to avoid them at all costs?

I talked about the risk of liver damage excessive acetaminophen could cause. This ingredient is common in many over-the-counter drugs, especially Tylonel. But there are other kinds of OTC drugs that are pain relievers and fever reducers as well – for example, Aspirin, Advil, Aleve, Motrin, and others, labeled as ibuprofen, ketoprofen, and nanoproxen.

Nonsteroidal anti-inflammatory drugs, known as NSAIDs, are found in these types of drugs. As with any medication, there is a chance of potential risk. In this case, NSAIDS are known to cause damage to the inside of the stomach, creating ulcers. NSAIDS have also been known to worsen blood pressure and cause reversible damage to the kidneys.

How serious are these effects? When taken daily, especially excessively, over long periods of time, “there is an increased risk of gastrointestinal complications ranging from stomach pain to ulcers” as well as “severe and potentially deadly gastrointestinal problems.” A study analyzing 43 generally healthy patients taking NSAIDS/aspirin daily for their arthritis found that “71 percent of those who were exposed to NSAIDs for more than 90 days had visible injury to their small intestine.” The long term side-effects of NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths each year. In addition, “more people die each …year from NSAIDs-related complications than from AIDS and cervical cancer in the United States.” I was not able to find the specific background on the study or statistics to evaluate their value, but if we can believe what they are saying to be accurate, NSAIDS effects are pretty serious.

Even though there are negative effects to taking an excessive amount of NSAIDS, many people do take these drugs despite the risks because, as rheumatologist John Klippel, MD, President and CEO of the Arthritis Foundation said: “pain is not just an inconvenience, it can be devastating. It can destroy people’s lives. NSAIDs can be a valuable treatment.”

Both Tylonel and Advil, ibphrofen, Aleve, Aspirin, Motrin, etc. have pros and cons to them that make the question “should you take OTC medicine or should you avoid it?” a touchy question to answer. Both kinds of drugs have risks to them when taken in excessive amounts, but do the risks really outweigh the benefits? In the case of acetaminophen and to a certain extent, NSAIDS, taking the drugs over the maximum dose increases the risk of negative effects such as liver damage, stomach ulcers, kidney damage, etc, not necessarily the damage itself. NSAIDS can cause more serious long term damage, but if you follow the instructions use it accordingly, you should not run into this problem.

Considering this, and weighing the positive benefits that OTC drugs offer, I think that people should not avoid using them as long as they use them safely. They do help – anyone who has had a fever reduced, their sinuses reduced, or a migraine cured because of them will attest. People should not avoid using them, but they still should be wary, only using them when necessary and never in excessive amounts. As the FDA says, “the best way to take your over-the-counter pain reliever? Seriously.”

There is a lot of negative information out there about OTC drugs, so I understand why many people would be deterred and not want to use them at all. There are holistic alternatives to OTC drugs, but these come in the form as supplements and are not as popular. I couldn’t find a study comparing the effects of both methods, but I believe there has not been a big movement from OTC drugs to holistic supplements because people find it harder to believe it will work. With OTC drugs, there is some element of placebo because you know so many other people have had success with them you will too.

Based on the information about acetaminophen and NSAIDS, do you think the negatives of OTC drugs should prevent them from being used? Should people be more wary of them?

No matter what kind of over the counter medicine you are taking, it is important to be aware of the following:

�         how much you can take at one time (dose)

�         how many hours you must wait before taking another dose

�         how many times you can take it each day

�         when you should not take it and talk to your doctor

http://www.sciencedaily.com/releases/2005/01/050111123706.htm

http://www.webmd.com/osteoarthritis/features/are-nsaids-safe-for-you?page=2

http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm133421.htm

http://www.webmd.com/pain-management/features/safe-use-otc-pain-relievers

http://www.consumerreports.org/cro/2012/04/pain-relievers-the-pros-and-cons-of-4/index.htm

http://www.spine-health.com/treatment/pain-medication/potential-risks-and-complications-nsaids

http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/SafeUseofOver-the-CounterPainRelieversandFeverReducers/ucm234272.htm

http://abcnews.go.com/Business/PainManagement/story?id=731159&page=1