Who among us hasn’t taken an over-the-counter (OTC) medicine for life’s little aches, pains and stomach ailments?

When taken as intended, or under your doctor’s care, a simple ibuprofen, antihistamine or analgesic can really save the day. The drugstore is full of remedies that don’t require a doctor’s prescription. But that doesn’t mean they’re safe to take any which way. Even taking the medicine per the bottle’s instructions can be dangerous for some people, and it’s important to understand your risks before you take that pill. Let’s discuss why.

Side effects

Some drugs, like certain antihistamines, have side effects such as sleepiness, or jitters. Unlike a true drug allergy, these side effects are sometimes baked into the general effects of the drug (such as cold medicines that also help you sleep). These side effects can interfere with your general functioning and may require planning to use properly. Understand your label’s warnings before you use these drugs. Some side effects, like shortness of breath, are rare but happen. If you’re experiencing strange, unexpected symptoms, don’t rule out your OTC as a source.

Drug interactions

Many people think only prescription drugs can interact with each other, but many times, it’s the sudden addition of over-the-counter medications that’s the problem. Everyone processes drugs differently, and that can lead to certain types of drug interactions including:

  • Duplication—when you take two medicines that have similar active ingredients, thus taking far more medicine than you need. For instance, this often happens when you take an OTC Advil or Motrin® with a prescription anti-inflammatory, causing liver or kidney damage.
  • Opposition—when you take medications which have the opposite effect, and cancel each other out, reducing the effectiveness of one or both medications. A common example is taking an OTC decongestant, such as Sudafed, that raises your blood pressure, negating the effectiveness of your prescription blood pressure medication.
  • Alteration—when you take a medicine that changes the way your body absorbs, spreads or processes another medication. An example of this is aspirin, which can change the way some prescription blood-thinning medicines work.

Drug/food interactions

Many people don’t realize it, but when, how and what you eat can have a big impact on how drugs react in your system. For instance, ignoring instructions on taking medications on a full or empty stomach can drastically affect the way they are absorbed in your system, or cause nausea. There are certain foods that can interfere with the way drugs work in the body, as well. For instance, grapefruit or grapefruit juice can interfere with cholesterol lowering medicines. Talk to your pharmacist to make sure the food you eat won’t interfere with your medicine regimen.


Nearly all OTC medications are designed to be taken for short periods of time. Unless instructed by your doctor, don’t take these medications daily. Some OTC medications can cause a type of mild addiction. OTC pain migraine medications, for example Excedrin, can sometimes cause rebound headaches. Decongestant nose sprays, such as Afrin, can lose their effectiveness over time, requiring more and more product to get the same relief. And even worse, they can mask what could be a concerning health issue. If you find yourself needing an OTC for longer than the label suggests, contact your doctor, who can get to the bottom of the problem.

Your primary care provider is there to help you manage your total medication picture and can advise you on the best course of treatment for life’s aches and pains.

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Hope Maniyar, Pharm.D., MBA

Hope Maniyar, Pharm.D., MBA, completed her undergraduate studies at University of Louisville and went on to receive her doctor of pharmacy and master of business administration degrees at Sullivan University College of Pharmacy. She has worked in the pharmacy field for the past 14 years and has a special interest in regulatory affairs, mental health and substance use disorders.

All posts by Hope Maniyar, Pharm.D., MBA
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