You’re probably already aware that when you see your doctor, it’s recommended you disclose all medications you’re taking.
This includes not only prescriptions (where many times primary care doctors aren’t aware of medications prescribed to patients by specialists), but over-the-counter drugs, supplements and vitamins. All carry potential risks and can interact in ways that could be unsafe or reduce the effectiveness of medications.
In addition, though, there are times when you need to take an extra step to alert your doctor about an OTC medication you’re taking or are considering taking — even if you don’t have a scheduled appointment to see your doctor. That’s because what might seem like a safe unilateral decision — to take a drug for which you don’t need a prescription — could put you at risk.
[See: 6 Drugs That Can Worsen or Increase Risk for Heart Failure.]
Here are some guidelines to follow when determining whether it’s best to get a professional opinion before taking — or continuing on — an OTC medication:
Read the label. You should be doing this anyway — along with reading all information that comes with a medication before taking it. However, research suggests that routinely consumers don’t do this, says Janet Engle, a professor and head of the department of pharmacy practice at the University of Illinois at Chicago College of Pharmacy and past president of the American Pharmacists Association.
OTC medications will list instances when you should contact your doctor before taking the drug. For example, if a person has had heartburn for more than three months or they’ve also had chest pain with it, or they’ve had lightheadedness, sweatiness or dizziness, it’s very clear that you need to ask a doctor before taking an OTC heartburn medication, Engle says — the label says as much. That’s because, experts say, the drugs could mask more serious conditions, such as ulcers or heart disease.
Exercise caution in self-treating lingering illnesses. OTC medications are generally meant to treat short-term illnesses — something that might clear up in days or a couple weeks — not to nurse health problems that span months or longer. “If you’re on that product for a longer period of time, that’s when it’s time to talk to your doctor,” Engle says — one, to ensure you’re taking the right medication and two that, again, you’re not masking symptoms of a more serious condition that should be treated in a different way.
Pause before adding to a growing medication list. The risk of an adverse drug reaction — from an unpleasant side effect, such as loss of appetite or upset stomach, to a potentially life-threatening issue, like bleeding — tends to increase with the number of medications a person takes, whether prescription or OTC.
Not only can drugs interact dangerously or counteract medication effectiveness when taken together, but often patients take too much of essentially the same medication contained in different drugs. “Over-the-counter medications [are neither] innocuous nor inert,” says Martin Iyoya, director of pharmacy services at John Muir Health, based in Walnut Creek, east of San Francisco. “They have active medications in them that, if misused, can lead to severe or significant consequences.” It needn’t be intentional or involve taking more than the recommended dose on purpose. A person can unknowingly take multiple medications containing acetaminophen (the active ingredient in Tylenol), for example — in an OTC pain reliever and a prescription pain drug — and end up with more than the recommended dose. Over time, Iyoya points out, taking too much acetaminophen could lead to liver damage. The most common cause of acute liver failure (when damaged liver cells are no longer able to function) in the U.S. is taking too much acetaminophen.
[See: How to Help Aging Parents Manage Medications.]
Consider your age. “Drugs are metabolized completely differently in the older population,” says Dr. Richard Dupee, a geriatrician and chief of geriatrics at Tufts Medical Center in Boston. Kidney function changes with age. This can worsen drug interactions and side effects and risks associated with prescription and OTC medications. For example, “the use of drugs like ibuprofen can cause fluid retention, worsening blood pressure and problems with the kidneys,” he says.
Seniors routinely take an average of four to five prescription medications, Dupee notes, along with other medications and vitamins. Many take more, increasing the risk of dangerous drug interactions. “So that’s why my patients hopefully have learned over all these years: Before they take any over-the-counter medication, they call me,” Dupee says.
If you’re a senior, you should check the medication against the American Geriatrics Society Beers Criteria, a series of lists of medications, updated in 2015, including OTC medications, that may be inappropriate for older adults. For example, diphenhydramine, which is also Benadryl, is associated with delirium and mental status or cognitive changes in older people, says Todd Semla, a pharmacist and an associate professor of medicine and psychiatry in the Feinberg School of Medicine at Northwestern University, who co-chairs the AGS Beers Criteria expert panel. “It’s something that we want [seniors] to avoid taking,” he says.
Talk to the pharmacist as well. While your doctor should be familiar with your health history and current conditions, pharmacists have extensive training in medications, and you needn’t be filling a prescription to ask questions.
Rather, experts advise anyone who has questions about any medication — including over-the-counter medications — to talk with the pharmacist to get those answered before taking the drug. Ask if the drug is safe to take — particularly if you’re older. Also, ask about drug interactions with other medications you’re taking, Semla says. For this reason, it’s a good idea to have a “home” pharmacy — or pharmacy chain (if patient records are shared between locations) — where a list of all your medications is readily accessible to the pharmacist, experts say. At the very least, if not using your usual drugstore, catch your pharmacist up on all medications you’re taking, Engle says.
[See: 8 Questions to Ask Your Pharmacist.]
Bottom line: Don’t hesitate to reach out to your doctor — there are often many more ways to do so today, besides calling, from patient portals offered by many health providers to email — and talk to the pharmacist. And make sure to do your due diligence, experts say, before taking any OTC medication.
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When Should You Alert Your Doctor About OTC Medications? originally appeared on usnews.com
