Over the Counter Medications: Tips for Patients





By Russell Durkee, DO
Published in Healthy Viewpoints
Over the Counter medications, or OTC, are those medicines that do not require a prescription from a physician and are readily available to the public. This does not mean that they do not need to be taken carefully. This article will explain the most commonly used OTC medicines, their names, effects and some cautions as to their use.

Pain Relievers

There are two types: NSAIDS (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, and ketoprofen; and acetominophen, which is Tylenol. NSAIDS work by reducing prostaglandins, which are involved in injury or infection and thus reduce pain and inflammation. Acetominophen helps to reduce pain and fever.


Histamines are chemicals in our bodies that produce itching and allergy responses. Antihistamines block these. Some common antihistamines are diphenhydramine (in Benadryl) bropheniramine (in Dimetapp) and chlorpheniramine (in Chlor-Trimeton).


These medicines work by shrinking blood vessels in the nose and decreasing congestion. The only over the counter decongestant is pseudoephedrine, which is in most, if not all cold medicines that claim to be decongestants.

Cough Medicines

Cough medicines come in two types: antitussives (ñanti coughî) and expectorants (ñmucous reducersî)
Dextromethorphan is the antitussive in most cough medicines. Common ones are Delsym and Robitussin DM, to name a few. Guaifensin is the expectorant that is most used. This is in Guiatuss and Robitussin. Now that we have a basic understanding of these medicines, let’s go over some tips on how to use them.

Reading the Label

Active ingredient
This is what you want to focus on. The active ingredient is why you are taking the medicine. Ask your doctor if the active ingredient is not on the list above.
This part will list the symptoms that the medicine is intended to treat.
Always read the warnings. This section will include important information on things you should watch for while taking the medicine and what drugs to be careful with in combination.
This part will guide you on how to administer the medicine.
Other information
Information on how to store it will be here.
Inactive ingredients
These are the ñglueî around the active ingredient. Users should read this part to see if they are allergic or intolerant to any of the inactive ingredients.

Some cautions taking over the counter medicine (OTC)

Always talk to your doctor before taking OTC medicines, if you have any questions. Provide your doctor with a list of your current medications when you ask about the OTC medicine. Your doctor should also know about any non-prescription herbal or mineral supplements you are using.

Side effects of common OTC medicines

NSAIDS can cause stomach upset and occasional gastrointestinal bleeding. If you take one of these medicines for a long period of time, tell your doctor. Persons on high doses of NSAIDS can have problems with kidneys. Talk to your doctor if you have kidney problems. Also, young children and those with liver diseases should use NSAIDS with caution.

Acetominophen users should be careful if they have kidney or liver disease. Alcohol should not be used with this medicine.

Antihistamines can cause drowsiness. Be careful driving or doing any dangerous work. The antihistamine Claritin does not cause drowsiness and is now OTC.

Decongestant use can cause sleeplessness, nervousness and trembling. This medicine should be for short term use and only as directed. It should not be used by anyone with heart disease, diabetes, or high blood pressure. This medicine is the most common OTC associated with illness and death. Also be cautious of other products containing psudoephedrine which also is called ephedra, mua huang and many other herbal names.

Cough Medicines can cause agitation and confusion for some users.

Some Tips:

  • Read the label.
  • Follow the label on how to take your medicine.
  • Tell your doctor about all the prescription and OTC medicines you take
  • Don’t combine prescription and OTC medicines until you know its safe
  • Don’t use other people’s medicines
  • Look at expiration dates
  • Don’t crush or break medicines unless the label or your doctor says to do so
  • Never take medicines with alcohol unless you speak to your doctor