Published: February 05, 2008 06:22 pm      

Over-the-counter drugs

Be careful to avoid harmful side effects

FAIRMONT — Read the label of ingredients or the warning sheet that comes with your favorite OTC (over-the-counter) cough or cold remedy.

Taking the extra time to inform yourself can spare you bad side effects if you are taking a prescription drug for a chronic health condition, like high blood pressure, says Joseph Frederick.

The head pharmacist at the Fairmont Family Pharmacy at Fairmont General Hospital, Frederick said health experts have long known about interactions between OTCs and prescribed drugs.

“We are so blessed today than we were about a decade ago because we now have all the ingredients listed in OTC medications,” Frederick said.

OTCs also now come with warnings that consumers should avoid taking the remedy if they have a certain health condition, like high blood pressure or depression.

Pseudoephedrine is a common ingredient in many cough and cold remedies, he said.

Unfortunately, it can elevate blood pressure, something that those with hypertension or high blood pressure want to avoid, Frederick said.

If one is seeking relief from that stuffy nose symptom common to a cold, a nasal decongestant that, in reality, is simply a saline solution (salt plus water) is the answer, he said.

Diet, as diabetics know, can also affect the way an individual metabolizes an OTC or prescription drug, Frederick noted.

Salt or sodium is another red flag ingredient in processed foodstuffs for those with high blood pressure.

When MAO inhibitors — monoamine oxidase, to be specific — were popular several years ago for depression, interactions with an individual’s diet were more marked, Frederick said.

Consumption of “red wines, cheeses and red meats were found” to interact with those prescribed ingredients.

That problem has been greatly reduced with today’s anti-depressant prescription treatments for depression, like Prozac and Paxil, Frederick and Dr. Tara Whetsel said.

Whetsel is a clinical assistant professor of pharmacy at the West Virginia University School of Pharmacy.

Besides checking the ingredient list and reading the warning labels and sheets that come with OTCs and prescription medications as well, the other rule-of-thumb for individuals with chronic health problems is to ask their pharmacist or doctor about their use of OTCs, she and Frederick said.

“If you don’t know if you can take an over-the-counter remedy, then check with the pharmacist or your doctor,” Whetsel said.

One of today’s more common interactions is with acetaminophen, the major ingredient in Tylenol.

“Acetaminophen is found in lots of products, in OTCs and in lots of prescription medicines,” she said. Overdoses can harm your liver.

Using an OTC or prescription as directed is also important.

“The problem with a lot of overdoses is that they are unintentional. The more medicines that you are taking, the greater the likelihood for interactions with OTC remedies,” Whetsel said.

Merck & Co., a global pharmaceutical company, has a good discussion of the OTC drug-drug interaction issue online at its Web site at this address: www.merck.com.

“Certain groups of people, such as the very young, the very old, the very sick and pregnant and breastfeeding women, are more vulnerable to harm from drugs, including OTC drugs.”

“When such people use drugs, special precautions, which may include a doctor’s supervision, should be taken,” states the essay on “Precautions with Over-the-Counter Drugs.”

Besides following the rule of asking a doctor or pharmacist about taking any drug — OTC, prescription or herb — during pregnancy or breastfeeding, the Merck Web site highlights the following drugs as “particularly problematic” for these women: antihistamines (commonly found in cold and allergy medicines, motion sickness drugs and sleep aids); and nonsteroidal anti-inflammatory drugs (NSAIDs).

OTCs are primarily for occasional use by “essentially healthy” people, the essay notes.

People with chronic disorders — like alcoholism (some cold remedies contain as much as 25 per cent alcohol), diabetes, enlarged prostate, glaucoma, heart disease, high blood pressure, hyperthyroidism or kidney disorders — should thus check with their pharmacist or doctor about using OTCs, the Merck site advises.

During checkups, they should mention all the OTC products they are taking to their physician, the essay notes.

“If you don’t know for sure, ask your pharmacist or doctor,” said Dr. Whetsel. “That’s rule No. 1.”

E-mail Bill Byrd at bbyrd@timeswv.com.