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You can buy many medicines for minor problems at the store without a prescription (over-the-counter). They are safe and effective when you follow the directions on the label and as directed by your doctor. These medicines can have serious side effects if you take them in high doses or for a long time. Tell your doctor if you are taking these medicines several times a week. You may need to be checked for side effects.

The Basics

Follow the same safety steps you would take for prescription drugs.

  • Talk to your doctor before starting a new medicine.
  • Always follow the directions and warnings.
  • Know what you are taking. Look at the list of ingredients and choose products that have fewer items listed.
  • All medicines become less effective over time and should be replaced. Check the expiration date before using any product.
  • Store medicines in a cool, dry area.
  • Keep all medicines out of the reach of children.

Special Populations

People in these groups should take special care when taking over-the-counter medicines.

  • Women who are pregnant or breastfeeding – whatever you take, so does your baby.
  • Children and older adults – medications affect them differently.
  • People with medical conditions – over-the-counter medications can interact with prescription drugs.

Types of Over-the-counter Medications and Products

  • While many healthy Americans are able to meet their daily vitamin and mineral needs through food sources, some may benefit from supplementation if they have specific deficiencies.
    • Vitamins are chemical compounds that are essential for normal body function. Because vitamins (with the exception of Vitamin D) cannot be created by our bodies, they must be ingested from dietary sources to meet our daily needs. There are 13 essential vitamins and the USDA has determined the recommended daily amounts (RDA) required for good health.
    • Minerals are naturally occurring inorganic substances used by the body to build bones, make hormones, and regulate muscle contraction among other important functions.
  • Over-the-counter pain medicines can help with headache, arthritis pain, sprains, and other minor joint and muscle problems.
    • Acetaminophen -- Try this medicine first for your pain. DO NOT take more than 3 grams (3,000 mg) on any one day. Large amounts can harm your liver. Remember that 3 grams is about the same as 6 extra-strength pills or 9 regular pills.
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
  • Acetaminophen and ibuprofen help reduce fever in children and adults. Aspirin works very well for treating fever in adults. DO NOT give aspirin to a child unless your child's provider tells you to.
  • Cold medicines can treat symptoms to make you feel better, but they do not shorten a cold. Taking zinc supplements within 24 hours of the start of a cold may reduce the symptoms and duration of a cold.
    • Cough medicines:
      • Guaifenesin helps break up mucus. Drink lots of fluids if you take this medicine.
      • Menthol throat lozenges soothe "tickle" in the throat.
      • Liquid cough medicines with dextromethorphan suppress the urge to cough.
    • Decongestants:
      • Oral and nasal spray decongestants help clear a runny nose and relieve postnasal drip.
      • Decongestant nasal sprays may work more quickly, but they can have a rebound effect if you use them for more than 3 to 5 days. Your symptoms may get worse if you keep using these sprays.
      • Check with your provider before taking decongestants if you have high blood pressure or prostate problems.
    • Sore throat medicines:
      • Sprays to numb pain.
      • Painkillers.
      • Hard candies that coat throat. Be careful in young children because of the choking risk.
  • Antihistamine pills and liquids work well for treating allergy symptoms.
    • Antihistamines may cause sleepiness. Talk to your doctor before giving medicines that cause sleepiness to a child, because they can affect learning. They can also affect alertness in adults.
    • Eye drops soothe or moisten the eyes.
    • Preventive nasal spray.
  • Medicines for diarrhea:
    • Antidiarrhea medicines slow down action of intestine and reduce number of bowel movements. Talk to your provider before taking them because they can worsen diarrhea caused by infection.
    • Medicines that contain bismuth may be taken for mild diarrhea.
    • Rehydration fluids may be used for moderate and severe diarrhea.
  • Medicines for nausea and vomiting:
    • Liquids and pills for stomach upset may help with mild nausea and vomiting.
    • Rehydration fluids may be used to replace fluids from vomiting.
    • Medicines for motion sickness.
  • Medicine for skin rashes and itching:
    • Antihistamines taken by mouth may help with itching or if you have allergies.
    • Hydrocortisone cream may help with mild rashes.
    • Antifungal creams and ointments may help with diaper rashes and rashes caused by yeast.
  • Topical Antiseptic Products:
    • Hand sanitizers and antibacterial soaps may help stop the spread of germs.

Abuse

It is a common misconception that only illegal drugs are dangerous. There are many different over-the-counter drugs with psychoactive, or mind-altering properties that may lead to a number of serious medical and mental health consequences if abused for the mere purpose of getting high.

These harmful effects of OTC drugs frequently are compounded when they are combined with alcohol or other drugs.

In addition, OTC drugs have been used inappropriately to lose weight or get an extra boost of energy. 

  • Dextromethorphan (DXM) is the active ingredient found in many different cough syrups. It can produce psychoactive effects when taken in larger doses than recommended, especially combined with other substances. 
  • Ephedrine is a central nervous system stimulant contained in some asthma medications. It is safe when used as directed by your doctor. It produces an energy boost and suppresses your appetite when used inappropriately. It is harmful when used for weight loss, athletic performance enhancement, or as a substitute for ecstasy.
  • For millions of people, caffeine, which is a central nervous system stimulant, has become an integral part of their lives. Although safe when taken in moderate amounts, it can be fatal when abused in large doses in order to get high or stay awake.
  • People with eating disorders, such as anorexia or bulimia, may abuse laxatives with the intention of losing weight; however, laxatives don’t remove calories and can cause serious health consequences. Abuse can be perpetuated by the temporary weight gain and bloating that occurs when laxative use is discontinued.
  • Pseudoephedrine is used to relieve symptoms associated with a cold, allergies, or hay fever. What was once available on the shelves of pharmacies is now regulated by having to show identification and sign for the medication behind the pharmacy counter. The amount you are allowed to buy is limited as well – this limitation having been put in place due to the illegal production of methamphetamine from pseudoephedrine pills. Still, some people abuse pseudoephedrine in order to experience euphoria and a stimulant-like effect.
  • Motion sickness pills are abused by some people because they can produce mild euphoria and relaxation. Higher doses can cause hallucinations as well.