Lifelong Health:

Over-the-Counter Drugs Get Side-Effect Warnings

By Dr. David Lipschitz

Recently the Food and Drug Administration announced that it will require warning labels describing the side effects of some of the most common over-the-counter medications. This brings positive and negative ramifications for American consumers.

It is vitally important that potential side effects be understood. On the other hand, it may lead to unnecessary fear and apprehension, causing people to stop taking medications. Regardless, make sure that you discuss all medications -- prescribed and over the counter -- with your physician to understand and avoid complications.

Tylenol, a trade name for the analgesic acetaminophen, is the safest and is a highly effective painkiller. However, recent newspaper reports indicated it might cause liver damage, a finding that caused many adults to stop taking the drug. What the reports did not say was that Tylenol could cause life-threatening liver damage only if taken in excess.

A dose of acetaminophen must never exceed 4 grams daily, or two extra-strength tablets four times daily. Some patients believe that if two is not helpful, why not take four or six at a time?

Sometimes patients take too much by mistake. For example, I have a patient who was taking eight Tylenol daily and eight generic acetaminophen daily, not realizing that they were the same medication. Even more insidious, many other medications include acetaminophen, including Darvocet (Darvon and acetaminophen), Lortab (hydrocodone and acetaminophen) and Ultracet (ultram and acetaminophen).

It is very important not to take eight Tylenol daily and also take six to 10 of another pain medication containing acetaminophen, as risk of liver damage will increase.

Many believe that the over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), including Motrin (ibuprofen) and Aleve (naproxen), are safer and more powerful than Tylenol. Not true! Many TV advertisements tout Aleve or Motrin as being more powerful than Tylenol because one or two tablets of these drugs taken daily may be as good as two Tylenol four times a day.

However, at therapeutic doses, the risk of side effects of anti-inflammatories is greater than Tylenol. Anti-inflammatories can damage the lining of the stomach, causing abdominal pain, indigestion and gastrointestinal bleeding.

These side effects led to the development of Vioxx and Celebrex, medications highly effective in controlling pain without damaging the stomach lining. Sadly, both these drugs, but most particularly Vioxx, increase the risk of heart attacks and strokes. Anti-inflammatories can also lead to high blood pressure, fluid retention and kidney damage.

Remember, any medication or substance that is used to relieve a particular symptom carries risks. Benadryl can cause depression, memory loss and risk of falling. Pepcid AC can cause dizziness, nausea, vomiting, constipation and diarrhea. Prilosec can cause dizziness, nausea, vomiting, potential risk of gastric cancer and hip fractures.

A similar warning must be made for all alternate remedies, including Saint John's Wort, ginkgo biloba, saw palmetto and many others. If it has an effect on a bodily function, it acts as a drug. Potential benefits always come with risks. A decision to use any remedy must be taken very seriously.

So, with all this information, should you avoid over-the-counter pain pills completely? The answer is obviously no. The question is not whether you take the medication, but rather how you take it. Make sure you understand the benefits and potential harm. And if you are on any prescription medications, remember that over-the-counter and alternate remedies may interact with prescription drugs, making them less or more effective or increasing the risk of side effects.

Before taking any medication, read the instructions very carefully. Never exceed the maximum recommended dose and make sure that your doctor is aware of every pill you are taking. If you are about to buy an over-the-counter medication and are on prescription medications, your pharmacist should always be consulted. He will be able to counsel you on potential drug interactions and side effects and assure that you are not taking an incorrect dose.

By being careful and educated you can safely take medications to relieve minor symptoms. But, always do so with caution and make sure you clearly understand the potential ramifications.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz, .... visit the Creators Syndicate Web page at www__.creators.com. Dr. David Lipschitz'. More information is available at www_.drdavidhealth.com.