A nonprescription medicine—sometimes called an over-the-counter, or
OTC, medicine—is any drug that you can buy without a doctor's prescription. But
don't assume that all nonprescription drugs are safe for you. These drugs can
interact with other medicines and can sometimes cause serious health
problems. And if you take more than the normal or recommended amount, overdose may occur.
Some medicines should only be used by adults or older
children. Be sure to read the package instructions carefully, or ask a
pharmacist before giving any product to an infant or
young child. If you are pregnant, always check with your pharmacist or doctor
before using any nonprescription medicine, to make sure it is safe to use
Carefully read the label of any nonprescription
drug you use, especially if you also take prescription medicines for other
health problems. Ask your pharmacist for help in finding a nonprescription drug
best suited to your needs. Use these
tips on how to avoid common
And find out the safest way to throw away medicines that are expired or no longer used. Use these drug disposal tips to help prevent people and animals from taking medicines that aren't intended for them:
Find out if your local trash and recycle center offers a medicine take-back program. Ask your pharmacist if he or she knows of one. This is the best way to safely throw away medicines.
If there is not a take-back program near you, follow these steps to throw away medicine with the rest of your garbage:
Mix medicine with a substance that doesn't taste good, such as cat litter, sawdust, or coffee grounds. Do not crush tablets or capsules.
Place the mixture in a container, such as a sealed plastic bag.
Put the container in your household trash.
Some common nonprescription medicines
Antacids and acid reducers.
agents, laxatives, and stool
Cold and allergy
These drugs can be very helpful when used properly but can
cause serious problems if used incorrectly. The following tips will help you
use common nonprescription drugs wisely and safely. In some cases, you may find
that you don't need to take them at all.
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems.
Antacids are taken to
indigestion caused by excess stomach acid.
There are several kinds of antacids. Learn what ingredients are in each type so
that you can avoid any adverse effects.
Sodium bicarbonate antacids (such as
Alka-Seltzer and Bromo Seltzer) contain baking soda. Avoid these antacids if
you have high blood pressure or are on a salt-restricted diet. Alka-Seltzer
contains aspirin, which is linked to
Reye syndrome, a rare but serious illness in
Calcium carbonate antacids (such as Tums) are
sometimes used as calcium supplements. These products may cause
Aluminum-based antacids (such as Amphojel) are less
potent and work more slowly than other products do. They may also cause
constipation. Some may cause calcium loss and should not be taken by women who are past menopause. If you have kidney problems, check with your doctor
before you use aluminum-based antacids.
Magnesium compounds (such as
Phillips' Milk of Magnesia) may cause diarrhea.
antacids are less likely to cause
constipation or diarrhea than are aluminum-only or magnesium-only
antacids. Examples include Maalox, Mylanta, and Riopan. Many of these types of antacids contain simethicone to help break down gas bubbles in your stomach.
Antacids with alginic acid (such as Gaviscon) contain a foaming agent that floats on top of the stomach contents. This may help keep stomach juices from coming in contact with your esophagus.
Acid reducers decrease the amount of acid produced by the
stomach. They help relieve heartburn. There are several types of nonprescription acid reducers on the
market. Examples include H2 blockers (such as famotidine and ranitidine) and proton pump inhibitors (such as lansoprazole and omeprazole). Each has slightly different cautions for use. Read and carefully follow
the instructions included with the package.
Antacid and acid reducer precautions
Try to eliminate the cause of frequent heartburn instead of
taking antacids regularly. For more information, see the topic
Consult your doctor or
pharmacist before taking an antacid if you take other
medicines. Antacids may interfere with the absorption and action of some
prescription medicines. Also consult your doctor if you have ulcers or kidney
Do not use antacids for more than 2 weeks unless you have talked with your doctor about taking them on a long-term basis.
If you have a problem with the function of your kidneys
or liver, you should be careful using antacids. All drugs are broken
down and removed from the body by the combined action of the liver and kidneys.
If your kidneys are not working correctly, it is possible that too
much of the drug will build up in your body.
If you are on a low-salt diet, talk with your doctor or pharmacist before choosing an antacid. Some antacids have a lot of salt (sodium).
If you are pregnant, don't use antacids that have sodium bicarbonate (such as Alka-Seltzer).
Bulking Agents, Stool Softeners, and Laxatives
are four types of products used to prevent or treat constipation: bulking
agents, stool softeners, osmotic laxatives, and stimulant laxatives.
Bulking agents, such as bran or psyllium (found in Metamucil, for example) ease
constipation by increasing the volume of stool and making it easier to pass.
Regular use of bulking agents is safe and helps make them more
Stool softeners (such as Colace
and Docusate Calcium) soften the stool, making it easier to pass. Stool
softeners can be most effective if you drink plenty of water throughout the
Osmotic laxatives, such as Fleet Phospho-Soda, Milk of Magnesia, or Miralax, and nonabsorbable sugars (such as lactulose or sorbitol), hold fluids in the intestine. They also draw fluids into the intestine from other tissue and blood vessels. This extra fluid in the intestines makes the stool softer and easier to pass. Drink plenty of water when you use this type of laxative.
Stimulant laxatives (such as Correctol, Ex-Lax, and Senokot) make stool move faster through the intestines by irritating the lining of the intestines. Regular use of stimulant laxatives is not recommended. Stimulant laxatives change the tone and feeling in the large intestine, and you can become dependent on using laxatives all the time to have a bowel movement.
Take any laxative or bulking agent with plenty
of water or other liquids.
Do not take laxatives regularly. They change the tone and feeling in the large intestine. And you can become dependent on using them all the time to have a bowel movement. If you need help having regular bowel movements, use a
Regular use of laxatives may change your body's ability to absorb
vitamin D and
calcium. This can lead to weakened bones.
There are two types of medicines that help stop diarrhea, those that thicken the stool and those that slow intestinal
Thickening mixtures (such as
psyllium) absorb water. This helps bulk up the stool and make it more firm.
products slow the spasms of the intestine. Loperamide (the active ingredient in
products such as Imodium and Pepto Diarrhea Control) is an example of this
type of preparation. Some products contain both thickening and antispasmodic
Use antidiarrheals if you have diarrhea for longer than 6 hours. Do not use these medicines if you have bloody diarrhea, a high fever, or other signs of serious illness.
Long-term use is not recommended. To avoid constipation, stop taking antidiarrheal medicines as soon as stools thicken.
If your child
or teen gets
flu, do not treat the symptoms with over-the-counter
medicines that contain bismuth subsalicylate (such as Kaopectate and Pepto-Bismol). If your child has taken this kind of medicine and he or she has
changes in behavior with nausea and vomiting, call your doctor. These symptoms
could be an early sign of
Reye syndrome, a rare but serious illness.
doctor if your child younger than 12 should take these medicines.
In general, whether you
take medicines for your cold or not, you'll get better in about a week. Rest
and liquids are the best treatment for a cold. Antibiotics will not help. But
nonprescription medicines help relieve some cold
symptoms, such as nasal congestion and cough.
especially runny nose, often respond to antihistamines. Antihistamines are also
found in many cold medicines, often together with a decongestant.
Decongestants can be taken orally or used as nose
drops or sprays. Oral decongestants (pills) provide longer relief, but they cause more side effects.
Sprays and drops provide rapid but
temporary relief. Sprays and drops are less likely to interact
with other drugs than oral decongestants are.
Saline nose drops are not decongestants but may help
keep nasal tissues moist so the tissues can filter air.
Your pharmacist can suggest a medicine for your cold and allergy symptoms.
Check the label before you use these medicines. They may not be safe for young children.
If you use these medicines, always follow the directions about how much to use based on age and in some cases weight. Not everyone needs the same amount of medicine.
Decongestants can cause problems for people who have
certain health problems, such as heart disease, high blood pressure,
glaucoma, diabetes, or an overactive
thyroid. Decongestants may also interact with some
drugs, such as certain antidepressants and high blood pressure medicines. Read
the package carefully or ask your pharmacist or doctor to help you choose the
best decongestant for you.
Drink extra fluids when you are taking cold
Don't use medicated nasal sprays or drops more than 3 times a day
or for more than 3 days in a row. Continued use will cause a "rebound effect"
in which your mucous membranes swell up more than before you used the
If you are pregnant, check with your
doctor or pharmacist before using a decongestant.
Coughing is your body's way of getting foreign substances and
mucus out of your respiratory tract. Sometimes, though, coughs are
severe enough to impair breathing or prevent rest.
There are two types of coughs: productive and nonproductive. A productive cough produces phlegm or mucus (sputum). It's generally best if you don't try to stop (suppress) a productive cough. A nonproductive cough does not produce sputum. It is a dry cough.
Water and other
liquids, such as fruit juices, are good cough syrups. They help
soothe the throat and also moisten and thin mucus so it can be coughed up more
You can make a simple and soothing cough syrup at home by
mixing 1 part lemon juice with 2 parts honey. Use as often as needed. This can
be given to children 1 year and older.
There are two kinds
of cough medicines:
Expectorants help thin the mucus and make it easier to cough
mucus up when you have a productive cough. Look for expectorants containing
Suppressants control or suppress the cough reflex and work
best for a dry, hacking cough that keeps you awake. Look for suppressant
medicines containing dextromethorphan. Don't suppress a productive cough too much (unless it is keeping
you from getting enough rest).
Cough preparation precautions
Cough preparations can cause problems for
people who have certain health problems, such as asthma, heart disease, high blood
pressure, or an
enlarged prostate (BPH). Cough preparations may also
interact with sedatives, certain antidepressants, and other medicines. Read the
package carefully, or ask your pharmacist or doctor to help you choose.
Cough suppressants can stifle breathing. Use them with caution
if you are older than 60 or if you have chronic
Be careful with cold medicines. They may not be safe for young children, so check the label first. If you do give these medicines to a child, always follow the directions about how much to give based on the child's age and weight.
Read the label so you know what the
ingredients are. Some cough preparations contain a large percentage of alcohol,
and others contain codeine. There are many choices. Ask your pharmacist to
Avoid cold remedies that combine medicines to treat many symptoms.
Avoid alcohol if you are taking medicine with dextromethorphan in it.
If you are pregnant, check with your doctor or pharmacist before
using a cough preparation.
Antihistamines dry up nasal secretions and are
commonly used to treat allergy symptoms and itching.
There are two types:
Older, first-generation antihistamines (such as chlorpheniramine and diphenhydramine). These may make you sleepy or make it harder for you to concentrate.
They can also affect your coordination, even when they do not make you drowsy.
Newer, second-generation antihistamines (such as cetirizine and loratadine). These have fewer side effects. Many of the newer antihistamines cause less drowsiness than older antihistamines or cause no drowsiness at all.
If your runny
nose is caused by allergies, an antihistamine may help. For cold symptoms,
home treatment and perhaps a decongestant will probably be more helpful. It is
usually best to take only single-ingredient allergy or cold preparations,
instead of those containing many active ingredients.
as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl) are
single-ingredient antihistamine products.
Products such as
Coricidin, Dristan, and Triaminic contain both a decongestant and an
Don't give antihistamines to your child unless
you've checked with the doctor first.
Use of antihistamines to
treat the stuffiness of a cold will often thicken the mucus, making it harder
to get rid of.
Drink extra fluids when taking
Avoid alcohol when taking antihistamines.
Antihistamines can cause problems for some people
with health problems such as asthma, glaucoma, epilepsy, or an enlarged
prostate. Antihistamines may also interact with certain antidepressants,
sedatives, and tranquilizers. Read the package carefully or ask your pharmacist
or doctor to help you choose one that will not cause problems.
When you take an antihistamine that makes you drowsy, the drowsiness usually decreases with continued use. Talk to your doctor or pharmacist if the medicine still makes you drowsy or if the medicine isn't helping your symptoms after 1 week. You may want to try an antihistamine that doesn't cause drowsiness.
you are pregnant, check with your doctor or pharmacist before using an
There are dozens of pain-relief
products. Most contain either aspirin, ibuprofen, or acetaminophen. These three
drugs, as well as naproxen, relieve pain and reduce fever. Aspirin,
ibuprofen, and naproxen also relieve inflammation. They belong to a
class of drugs called
nonsteroidal anti-inflammatory drugs (NSAIDs).
When you buy pain relievers, keep in mind that generic products are
chemically equivalent to more expensive brand-name products, and they usually
work equally well.
Aspirin is widely used for relieving
pain and reducing fever in adults. It also relieves minor itching and reduces
swelling and inflammation. Aspirin comes as adult-strength (325 mg) or low-dose (81 mg). Although it
seems familiar and safe, aspirin is a very powerful drug.
Keep all aspirin out of children's reach.
Aspirin increases the risk of
Reye syndrome in children. Do not give aspirin to anyone younger than 20 unless your doctor tells you to
Aspirin can irritate the stomach lining, causing bleeding or
ulcers. If aspirin upsets your stomach, try a coated brand, such as Ecotrin.
Talk with your doctor or
pharmacist to find out what may work best for
Do not take NSAIDs if you have had an allergic reaction to this type of medicine in the past.
Throw aspirin away if it starts to smell like
Because aspirin can increase the risk of bleeding, it is not recommended for new injuries. Take other medicines such as ibuprofen or naproxen for the first 2 or 3 days after an injury.
If you take a blood thinner (anticoagulant), such as warfarin, or if you have gout, talk to your doctor before you take aspirin.
High doses may result in aspirin poisoning
(salicylism). To help prevent taking a high dose, follow what the label says or what your doctor told you. Stop taking aspirin and call a doctor if any of these symptoms
Ringing in the ears
If you are pregnant, check with your
doctor or pharmacist before taking a pain reliever.
Other aspirin uses
addition to relieving pain and inflammation, aspirin is effective against many
other ailments. Because of the danger of side effects and the interactions
aspirin may have with other medicines, do not try these uses of aspirin without
a doctor's supervision.
Heart attack and stroke: Aspirin in low but regular doses may help prevent heart attacks and
strokes in certain people. For more
Migraines: Regular, low-dose aspirin use may reduce the
frequency of migraine headaches. For more information, see the topic Migraine Headaches.
Other pain relievers
Ibuprofen (the active ingredient in products such as Advil and Motrin)
and naproxen (in products such as Aleve) are
aspirin, these drugs relieve pain and reduce fever and inflammation. Also like
aspirin, they can cause nausea, stomach irritation, and heartburn.
NSAID precautions (also see aspirin precautions)
Do not use an NSAID for longer than 10 days without talking to your doctor.
Talk to your doctor before taking NSAIDs if you have:
Ulcers or a history of bleeding in your stomach or intestines.
Stomach pain, upset stomach, or heartburn that lasts or comes back.
Bleeding or easy bruising.
A habit of drinking more than 3 alcoholic drinks a day. This increases your risk of stomach bleeding.
High blood pressure.
Kidney, liver, or heart disease.
Talk to your doctor before using NSAIDs if you take:
Blood thinners, such as warfarin, heparin, or aspirin.
Talk to your doctor before you give fever medicine to a baby who is 3 months of age or younger. This is to make sure a young baby's fever is not a sign of a serious illness.
Acetaminophen (the active ingredient in products such
as Tylenol) reduces fever and relieves pain. It does not have the
anti-inflammatory effect of NSAIDS, such as aspirin and ibuprofen. But it also
does not cause stomach upset and other side effects.
package label will tell you how many milligrams (mg) of medicine are in each
pill or liquid dose, how much you should take; and how often you should take it. Do not exceed
the dosage limits, and follow the instructions on the package if you have
health problems that may make it unsafe for you to take the usual dosage of a
This website has tips for safe use of over-the-counter medicines for children and adults. It has information about drug labels, ingredients, drug interactions, and more.
This website is hosted by the Institute for Safe Medication Practices, a nonprofit organization. You'll find tips about how to prevent medicine errors at home, at the hospital, and at the pharmacy. You can sign up for safety alerts about your medicines, and you can report medicine safety concerns.
Food and Drug Administration (FDA): Consumer Health
10903 New Hampshire Avenue
Silver Spring, MD 20993
This website has health information for
people of all ages. Topics include the following: medicines, food and nutrition, medical
devices, cosmetics, and animal health. Spanish materials are also
Centers for Disease Control and Prevention (2010). Unintentional drug poisoning in the United States. Available online: http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdf.
U.S. Food and Drug Administration (2011). Disposal of unused medicines: What you should know. Available online: http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#MEDICINES.
How this information was developed to help you make better health decisions.