Hidden Side Effects of Common Over-the-Counter Medications You Need to Know About

When you have a headache, a mild fever, or seasonal allergies, it’s easy to reach for over-the-counter (OTC) medications without a second thought. After all, if you don’t need a prescription, how dangerous can they really be? However, while these medications are generally safe when used as directed, many people are unaware of the hidden side effects that come with them—especially if they’re taken incorrectly or over long periods.

In this blog, we’ll explore some lesser-known risks of common OTC medications and provide tips on how to use them safely. Being informed can help you protect your health and avoid any unwanted surprises the next time you pop a pill.

1. Ibuprofen and Other NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

Common Usage: Ibuprofen, found in brands like Advil and Motrin, is one of the most commonly used pain relievers. It’s part of a class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs), which are also used to reduce inflammation and fever.

Lesser-Known Side Effects:

  • Gastrointestinal Bleeding: One of the most serious risks associated with NSAIDs like ibuprofen is gastrointestinal bleeding, particularly with long-term or high-dose use. Stomach ulcers and bleeding can occur, sometimes without warning, especially in older adults or those with a history of ulcers.
  • Kidney Damage: Prolonged use of NSAIDs can lead to kidney damage, especially in people who are already at risk for kidney issues or those who are dehydrated.
  • Increased Risk of Heart Attack and Stroke: Some studies have shown that regular use of NSAIDs may increase the risk of heart attack and stroke, particularly at higher doses or when used over a long period.

Tips: To reduce the risks, take NSAIDs with food to help protect your stomach lining. Stick to the lowest effective dose for the shortest amount of time. If you need to use ibuprofen or another NSAID regularly, consult your doctor or pharmacist for advice.

2. Acetaminophen (Tylenol) – More Than Just a Headache Cure

Common Usage: Acetaminophen, sold under the brand name Tylenol, is widely used for pain relief and fever reduction. It’s found in many OTC products and is often a go-to for treating mild to moderate pain.

Lesser-Known Side Effects:

  • Liver Damage: Acetaminophen is generally safe at recommended doses, but taking too much can lead to serious liver damage, even liver failure. This risk is higher if you drink alcohol or take other medications that contain acetaminophen without realizing it.
  • Overdose Risks: Many cold and flu medications contain acetaminophen, making it easy to accidentally take more than the recommended amount. The risk is higher during cold and flu season when people may take multiple medications to manage symptoms.

Tips: Always check labels on all your medications to avoid doubling up on acetaminophen. Stick to recommended doses, and avoid drinking alcohol while taking it. If you have any concerns, ask your pharmacist for guidance.

3. Antihistamines (Diphenhydramine, Loratadine)

Common Usage: Antihistamines are commonly used to relieve allergy symptoms, such as runny nose, sneezing, and itchy eyes. They are also found in many cold and flu remedies.

Lesser-Known Side Effects:

  • Cognitive Impairment: Older antihistamines like diphenhydramine (Benadryl) can cause drowsiness, but what many people don’t know is that long-term use, especially in older adults, has been linked to cognitive decline, memory issues, and confusion.
  • Risk of Dependency: First-generation antihistamines, like diphenhydramine, are sometimes used as sleep aids due to their sedative effects. However, regular use can lead to dependency, and over time, the medication may become less effective.

Tips: For regular allergy management, consider switching to newer, non-sedating antihistamines like loratadine (Claritin) or cetirizine (Zyrtec). Always consult your doctor or pharmacist if you’re using an antihistamine for an extended period.

4. Proton Pump Inhibitors (PPIs) – Acid Reflux Relief Comes at a Cost

Common Usage: Proton pump inhibitors (PPIs), such as omeprazole (Prilosec) and esomeprazole (Nexium), are commonly used to treat heartburn and acid reflux by reducing stomach acid production.

Lesser-Known Side Effects:

  • Increased Risk of Bone Fractures: Long-term use of PPIs has been associated with an increased risk of bone fractures, particularly in the hip, wrist, and spine. This is due to the potential for PPIs to reduce calcium absorption.
  • Nutrient Deficiencies: PPIs can interfere with the absorption of important nutrients, such as magnesium and vitamin B12. Over time, this can lead to deficiencies that may cause additional health issues.
  • Link to Kidney Disease: Some studies suggest that prolonged use of PPIs may increase the risk of developing chronic kidney disease or worsening existing kidney problems.

Tips: If you need to take a PPI for more than a few weeks, speak with your doctor or pharmacist about whether it’s necessary to continue, and consider alternative treatments for heartburn or reflux.

5. Decongestants (Pseudoephedrine, Phenylephrine)

Common Usage: Decongestants like pseudoephedrine (Sudafed) and phenylephrine are used to relieve nasal congestion caused by colds, allergies, or sinus infections.

Lesser-Known Side Effects:

  • Increased Blood Pressure: Decongestants can raise blood pressure, making them risky for people with hypertension or heart disease. They can also cause an increase in heart rate.
  • Anxiety and Insomnia: Because decongestants are stimulants, they can cause anxiety, nervousness, or insomnia in some people, particularly if taken close to bedtime.

Tips: If you have high blood pressure or a heart condition, consult your doctor before taking a decongestant. Non-stimulant alternatives like saline nasal sprays may be a safer option.

6. Combination Cold Medications – What You Didn’t Realize You’re Taking

Common Usage: Many cold and flu medications combine several active ingredients to treat multiple symptoms—such as pain, congestion, and cough—at once.

Lesser-Known Side Effects:

  • Unintended Overdose: Combination medications can lead to an accidental overdose of certain ingredients, particularly acetaminophen or decongestants, if you’re not paying attention to what each product contains.
  • Drug Interactions: Some combination cold medications can interact with prescription drugs, potentially causing harmful side effects.

Tips: Always read the labels on combination medications and avoid taking multiple drugs with the same active ingredient. If you’re unsure about a combination, ask your pharmacist for advice on safe options.

Conclusion: How to Stay Informed and Safe

Over-the-counter medications offer quick relief for everyday ailments, but it’s important to remember that they can have hidden risks, especially if used incorrectly. By being aware of these lesser-known side effects and consulting with your pharmacist or healthcare provider, you can use these drugs safely and effectively.

If you have any questions about the medications you’re taking or need advice on safer alternatives, don’t hesitate to reach out to our pharmacy. We’re here to help you make informed decisions about your health!