A sponsored post in a campaign by BOOMboxNetwork.com on behalf of the American Gastroenterological
Association for which I received payment. All opinions however are my own.
After listening to Dr. Anne Larsen of the American Gastroenterological Association (AGA) speak about the overuse and misuse of over the counter (OTC) pain meds, I realized I am regularly subjected to subliminal messages suggesting I exchange one OTC med for another. The television ad that comes to mind involves a woman loading groceries into the trunk of her car while experiencing back pain. One of her friends approaches and suggests (I am paraphrasing) that she take 4 of her OTC brand meds for all day relief. Pam responds rhetorically, “So I should give up taking 2 of my brand for 4 of your higher dosage of pills.” On the surface, it seems to make sense that Pam chooses not to take a higher number of pills. But the Gut Check:Know Your Medicine Campaign suggests this is not enough information to help keep us safe. Because of the primary ingredients found in many OTCs, we need more information to understand dosage across more than 500 products
The question is how to safely take OTC drugs so as to effectively and safely manage pain among consumers who are largely unaware of the serious health issues and complications (such as life-threatening liver damage or gastrointestinal bleeding) caused by unintentional overuse of common OTC painkillers containing Acetaminophen (e.g. Tylenol) or NSAIDS (e.g. Advil).
The answer is without knowing what is in your drug, you cannot make this decision. Start with an understanding that Acetaminophen and NSAIDs are in most OTC meds but they cannot be safely taken together. Therefore you must read labels to know what your drug contains.
Common Ingredients
This seems like an obvious statement. Yet when it comes to what’s in our medicine cabinets for headaches, fever, hip joint, fever reducer, allergies, bursitis, and toothaches, I realized I am probably not the only one with a cavalier attitude about OTC drugs. These drugs are safe but not if you overuse or misuse them. And the number of people who die in hospitals from complications associated with dosage or liver poisoning is more than I would have imagined. I also learned from Dr. Larsen that with an understanding of the risks you can make decisions to safely manage your pain.b
Acetaminophen is a 6 syllable word that people commonly pronounce correctly. Why? Because we’ve come to think of it as something innocent. It is in more than 500 drugs such as Tylenol; but it is also in Percocet or Vicodin, drugs which we consider dangerous. Here is what you need to know:
- Even if you know it is acetaminophen, read the label because this drug comes in pill form, drops, capsules and liquid form
- Each product label may give dosages differently; some as a pill amount or in hourly increments
- No matter the form, there is a recommended maximum daily dosage of 4,000 mg/day whether it is a pill, capsule or liquid
- Sometimes this product is not referred to in the same way. It may be labeled as APAP, acet or acetam. So know how to recognize this ingredient.
On the other hand, non steroidal anti inflammatory drugs (NSAIDs) are often used for chronic conditions in OTC drugs like Imotrin, Aleve, Aspirin, Advil, and Naproxen. You can find some combination of this in more than 550 drugs. NSAIDs, like Acetaminophens have a maximum daily dosage that you have to be aware of and across products, these vary.
What Can Happen
If you take aspirin for a muscle pain and Advil for a headache you could suffer from gastroenterological (GI) problems that place you at risk of liver and/or stomach damage. Interestingly, liver damage from an overdose of acetaminophen is not easily recognized in hospitals. According to background information for this campaign, 458 deaths occur each year from acetaminophen-related overdose with liver failure being the most serious. This shocks me.
Chronic use of NSAIDs can cause stomach bleeding and ulcers. So the 81mg baby aspirin that is often recommended as we age in combination with a prescribed blood thinner innocently enough could cause GI complications. The numbers for annual deaths from NSAID-related overdose is 16,500, stemming from ulcers and stomach bleeding. Again, this is shocking.
How to Remain Safe
The Gut Check campaign encourages us to be more proactive in our health care decisions. Here are the recommendations:
- Do not exceed dosage just because you are taking an OTC medicine including supplements. Follow directions.
- Take products that contain either acetaminophen OR NSAIDs but not both at the same time
- Discuss your meds with your pharmacist or doctor
Although this is not an age sensitive topic it is important to note that as we age and OTC drug usage becomes more common, we may not manage drugs as well as we did in our earlier years. In fact there is research to suggest misuse or overuse of OTC meds becomes a significant problem for an aging demographic.
Just remember that taking OTC acetaminophens and NSAIDs together are dangerous for ANY and EVERYONE and can cause liver damage. Fifty percent of acute liver failure, according to Dr. Larson, is the result of accidental over dosage. Without being maudlin, do not let that be you or your love ones.
I am shocked that I feel so strongly about this. We have to know what exactly we are taking, what the recommended dosage is, and one pain med at a time. Gut Check:Know Your Medicine Campaign’s objective has definitely educated me on the importance of reading labels and staying within the recommended daily dose of combined medicines taken at the same time. For more information take a look at the resources here on their website.
Furthermore, labels, although annoying, are to be read even if they are “mice-print.” So please get out your magnifying glass and let’s start actually reading them. And if you feel this is an important message, please share with your family and friends at home or here online. Did you know there was real danger of overdose with OTC drugs?
PS. Here is one additional Gut Check:Know Your Medicine resource to share with your friends.
Debbie W. says
I appreciate this information. As a longtime migraine sufferer, I know how easy it could be to overdo the OTC medications. When you need relief you just don’t care about the consequences. I will certainly be more cautious from now on.
Patricia A Patton says
Hi Debbie I did not see your message until today. Indeed consider being more cautious. OTC culturally seem harmless but this information presents a totally different scenario, right. BTW love your site.
Nicole Brady says
I think too many people think that since it is over the counter that it is safe. Scary that there are so many issues that can arise!
Patricia A Patton says
Absolutely Nicole. I think I was sort of guilty as well.
diane says
This is such an important reminder, especially for people who suffer from chronic pain. It is so easy to just pop a few more advil without really thinking about what we are doing to our organs.
Patricia A Patton says
For as long as I can remember I have known people who carry advil or tylenol like they carry their cell phone. I presumed what was not used exited naturally. But there is the possibility of liver poisoning. Eckk.