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Over-the-Counter Drugs: Follow the Instructions

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Laxatives | Sleeping Pills | NSAIDs | How Much is Too Much? | Acetaminophen

Many people think over-the-counter (OTC) drugs are harmless, but they can be harmful if misused. Read on to learn about some common examples.


Stimulant-type laxatives are among the most misused OTC medicines. Their active ingredients work by irritating the lining of the intestine. They are often misused by people trying to lose weight, but the people most affected by laxative misuse may be the elderly in nursing homes.

People who take laxatives too often to prevent constipation may becomes dependent on them in order to have a normal bowel movement.

A different form of laxative overuse, intake to the point of diarrhea, may lead to the following complications:

  • Malnutrition occurs if your body cannot absorb certain nutrients before they leave your body.
  • Dehydration worsens your constipation.
  • Sodium and potassium deficiencies can affect a wide range of body systems, including the heart and nervous system.
  • Calcium depletion can contribute to an increased risk for fractures.

Sleeping Pills

Most OTC sleep aids contain antihistamines to cause drowsiness. Often, they lose effectiveness over time, which prompts people to take more than the recommended dose. Some people develop a psychological dependence.

Next-day drowsiness is a common problem with OTC sleep aids, even when taken as directed. Many people feel drowsy for longer than eight hours after taking them.. Overuse of OTC sleep aids can also cause the following symptoms:

  • Dizziness
  • Disturbed coordination
  • Abdominal pain
  • Thickening of bronchial secretions

People with glaucoma, respiratory conditions, or difficulty urinating should talk to their doctor before using products containing an antihistamine.


Taking OTC pain relievers can be harmful if you take too many for too long. Commonly used nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin , ibuprofen (Advil), and naproxen (Aleve), when used too often for too long, can cause the following:

  • Ulcers, which may bleed
  • Kidney damage
  • Liver damage

NSAIDs may also increase the risk of having a heart attacks or stroke. This risk may increase with longer use.

How Much is Too Much?

To be safe, carefully follow the package directions or your doctor's recommendations when taking NSAIDs. Taking too much of these medicines can increase your risk of adverse effects, especially if you are older.


Acetaminophen (Tylenol), a widely used pain reliever, may cause liver damage if used improperly.

As with NSAIDs, do not to take more than the recommended dose on the acetaminophen label. Also, do not take this medicine for more days than recommended. It is important to keep in mind that taking more than the recommended dose will not result in added relief. And remember that acetaminophen and NSAIDs are in many OTC cough and cold remedies. Also, acetaminophen is in some prescription pain medicines like percocet and vicodin. So watch to make sure that you are not getting extra amounts of acetaminophen from other sources.

Talk to your doctor before using acetaminophen or NSAIDs if you have liver disease, are on warfarin therapy, drink more than three alcoholic beverages per day, or are taking other OTC or prescription medicines. To learn more, read Acetaminophen: Are You Taking Too Much?

Over-the-counter drugs are generally safe, but if you ignore the package directions or your doctor's recommendations, there can be dangerous consequences.


American Academy of Family Physicians


US Food and Drug Administration



Acetaminophen. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 20, 2012. Accessed July 22, 2012.

Health hints: use caution with pain relievers. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm133428.htm. Updated April 27, 2012. Accessed July 22, 2012.

Laxative abuse. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 13, 2010. Accessed July 22, 2012.

Naproxen. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2012. Accessed August 1, 2012.

Pain Relievers: Understanding Your OTC Options. American Academy of Family Physicians. FamilyDoctor.org website. Available at: http://familydoctor.org/online/famdocen/home/otc-center/otc-medicines/862.html. Updated February 2012. Accessed July 22, 2012.

Side effects of sleep drugs. US Food and Drug Administration website. Available at: http://www.fda.gov/forconsumers/consumerupdates/ucm107757.htm. Accessed July 22, 2012.

Stahl R. Acetaminophen: are you taking too much? EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated August 19, 2011. Accessed July 22, 2012.

Use caution with pain relievers. Food and Drug Administration website. Available at: http://www.fda.gov/fdac/features/2003/103_pain.html. Updated April 27, 2012. Accessed July 22, 2012.

Last reviewed July 2012 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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