The Most Misused Over-the-Counter Drugs

Every year hundreds of thousands of people are rushed to the emergency room after misusing over-the-counter drugs. Dr. Oz counts down the top 5 OTC medications that you need to exercise caution with when taking.

The Most Misused Over-the-Counter Drugs

Every year 200,000 Americans land up in the hospital because they use over-the-counter (OTC) drugs incorrectly. Many people assume that OTC drugs are completely safe since they don’t require a prescription. But this is dangerous thinking.

The main danger with OTC drugs lies with users neglecting to thoroughly read labels. Second, people don’t take the time to consult with their pharmacist to make sure they’ve chosen the right drug. Lastly, these medications can affect women and men very differently – mainly because of weight differences – but dosing directions usually only distinguish between adults and children, posing yet another danger.

Practice over-the-counter drug safety by remembering this simple acronym: O-T-C.

  • Obey directions by reading drug labels.
  • Talk to your pharmacist – it’s a free consultation with an expert.
  • Choose the lowest dose first.For example, if the suggested dose is 1-2 tablets, take 1 pill first and see how you feel before upping the dose.

The Top 5 Misused Over-the-Counter Drugs


5. Multi-symptom Cold and Flu Medications

Over 700 OTC multi-symptom cold and flu remedies exist in the marketplace. The biggest misuse issue involves medications containing multiple drug ingredients that target a host of symptoms – including some you might not have. Excess medication can cause unwanted side effects and potentially dangerous drug interactions. For example if you have a cold and you only have 1 symptom, such as nasal congestion, there’s no reason to take a product that also treats cough, headache, body aches, etc. For congestion, take a decongestant with an ingredient such as phenylephrine, which solely treats that symptom.


Safety Rule

When taking a multi-symptom cold or flu medication, make sure you have at least 3/4 of the symptoms it’s treating. Otherwise choose a single-ingredient medication to avoid putting excess chemicals in your body.

4. Acetaminophen

To relieve pain from ailments ranging from headaches to menstrual cramps, many people reach for the OTC drug acetaminophen, most widely known as Tylenol, but now found in many other cough and cold medications. Acetaminophen misuse is the leading cause of acute liver failure. Symptoms of liver failure include abdominal pain, nausea, vomiting and jaundice.

The overuse of acetaminophen can also worsen headaches, a side effect known as rebound syndrome. Women especially need to take note of this danger since they suffer from headaches more frequently than men do. Click here to learn more about rebound headaches.

Safety Rule

Never take more than 8 tablets (4,000 mg) of acetaminophen a day.

3. Proton Pump Inhibitors (PPIs)

Approximately 15 million Americans suffer from heartburn every single day. To get relief, many take OTC drugs called proton pump inhibitors, or PPIS, like Prilosec and Prevacid that work by shutting down stomach-acid production. Frequent PPI use has been shown to form some sort of drug dependency in as little as a few weeks. Also the low-acid environment created by PPIs decreases absorption of calcium, which increases fracture risk (especially in women) and is also linked to vitamin B12 deficiency, which can cause nerve damage.

Safety rule

Use proton pump inhibitors for no longer than 4 weeks. As a safe, well-tolerated alternative, try an antacid, but don’t for more than 2 weeks without consulting a doctor.

2. Antihistamines

Millions of Americans experience the sniffles, sneezing, itching, coughing, watery eyes and scratchy throats associated with allergies. OTC antihistamines with certain ingredients, such as diphenhydramine, cause drowsiness. They should only be taken at night – not during the day – when you need to be most alert, particularly while driving.

Safety rule

Take most antihistamines, especially those containing diphenhydramine, only at night. If your main symptom is congestion, try a decongestant instead to avoid drowsiness.

1. NSAIDs (Non-steroidal Anti-inflammatory Drugs)

The #1 most misused drugs in America are non-steroidal, anti-inflammatory pain relievers, or NSAIDS (Advil, Aleve, Motrin). Too often people use NSAIDs for longer than needed at too high a dosage, which can thin stomach lining and cause ulcers. In fact, NSAID use is the second most common cause of ulcers after H.pylori infection. Misuse can also lead to rebound headaches, kidney problems and increased risk of heart and stroke.


Safety rule

To avoid gastrointestinal problems, always take NSAIDs with food. (A glass of milk provides a quick way to avoid an upset stomach.) Never take NSAIDs for more than 10 days without talking with your doctor. 

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