OTC Medications

Say he came into the outpatient pharmacy asking about over-the-counter medications that he could use for pain, are there any options that would be safe for him?

Nicole Metzger and her team of pharmacy residents are examining the medical charts of patients admitted to Emory University Hospital… searching for possible drug interactions. The first patient has liver disease:

Are there any options that would be safe for him?

No, there wouldn't be much options for him because of his liver function.

Pain relievers such as acetaminophen – or those combined with acetaminophen – can cause liver damage if patients exceed the maximum daily dose.

And if you mix in three or more alcoholic drinks a day:

It can interact to change the metabolism. The absorption or distribution of a particular medication.

Right now the patient does have some high blood pressure

High blood pressure medications are another class of prescription drugs that don't mix well with some over the counter pain relievers:

So we want to watch out for things like NSAIDs….

NSAIDs stand for non steroidal anti-inflammatory drugs…

The common ones are naproxen sodium, ibuprofen…Those are the ones people commonly use or aspirin. Those actually raise you blood pressure and so if your blood pressure is not well controlled you can actually have some complications as a result of increasing the blood pressure.

NSAIDs can also lead to stomach bleeding.

Lauren, this patient was admitted and she basically has metastatic cancer and she is on a blood thinner called Warfarin.

Because of the bleeding risk, I am going to make sure she takes acetaminophen.

Warfarin is unfortunately a medication that has a whole host of drug interactions.

Something book seller Linda Bryant discovered when she was prescribed Warfarin several weeks ago to treat her atrial fibrillation.

I talked to the triage nurse this morning at the doctor's office and she said to talk to my pharmacist.

I have your prescription and I want to go over a couple of things with you.

Pharmacist Ira Katz uses a computerized, drug interaction tool to help patients flag potentially dangerous drug interactions.

Do not take these medications together.

Linda also discovered she had to stop using the NSAID, naproxen sodium for her arthritis pain: Since it can increase the risk of stomach bleeding when combined with Warfarin.

I can take a little bit of acetaminophen, not every day but as needed when I’m really struggling and having a bad day with it, I can take a little bit with that.

Over-the-counter medications, though they are safe when people use them as directed, they can still interact even at safe doses with medications that are prescription products.

That's why it's important for your doctor or pharmacist to know all the medications, herbs and supplements you may be taking. For WebMD, I’m Rhonda Rowland.