Colds. Fevers. Headaches. Muscle pain. Stomach discomfort. Sleeplessness.

Any of these conditions may have you reaching for an over-the-counter medication. The Consumer Healthcare Products Association says 81% of adults turn to OTCs for initial treatment of minor illnesses.

Although these medications are available without a prescription, they shouldn’t be treated – or used – casually.

“Anything that’s going to be over the counter, you have to follow exactly what the guidelines are on the label,” said Sophia De Monte, a Nesconset, NY-based pharmacist and spokesperson for the American Pharmacists Association. “If it tells you to take one to two tablets in whatever amount of time, you have to follow the guidelines and not go over that. Follow the directions.”

Hazards of overuse

You may know someone who, for example, takes more than two ibuprofen tablets at a time. But what can happen when people take too much of an OTC medication?

“There are lots of things to watch out for,” said Shonna Yin, an associate professor of pediatrics and population health at New York University. She offered examples of common active ingredients in OTC medications – and the side effects that could result from taking more than the recommended dosage:
Acetaminophen (analgesic for aches and pains): Stomach pain, loss of appetite, weakness, irritability, nausea, vomiting and diarrhea. Severe overdose can trigger seizures and comas.
Dextromethorphan (cough suppressant): Dizziness, unsteadiness, accelerated heartbeat, skin flushing and rash.
Diphenhydramine (antihistamine for allergies and colds): Drowsiness, sleepiness, confusion, agitation, hallucinations, tremors, seizures, unsteadiness, nausea and vomiting.
Ibuprofen (nonsteroidal anti-inflammatory for pain, fever and inflammation): Abdominal pain, nausea, vomiting, confusion, drowsiness, headache, unsteadiness, and decreased urine production or related issues affecting kidney function.

Dosage do’s and don’ts

Dosing charts usually are included on the Drug Facts label, Yin said. Dosage instructions include when, how much and how often to take the medication. Although 1 teaspoon equals 5 milliliters, don’t use a spoon from your kitchen drawer to measure – it may not be accurate. Instead, use a tool with milliliter measurements marked and that’s appropriately scaled for the dosage.

“If you have a large tool with a small dose, that’s a recipe for error,” Yin said.

Because many dosages are determined by a person’s weight, she urges users to be aware of that number, pointing out that it’s frequently overlooked.

Mixing medications

Simultaneous use of multiple OTC medicines can trigger an overdose, the staff at Ocean Breeze Recovery, an addiction rehabilitation center in Pompano Beach, FL, cautions.

For example, inadvertently mixing antihistamines with cold medicine could trigger excessive sedative effects. Similarly, taking two OTC medications that both contain acetaminophen could put you over the recommended dosage. It’s important to take only one medicine with the same active ingredient at a time.

Users can find a medication’s active ingredient(s) on the Drug Facts label on the packaging. Other information on the Drug Facts label includes the amount of active ingredient(s) in each dosage unit, purpose and uses of the product, specific warnings, and the product’s inactive ingredients.

Ocean Breeze Recovery also warns against mixing medications – including OTC meds – with alcohol or other drugs, saying it “can and often will” lead to an overdose.

If you have questions, answers can be found at your local pharmacy counter. “Don’t be afraid to ask the pharmacist,” De Monte said. “Because we’re there. We’re willing to help [you] sort through everything.”