Read the Drug Facts panel
Every over-the-counter medicine carries a standardized Drug Facts label on the back. The first line lists the active ingredient and the amount in each dose, and the rest gives the uses, the warnings, the directions and the daily maximum. Treat that maximum as a ceiling and not a target. The store brand beside the name brand contains the same active ingredient at the same strength and usually costs far less.
The three pain relievers
Almost every pain and fever product is one of three drugs.
- Acetaminophen reduces pain and fever and is gentle on the stomach, but too much damages the liver, and the risk climbs if you drink heavily.
- Ibuprofen and naproxen are anti-inflammatory drugs that suit sprains, cramps and dental pain, but they can irritate the stomach, strain the kidneys and raise blood pressure, so take them with food.
- Aspirin is now used mainly for heart protection under a doctor's direction, and it should never be given to children or teenagers with a viral illness because of the risk of Reye's syndrome.
Multi-symptom cold and flu products often contain acetaminophen alongside a cough suppressant and a decongestant. Taking one with a separate pain reliever is how people exceed the daily limit unknowingly.
Allergy and cold medicines
Older antihistamines, such as diphenhydramine, work well and cause real drowsiness. Newer ones, such as loratadine, cetirizine and fexofenadine, last all day and sedate far less. Among decongestants, pseudoephedrine is effective and is kept behind the pharmacy counter, where you show identification to buy it. An FDA advisory panel concluded in 2023 that phenylephrine taken by mouth does not relieve congestion. Decongestant nasal sprays work within minutes, but using one for more than three days in a row causes rebound congestion that is worse than the original.
When to ask first
Talk to a pharmacist or doctor before taking anything new if you are pregnant or nursing, take a blood thinner, or have high blood pressure, kidney disease, liver disease or a history of stomach ulcers. Children's doses go by weight, so use the children's product and the measuring device packed with it, never a kitchen spoon. If someone has taken too much of anything, call Poison Control at 1-800-222-1222, and call 911 if the person collapses, has a seizure or struggles to breathe.
Note An expiration date is the last day the maker guarantees full strength. Replace expired medicine, and be strictest about liquids and anything you would rely on in an emergency.
