Over-the-Counter Drugs: Safe?


Almost all OTC medications were at one time prescription drugs and have inherent risks of adverse reactions like any prescription.

How many consumers realize that almost all over-the-counter drugs were at one time prescription medications? “Don't ever think that because they are now available to purchase from your local drugstore they are completely safe,” advises medical expert, Dr. Ray Strand, M.D., in his book, Death by Prescription: The Shocking Truth Behind an Overmedicated Nation. “We must have the same respect for over-the-counter drugs as we do prescription drugs.”

“Drug safety means finding the right balance,” weighing a drug's risk against a drug's benefit.

—William Comanor, PhD, director of the UCLA program on pharmaceutical economics and policy, professor of health services at UCLA, and professor of economics at University of California at Santa Barbara.

ABOVE: DeNoon, D. “Are U.S. Drugs Safe? A review of 2004's Drug Controversies,” WebMD, Jan. 1, 2005:,2933,143035,00.html.

CASE 1: Over-the-counter medications cause an estimated 16,000 deaths per year, according to a report published in American Family Physician.

CASE 2: There are growing reports of deaths, convulsions, rapid heart rates and some loss of consciousness associated with pediatric cold medicines--and there is no evidence they provide any relief to children suffering from colds, according to an article published in the New York Times.

CASE 3: Ibuprofen, the popular over-the-counter painkiller found in Advil and Motrin, may increase the risk of heart problems in patients with osteoarthritis who take daily aspirin to help lower their cardiovascular risk, according to a study published in the Annals of the Rheumatic Diseases.

Ways Minimize Your Risk

Dr. Strand's book recommends the following to minimize your risk of developing serious adverse reactions to over-the-counter drugs.

  • Remember that over-the-counter medications are drugs and have inherent risks of adverse drug reactions like any prescription medication.
  • Be aware of the “active ingredients” contained in each of the over-the-counter drugs you are taking. The box or container of your medication plainly notes these ingredients.
  • Read the directions carefully for exactly how and how much you should take of your medication, especially if it is in liquid form.
  • Read all the information that appears on the OTC label and package insert.
  • Become familiar with medical conditions that are contraindicated (medical situations where this drug should not be taken) when taking each medication. For example, there are over-the-counter drugs that should not be taken if you suffer from illnesses such as hypertension, glaucoma, heart disease, or ulcer disease. You need to avoid these medications, and consult your physician.
  • Inform your physician of any over-the-counter medications you may be taking on a routine basis.
  • Know which drugs may interact with your particular over-the-counter medication.
  • Consult your pharmacist anytime you have questions about what you might need to take.
  • If your symptoms do not improve within a few days, make an appointment to see your personal physician. After all, you have been self-diagnosing and self-medicating; there is a possibility you made the wrong diagnosis and are taking the wrong kind of medication.
ABOVE: Strand, R.D. Death by Prescription: The Shocking Truth Behind an Overmedicated Nation. Nashville: Thomas Nelson Publishers, 2003.
  • Strand, R.D. Death by Prescription: The Shocking Truth Behind an Overmedicated Nation. Nashville: Thomas Nelson Publishers, 2003.
  • Kirchner, J. “Improper dosing of over the counter medications given by caregivers,” American Family Physician, Feb. 1, 1998; as cited in the above.
  • Harris, G. “Renewed warning on cold medicines,” New York Times, Jan. 18, 2008:
  • “Ibuprofen May Boost Aspirin Users' Heart Risk,” Forbes, HealthDay News, Apr. 4, 2007.
  • Simon, H.K, et al. “Over-the-counter medications. Do parents give what they intend to give?” Arch Pediatr Adolesc Med, Jul;151(7):654-6, 1997.
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