I am participating in a sponsored campaign for the BOOMbox Network on behalf of the American Gastroenterology Association. I received compensation for this post. All opinions are my own.
I call myself a Headache Person. Not the way that I’d really like to see myself, but true nonetheless. I have been suffering from migraines since I was 10 years old. They used to keep me out of school (and get me out of piano lessons, the only upside), a couple days a month. I used both prescription and over-the-counter medications to control my pain, probably at a level that would shock most parents today.
Fast forward 40 (or so) years. I still get the migraines occasionally. Not only that, my system expresses stress and tension in the form of headaches, so I actually have a headache almost daily. Fortunately, most are minor and can be controlled with over-the-counter medication. I will pop a couple acetaminophen tablets and my headache will usually subside.
As for the migraines, well, you can’t always tell if a headache is going to be a migraine or just a “normal” headache, so my tendency is to start with acetaminophen to see if it works. Insurance allows for only so much prescription medication per month after all, so one doesn’t want to “waste” them on a minor headache.
While I always knew that all that OTC medication probably wasn’t good for me, it was until listening to Dr. Anne Larson of the American Gastroenterology Association that I learned just how bad it could be.
Acetaminophen is the most commonly used over-the-counter medication, usually used to reduce fever and relieve minor aches and pains. I was surprised to learn though, that acetaminophen is found in over 500 prescription and over-the-counter medications! You probably know that it is in brand name medications like Tylenol® for pain, and a variety of cold and flu medications like Nyquil®, but it can also be found in prescription medications like Percocet® and Vicodin®.
That can mean if you are taking Tylenol® for a headache, then taking a recommended dose of a cold medicine, you may be doubling your dose of acetaminophen without even realizing it. This demonstrates the importance of label reading. It is vital to know what is in every medication that you take, prescription or over-the-counter.
The maximum dosage for acetaminophen is 4,000 mg a day. Depending on the form that it comes in, the dosage may be written differently from product to product. It may be written as the total pill amount, or times per day, so careful reading is a must. Regardless of how it is written, the maximum per day is still 4,000 mg. What is scary is that one overdose can cause permanent liver or stomach damage. Every year there are 26,000 hospitalizations and 458 deaths from aceaminophen-related overdoses.
There are also risks to using NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs are commonly used to treat conditions where pain and inflammation are present. They are found in such over-the-counter medications as Advil®, Aleve®, and aspirin. In fact, NSAIDs are found in more that 550 prescription and over-the-counter medications! So if you were taking aspirin for muscle pain, then took a couple Advil® to relieve a headache, you could suffer GI issues from using too many NSAIDs.
It can be more complicated to estimate the maximum dose because different NSAIDs have a variety of recommended doses. The wisest choice is to read labels and to take only one product at a time that contains NSAIDs. Taking too many can cause gastrointestinal issues including stomach bleeding and ulcers. It is estimated that every year 100,000 people are hospitalized and 16,500 die from NSAID overdose.
There are other precautions to use when taking NSAIDs. Using them in conjunction with blood thinners, low-dose aspirin, or diuretics can also cause complications. Read labels and talk to your doctor and/or pharmacist.
Here are some common misconceptions and barriers to safe drug use according to the AGA:
- While many people understand that misuse of over-the-counter medications can be bad, most don’t realize the serious potential consequences to overuse.
- Many people think that because these medications are so easily available that they don’t carry the same risks as prescription medications, but that is just not true.
- The main reason people intentionally exceed the recommended dosage is because they want instant relief from pain.
This information has been an eye-opener for me. I am taking it to heart, and in the future I will follow these guidelines (and I hope you will too):
- Read and follow ALL of your medicine labels, both prescription and over-the-counter, and do not exceed recommended dosages.
- Only take one product at a time that contains either acetaminophen or an NSAID.
- Talk with your doctor or pharmacist about your medicine use and other options that can help manage your pain.
Through this Gut Check campaign, the AGA is striving to increase awareness and empower individuals to be more active in their health care decisions. For more information check out the AGA website, Gut Check: Know Your Medications.
I NEVER EVER EVER take over the counter products. EVER. I don’t get headaches or pains very often, and when I do, I just ride it out. If I complain, people say, take some aleve or other pain medication, but I push it aside and tell myself to just stop complaining, because the pain will subside!
I’m so jealous that you get headaches that you can ride out. When I get one all I can think about is relief. And they are really the only thing I take pain medications for. Otherwise, I pretty much grin and bear it.
Im much more focused on these types of risks with my daughter and her friends always running around the house investigating my stuff (!).
Yes. So important to keep this stuff locked away when you have young children. Plus to be careful if you need to give them medications for a fever or cough.
Good to know, thanks for sharing all this important info. My dad has chronic ringing in ears and some hearing loss related to too much Ibuprophen
Thanks for sharing that. I think sometimes people think a little stomach ache is the only downside to using ibuprofen.
This is such an interesting read Debbie, and so very important! I actually made a HUGE mistake in the week before my marathon in the fall. I usually do not take any kind of painkillers unless I absolutely have to. I did used to suffer from migraines in the past, which were miserable, but I tried to avoid the medication as much as possible.
However, I desperately was trying to get rid of my muscle strain in the week leading to my marathon and was taking OVER the recommended daily max in the week before. Luckily, I stopped taking them the day before the race (or my doctor said my kidneys probably would have failed in the state I put myself into during that race). I know that was such a stupid move, but I have been scared off them since. So dangerous, and we do not even know the long term effects yet. This was a very insightful read, thank you!
I’m glad that everything turned out okay for you. I think that athletes are at extra risk because they are frequently injured or in pain, but still expected to perform at a high level.
Between my TMJ pain and marathon training last Fall I was taking up to 12-15 advil a day. Unsurprisingly I ended up going to a gastroenterelogist to try and find out what was causing my severe GI issues. Stopped taking advil and all the symptoms went away. I think I’ve taken it twice since then!
The need for pain relief is one of the main reasons that people take too much medication even when they know that they shouldn’t. I’m glad that you got it figured out.
Wow! Excellent information. I do read labels very carefully and try not to mix meds, but now I will be even more careful. Great post.
Good for you. Reading the labels is so important. Not realizing that we are getting the same medication in two different drugs can be very dangerous.
great info!!! i try not to take otc meds unless i HAVE to!
Very good article! My doctor has now been asking more about otc meds and informing me of what can and cannot be combined. Some I had been combining and now it scares me.
I am always happy to hear when doctors proactively question their patients about things like this. Too often it seems like they react after the fact.
Unfortunately, I am a headache person too. They seem to stick around for DAYS sometimes and the temptation to take more and more advil is strong. Thanks for raising awareness of the dangers of OTC meds!
It is hard to stop taking more medication when it doesn’t seem to be working. I totally understand that and also that, aside from the overdose risk, that more probably won’t make a difference anyway.
I think it is super important for people to realize that ALL medicines carry risks. Whether it’s prescribed, OTC or even an herbal remedy. Great information here!
Good point about the herbal remedies. Lots of people think that herbal and natural means safe, with definitely is not true.
This is great information. I know many of the medications chemical makeup since I was studying nursing for awhile but not everyone knows and that is what can be scary. This is so great to get the word out for everyone and hopefully keep them and their families safe.
I rarely take any pain medications for my aches and pains anymore. I would rather ride it out and have turned to alternatives such as yoga. That is making a big difference with the tension headaches. On a side note, when I went to the chiropractor years ago for my hips being out of alignment she checked my whole body and asked if I had headaches. Yes, every day. She said no wonder since my neck was out of alignment too. She adjusted me and not headaches are not a daily thing for me.
Thanks for the suggestion. I just went to a chiropractor a couple days ago since I’ve been having a few extra headaches since my car accident. He did adjust my neck. It would be so wonderful if that was what it took to relieve the daily headaches.
Such important info Debbie!!!! Thank you! I rarely take stuff unless I am beyond now that the monthly is gone.. but I am careful! 🙂
You Can NEVER Be Too Cautious Thank You For All The Valuable Information!!
We very rarely do any OTC meds. We rarely use prescription meds either. Pretty med free here thankfully with our home remedies, herbs, oils, and such. As an RN I know too many cases where people got illnesses from too much of a med.
That’s good. Knowledge is power 🙂
I have horrible allergies and sinus problems, so I take my fair share of OTC meds. But I always stick to the recommended dosage. Thanks for getting this info out there!
That is smart. But even the recommended dosage can get you into trouble if you take two different medications that have some of the same medicines in them.
EEK, I read this just as I swallowed 600 mg. of Motrin. I have chronic injuries that often lead me to take Motrin in waves, a herniated disc is no fun, and I’d much rather take Motrin over a pain killer, but reading this makes me want to take the Gigi method and grin and bare it. I wonder if an influx of Ibuprofen could irritate my IBS… great post!
Just make sure that you stick with the recommended dose and don’t take other medications that contain NSAIDs. These medications aren’t the devil and sometimes they are really needed. NSAIDs in particular because they can help reduce inflammation in addition to the pain relief.
I always worry about this – I take Excedrine Migraine daily (and sometimes more than once a day) – I have told my DR this every year at my physical and she never seems concerned. This year (just a month ago), she finally said that I really need to wean myself off – I have tried and it’s not going well – so I’m still taking it daily!!
Maybe I should start drinking coffee!!
The problem with daily OTC pain medicine use is the bounce back effect it can have. It can turn into a vicious circle. I’m certainly not an expert about that, but it sounds like you should listen to your doctor.
Great job pulling all of this important information together, Debbie, and you did a beautiful job pulling the charts and pictures together. This really is such important information to get out there.
I used to be very loosey-goosey about taking OTC pain relief, but after learning the dangers I changed my attitude toward taking them. Now I only use them when absolutely necessary. Luckily, I don’t suffer from the headaches you get, but sometimes my sciatic pain rears its ugly head when I have to drive a long distance and then I have no choice but to take something.
Sometimes it is just necessary to take some OTC medication. As long as we’re aware how much and what we’re combining it with.
I hear you on the long drive thing. I remember driving to San Francisco a few years back and I basically sat on a tennis ball the whole drive because that gave me some relief 🙂
My headaches are always triggered by something like caffeine or exercise. I try not to take too many over-the-counter medications. Thanks for sharing!