Don't Plug & Play with Pills

A few weeks ago we ordered a bookshelf and tried to assemble it. Our crew of two was divided on the proper way to proceed.

One of us thinks that such tasks should be intuitive and you should just dive in and do it. The other one likes to sit down with the instructions and read them cover-to-cover before beginning.

Unfortunately, the impatient one (Joe) wouldn’t wait for the methodical one to finish reading. As a result, the bookshelf, while assembled, is not quite right. Some pieces got put in upside down and backwards. Because it could not be disassembled again, we will live with this mistake.

Too many Americans use Joe’s plug-and-play approach. They don’t want to spend time reading manuals or instructions. That may be fine when it comes to microwave ovens, TVs or computers, but this approach could lead to disaster when applied to over-the-counter medicines.

Most consumers assume that if you can buy a drug without a prescription it must be perfectly safe. After all, if you needed a medical degree to use it properly, it couldn’t be sold OTC, could it?

The National Consumers League (NCL) discovered just how widespread this attitude is when it polled people about their use of nonprescription pain relievers such as ibuprofen and naproxen. These non-steroidal anti-inflammatory drugs (NSAIDs) were once popular prescription pills (Motrin and Naprosyn), but Advil and Aleve have been available over the counter for years.

Researchers report that more than 80 percent of the people responding to the NCL survey had taken OTC ibuprofen or naproxen in the past year (Journal of Rheumatology, Nov. 2005). Half of them were not worried about any potential side effects.

Maybe that’s because fewer than one in five of the people taking one of these pain relievers actually bothered to read the whole label. Less than a third read the dosing instructions, which may account for why almost half took more than the recommended dose.

If such drugs were benign, this might not pose a problem. But NSAIDs have a long list of potential side effects. They can cause serious heartburn or even bleeding ulcers. Such drugs may raise blood pressure, contribute to heart attacks or strokes and put people at risk of kidney disease. Other possible reactions include dizziness, ringing in the ears, fluid retention, rash or breathing difficulties.

Experts estimate that more than 100,000 people are hospitalized each year because of NSAID-related ulcers and other adverse effects. Over 15,000 die. Some of those deaths may be caused by the use of seemingly safe OTC pain relievers.

Drug interactions are another huge concern with nonprescription drugs. NSAIDs can interact with dozens of prescription medications to cause more serious complications. Even if you wanted to find out about possible incompatibilities, there’s not enough room on the OTC label to list every risky combination.

NSAIDs are not the only nonprescription drugs that have potential side effects. Almost every medication may cause adverse reactions in some people. To avoid becoming a statistic, take a few moments to read the label before you pop that pill. And if you are taking other medicine, check with your doctor or pharmacist to avoid dangerous interactions.