15 over-the-counter drugs you use but can be dangerous

Most of the time, when they have a headache, colic, have a fever or muscle pain, for example, people go to a pharmacy in search of the so-called MIPs (Open Medicines). They are approved by health authorities and are intended to treat minor symptoms. The sale is possible without prescription or prescription.

However, this does not mean that they can be used always and anyway. They are medicines, and based on their peculiar characteristics, MIPs can also cause health problems, either through excessive or inappropriate use. Care should be even greater in the case of children, the elderly, pregnant women and people with any disease.

Priscila Vautier, pharmacist, Master in Pharmacy, professor in Pharmacy course and Director at the Union of Pharmacists in the State of São Paulo, comments that the non-prescription drugs most used by people are analgesics, anti-inflammatory drugs, muscle relaxants, antipyretics and antacids.

It is worth noting that MIPs, although considered low risk, can cause, in some cases, adverse reactions, intoxications and drug interactions. For example, if there is no correct orientation, the person can commit underdosing (which will not relieve the desired symptoms), or there can be an overdose, leading to intoxication. There is also the risk of using two drugs with the same active ingredient, which can also lead to intoxication; in addition to the possibility that the patient already consumes a drug of chronic use which, in turn, interacts with the drug present in the PIMs.

15 classes of drugs you shouldn’t take indiscriminately

In the topics below you can see the main risks of using certain groups of drugs, which seem harmless, but which, when used in an exaggerated or inappropriate way, can become dangerous.

1. Hormones and contraceptives

Priscila points out that misuse can lead to hormonal imbalance in the body. “And continued use can increase the risk of increased blood pressure, deep thrombosis (especially when associated with smoking) and migraines,” she says.

Amouni Mourad, technical advisor for the CRF-SP (Regional Council of Pharmacy), points out that several epidemiological studies demonstrate a clear association between the use of combined oral contraceptives and the increased risk of venous and arterial thrombosis.

2. Absorbents and intestinal antiphysetics (Simethicone)

Amouni comments that an example of this class of drugs is simethicone. “It is an antiphysetic silicone with antiflatulent action, which relieves gastric discomfort caused by excess gases.”

The technical advisor explains that simethicone is not absorbed by the body, and acts only within the digestive tract, being completely eliminated in the feces. “Although undesirable reactions are unlikely, the following are reported: contact eczema (inflammatory reaction that occurs due to skin contact with an irritating or allergic agent); and, in rare cases, immediate reactions such as hives (red rashes on the skin that are very itchy).

Luftal is also a well-known intestinal antiphysetic and is often used by patients with excess gas. It is worth noting that it relieves symptoms, but does not “solve the problem”. It does not usually cause side effects, but they can occur in rare cases: skin inflammation or skin allergy.

Priscila points out that the inappropriate use of this type of medication can, in some cases, lead to temporary constipation.

3. Analgesics and antipyretics (AAS, Dipyrone, Paracetamol)

Priscila explains that Paracetamol is a non-steroidal anti-inflammatory: “chronic use can lead to hepatotoxicity (liver damage caused by chemicals called hepatotoxins)”.

Amouni points out that, although Paracetamol can be used during pregnancy, the doctor should be consulted before that. “Also, it should not be given for more than 10 days for pain or for fever for more than 3 days,” she says.

AAS, as explained by Priscila, can cause gastric bleeding and is contraindicated in cases of dengue.

“Dipyrone, when used improperly, can cause hypothermia, skin reactions, inflammation of the kidney tissue”, highlights Priscila.

“When these drugs are taken together with alcohol, ulcers, gastrointestinal disorders and bleeding can occur”, adds pharmacist Priscila.

4. Antacids

Amouni comments that most antacids contain one or more of four main components: aluminum salts, magnesium salts, calcium carbonate and sodium bicarbonate.

“They can interact with many prescription drugs, so it is very important to consult a pharmacist about drug interactions before taking them. In addition, especially people with heart conditions, hypertension or kidney problems should consult their doctor before taking an antacid”, adds the technical advisor.

Priscila highlights as the main risks/problems of overuse or misuse of this type of medication: deficiency in the absorption of food and medication; constipation and diarrhea.

5. Antiallergic and antihistamines (Dexchloropheniramine, Loratadine)

Amouni comments that Dexchloropheniramine, Hydroxyzine, Promethazine and Cyproheptadine are the oldest and most well-known antiallergics, as they were the first to be used in the treatment of allergic diseases. “The most common and bothersome side effect is sedation. Drowsiness (or agitation), decreased concentration, memory and psychomotor coordination alterations, in addition to dry mouth, blurred vision, urine retention, increased appetite and weight gain may also occur. Even because of the possibility of these side effects, this type of medication should be avoided in drivers, pilots or in workers at risk of an accident”, he says.

Loratadine, Desloratadine, Cetirizine, Levocetirizine, Ebastine and Fexofenadine are the so-called “second generation” antiallergics, considered more modern. “They provide symptom relief with little sedation and minimal effects on psychomotor activity. In some cases, headache (headache) may occur, which is the most significant side effect,” says Amouni.

The pharmaceutical Priscila highlights as the main problems of the exaggerated or inappropriate use of antiallergic: drowsiness, thickening or thickening of the mucus.

6. Antiemetics (Metoclopramide)

It acts on common digestive functions such as nausea and vomiting. Priscila says that, in risk groups (elderly, children, diabetics), this type of medication has several adverse effects. “Abuse can cause anxiety and restlessness and sometimes drowsiness,” she adds.

According to information in the drug’s package insert, the most frequent adverse reactions are: restlessness, drowsiness, fatigue and lassitude/exhaustion (occurring in approximately 10% of patients). Less frequently: insomnia, headache, dizziness, nausea, galactorrhea, gynecomastia, skin rashes including hives or bowel disorders.

Also according to the drug leaflet, reactions such as restlessness, involuntary movements, slurred speech, etc. may be more frequent in children and young adults; while abnormal or disturbed movements are common in the elderly under prolonged treatment.

7. Antispasmodics (Buscopan)

Buscopan (N-butylscopolamine bromide) is an example of this type of medication. It is indicated for the treatment of symptoms of gastrointestinal colic, colic and abnormal involuntary movements of the bile ducts and colic of Organs sexual and urinary organs.

“Abuse can lead to dry mouth and drowsiness, blurred vision and tachycardia,” says Priscila.

“When associated with analgesics (Dipyrone, for example) it is necessary to be even more careful. High doses of scopolamine can cause delirium, mental confusion, paralysis, stupor and even death.

8. Antifungals and antimycotics

Antimycotics or antifungals are basically pharmaceuticals used to treat and/or prevent mycoses, such as “athlete’s foot”, dermatophytosis (superficial mycoses that occur in hair, nails and skin), candidiasis, systemic infections such as meningitis, etc.

Many of these drugs are available only by prescription, but some are available as over-the-counter drugs.

The inappropriate use of this type of medication, according to Priscila, can cause: resistance to treatment, redness and a burning sensation.

9. Anti-inflammatory and antirheumatic (Diclofenac, Nimesulide)

Diclofenacs, Nimesulide, Piroxicam, Tenoxicam are examples of drugs in the class.

Priscila explains that, with exaggerated/inadequate use, the patient may have: stomach pain, heartburn, nausea, vomiting, development of ulcers that will cause bleeding or perforation (stomach and duodenum), liver problems (drug cirrhosis), nephritis (compromised kidney disease), anemia and heart problems.

10. Antiulcers (Omeprazole)

It is indicated to treat reflux esophagitis, gastritis, gastric ulcer and duodenal ulcer, in addition to functioning as a “gastric protector” for those who are going to use drugs that “hurt” the stomach.

Although Omeprazole is a prescription drug, many people are able to buy it without a prescription. But, it is worth reinforcing: the exaggerated and inappropriate use can cause health problems.

“Abuse can mask other diseases such as stomach cancer, liver and gallbladder problems. It can inhibit the absorption of some vitamins and minerals, which can cause effects such as cramps and heart problems”, explains pharmacist Priscila.

11. Expectorants (Syrups)

This is a type of medication widely used when the person has a lot of coughing with phlegm.

The expectorant acts, in short, to increase the amount of phlegm and reduce the viscosity of secretions, promoting the consequent removal of the airways.

Amouni says an example of an expectorant is bromhexine hydrochloride, which is generally well tolerated. “However, diarrhea, nausea, vomiting and other mild gastrointestinal manifestations may be observed. Allergic reactions have also been reported, including rashes, hives, bronchospasm, angioedema and anaphylaxis,” he says.

Priscila highlights gastrointestinal disorders (nausea, vomiting) as the main problems of inappropriate use of expectorants.

12. Muscle relaxants (Carisoprodol)

An example of a muscle relaxant, according to Amouni, is Carisoprodol. “The muscle relaxant produces muscle relaxation and also sedation as the most common reactions (they occur in at least 10% of patients). There may also be a drop in blood pressure, drowsiness and dizziness,” he says.

Priscila points out that the abuse of relaxants, such as Carisoprodol, “can lead to dependence and tolerance, developing mental confusion, anxiety, lack of coordination and balance”.

It is also worth noting that, if used simultaneously with alcohol or another central nervous system depressant, it can cause more serious problems,…