Khaberni - Many believe that over-the-counter medications are inherently safe because they have become easy to obtain in pharmacies and stores.
However, the reality is more complex; some of these drugs may cause addiction, misuse, or health damage, especially when taken in higher doses than recommended, for longer periods, or for incorrect purposes.
Below are 5 types of common medications that require caution and awareness when using them:
1. Pain relievers containing "codeine"
Codeine is known as an opioid drug used to treat mild to moderate pain and is also used in some cough medicines. It is often sold mixed with ibuprofen or paracetamol. After ingestion, the body converts codeine to morphine, which is responsible for its pain-relieving effect.
Common side effects include drowsiness, nausea, constipation, and dizziness, while high doses can lead to slow breathing and poor motor coordination. Some individuals, particularly those with ultra-rapid metabolism, convert codeine to morphine faster, increasing the risk of complications even at normal doses.
With repeated use, the body develops tolerance to the drug, reducing its effectiveness and increasing the need for higher doses, increasing the risk of physical dependence. Sudden discontinuation may lead to withdrawal symptoms such as anxiety, insomnia, and sweating. Therefore, it is advised to use codeine for the shortest possible duration, adhering to the product's maximum specified duration for over-the-counter use, which usually does not exceed three days.
2. Decongestants
Decongestants are available in the form of pills containing "pseudoephedrine," or as nasal sprays and drops such as "xylometazoline" and "oxymetazoline." All of them work by constricting blood vessels in the nose to reduce swelling and mucus.
Some sedative antihistamines, such as "promethazine" and "diphenhydramine," are sold as short-term sleep aids. Recent studies have shown a link to increased health risks, prompting calls for review of their dispensing methods.
Promethazine may quickly lead to bodily tolerance, requiring the user to take higher doses to achieve the same effect, and may cause rebound insomnia upon discontinuation after prolonged use. It is sometimes misused for recreational purposes in what is known as "purple drank," a mixture of cough syrup and soft drinks, which can cause severe sedation, slow breathing, and serious health complications.
4. Cough syrup
Dextromethorphan (DXM) is a common cough suppressant, and reviews have shown it to be one of the most misused over-the-counter drugs. When taken in high doses, it inhibits NMDA receptors in the brain, potentially resulting in dissociative effects similar to ketamine (a drug medically used as an anesthetic and pain reliever). Although it is safe when adhering to recommended doses, its psychological effects raise concerns about its misuse.
5. Laxatives
Stimulant laxatives work by moving the muscles of the intestines to facilitate bowel movements, and they are often misused by individuals with eating disorders, athletes who need to maintain a specific weight, or those who believe daily bowel movements are a health necessity. In reality, constipation is typically defined as having fewer than three bowel movements a week.
Abuse of laxatives can cause dehydration and long-term intestinal damage, with severe complications for the heart and kidneys in extreme cases.
The report was prepared by Deepa Kamdar, Senior Lecturer in Pharmacy Practice, Kingston University.
