Double-edged sword

Some over-the-counter medications are “potent, powerful and perilous”

Partner MD

If we can grab a medication right off of the shelf while grocery shopping, that means the product is safe, right?

Dr. Jim Burford, a physician at PartnerMD, says that’s a popular misconception that he hears from patients. “It used to be that anything you could get over the counter was harmless,” he says. “The opposite is true now. You can buy a lot of medications over the counter that are potent, powerful and perilous.”

He suggests a conversation with a physician who has the time and motivation to discuss any over-the-counter medications, the dangers they pose – and if there is a better way to treat what ails you.

Prilosec and Nexium:

Burford points out that these proton pump inhibitors – strong acid surppressors – were once prescription-only. In 2003, they became over-the-counter, which some people questioned due to possible hazards of long-term use.

“They are extremely popular for the relief of heartburn and acid indigestion,” he says. However, the drugs also prevent the digestive system from absorbing iron, calcium and vitamin B-12, which can lead to additional health issues. They also make people more susceptible to severe digestive infections like C. diff.

He suggests starting with an examination of what you eat. Many patients who begin to eat healthier and reduce consumption of fast foods report a reduction or disappearance of heartburn and indigestion. If the problem persists, he says less potent medications like Pepcid and Zantac have fewer long-term side effects.


Many people take a daily dose of aspirin in an effort to prevent heart attacks and strokes, and studies show that in certain populations, it does have a positive effect. However, Burford says daily aspirin can also increase internal bleeding.

“When those complications are considered, the net benefit for the average healthy person is negligible,” he says. Patients should talk to their doctor about whether their individual case warrants the risks of the aspirin regimen.

Sleep aids:

Burford says this issue primarily affects older people, who are more likely to have disrupted sleep. “People who take higher doses of sleep medications have an increased risk of falls during the night, fractured bones and other problems. Some even take additional doses of medications without remembering it.”

While sleep medications are sometimes necessary, he recommends starting with a sleep hygiene plan that includes avoiding stimulants like coffee and exercise too close to bedtime, avoiding screens at night, and having a consistent wake time.

Anticholinergics: (found in some allergy, mood and sleep medications)

Researchers have only recently discovered that many drugs that fall into the category of “anticholinergic” are associated with increased risk of Alzheimer’s disease. An anticholinergic is a substance that blocks the action of the neurotransmitter acetylcholine.

“These can include antihistamines, medications that control overactive bladder, and some that are given for anxiety and depression,” Burford says. He suggests patients ask their doctor if medications with a minimal anticholinergic effect will still address their health problems. “This issue applies to chronic use, not just a few weeks,” he says. “It affects people who are on these meds for months and years.”



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