Dangers of OTC drugs often given short shrift
Will your vitamins or dietary supplements hurt you? Millions of Americans take multivitamins, herbs or other supplements every day. Most people don't worry about possible dangers from these pills.
Many health professionals, on the other hand, warn that dietary supplements could send you to an early grave. The Food and Drug Administration often cautions about the risks of taking supplements.
While high doses of some vitamins or minerals certainly could be harmful, they rarely cause life-threatening reactions. Prescription and over-the-counter drugs, on the other hand, might cause serious complications. Public health authorities rarely warn about dangers associated with OTC medications.
If a vitamin, herb or other dietary supplement caused hypertension, heart attacks, strokes, bleeding ulcers and kidney disease, there would be headlines in newspapers. Physicians would demand that the product be pulled off the market.
Yet millions of people take nonsteroidal anti-inflammatory drugs daily without a second thought. The OTC label often is hard to read because of tiny print. About the only side effects mentioned are allergic reactions and stomach bleeding.
Doctors frequently prescribe NSAID such as diclofenac, ibuprofen, meloxicam, naproxen and piroxicam without warning their patients about all the potential side effects. These pain relievers can trigger hypertension, fluid retention, heart attacks, strokes, atrial fibrillation, congestive heart failure, severe allergic reactions, bleeding ulcers, kidney damage and liver damage. Any of these could be fatal.
Because NSAIDs can be irritating to the digestive tract, it is not unusual for people on such medicines to be prescribed heartburn medicine. Proton-pump inhibitors to treat heartburn are among the most popular drugs in the pharmacy.
Medications such as omeprazole (Prilosec), lansoprazole (Prevacid) and pantoprazole (Protonix) originally were developed to treat severe gastroesophageal reflux disease. But they are so good at alleviating the pain of reflux that doctors soon were prescribing them for all sorts of digestive distress.
At first, PPIs were considered pretty innocuous. The FDA decided they were so safe, in fact, that no prescription was necessary. You can find OTC esomeprazole (Nexium 24HR), lansoprazole and omeprazole.
According to Danish scientists, though, PPIs are associated with an increased risk of stroke. These investigators reviewed the medical records of almost a quarter-million Danes and told the doctors attending the recent American Heart Association meetings that people taking a PPI were more likely to experience a stroke than those not taking an acid-suppressing drug.
Last year, researchers found that PPI users were 16 percent more likely to have heart attacks (PLOS One, June 10, 2015) than nonusers. Other drugs used to treat heartburn (cimetidine, famotidine, ranitidine) had no such association.
Other side effects of proton-pump inhibitors include an increased risk for infection, kidney damage, dementia, weakened bones and fractures, and blood disorders. Nutrients such as calcium, iron, magnesium, vitamin B-12 and zinc may not be well-absorbed.
Treating over-the-counter drugs as if they had no hazards is shortsighted. Perhaps it is time for public health authorities to be more evenhanded in their warnings.
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