Doctors wary of over-the-counter craze


August 02, 1994|By Joe Graedon and Dr. Teresa Graedon | Joe Graedon and Dr. Teresa Graedon,King Features Syndicate

What do the popular medicines Advil, Afrin, Aleve, Benadryl, Dimetapp, Gyne-Lotrimin, Monistat 7, Motrin IB, Tavist-D and Tylenol have in common? They all started out as prescription products, but are now highly successful over-the-counter (OTC) brands.

Many drug companies have recognized that the self-care revolution has a huge profit potential. Sales often double or triple when a product becomes available without prescription.

People like being able to buy athlete's foot remedies or pain relievers that once required a visit to the doctor. But some physicians are getting nervous that such self-treatment might go awry.

Digestive disease experts confide that they worry every time a new nonsteroidal anti-inflammatory pain reliever like ibuprofen or naproxen becomes available over the counter. They see serious cases of stomach irritation and even ulcers due to use of these medications.

Gynecologists fear that women who self-diagnose and treat vaginal yeast infections may miss other more serious conditions. Chlamydia, for example, is widespread and can lead to pelvic infections and even infertility.

Ear, nose and throat specialists tell us that over-the-counter nasal spray addiction is a big problem. Long-acting topical decongestants can provide rapid relief. But the effect wears off, and many people are tempted to use such a spray for more than the three days indicated on the label. If they do, they run the risk of rebound congestion when they stop. Blood vessels dilate and lead to prolonged stuffiness.

We have received letters from readers of this column reporting continuous nasal spray use for many months or even years. Some people sleep with a bottle of nose drops under the pillow. Others keep extras in their pocketbook, car or desk drawer. Weaning patients off such drugs can be a challenge.

People tend to think of over-the-counter drugs as mild and safe. But nonprescription medications have side effects and can cause hospitalization and even death. Companies have not been required to monitor complications of over-the-counter products the same way they follow problems with prescription medicines.

The answer to this dilemma would be to follow the Canadian and Australian examples. Some medications available without prescription require a pharmacist to dispense them and provide valuable information. In Canada, for example, the nonsedating antihistamines Seldane and Hismanal are kept behind the counter, even though they don't require a doctor's prescription. That also goes for the diarrhea medicine Imodium and the motion sickness patch Transderm-V.

U.S. consumers would also benefit from more information about the powerful medicines now at their disposal. Please take time to read the instructions and precautions. Then consult with your pharmacist to get the information you need to use these medicines safely.

Q: I read that tannic acid is good for clammy hands. Would it also work for underarm perspiration?

A: Dermatologists have recommended a 30-minute tea soak for sweaty hands and feet (five tea bags to a quart of water). Whether this would work for underarms is hard to say. An alternative would be an aluminum chloride antiperspirant available in Certan-Dri and Xerac AC or by prescription as Drysol.

Q: I haven't had my cholesterol checked in a long time as it is expensive to see the doctor. I recently noticed in the drugstore a home cholesterol test. How accurate is this kind of test?

A: The new Advanced Care Cholesterol Test is quite accurate (97 percent) and easy to use.

The only disadvantage is that it will not tell you anything beyond total cholesterol. If you want to know about other blood fats such as HDL, LDL or triglycerides, you will still have to visit your doctor.

Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.

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