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OTC Drugs: Not necessarily harmless

Just because a medication or nostrum is sold over the counter does not mean the Food and Drug Administration has certified it harmless. Some meds that we take routinely and think of as benign (because after all, if they weren’t, wouldn’t they be available by prescription only?) have all sorts of strange side effects.

We all know that aspirin can rot a hole in your gut if you overdo it or use it to pre-empt a hangover after a night of drinking. And most of us are probably aware that acetaminophen, taken in excess, can damage your liver. But it’s amazing what some of the other commonly available goodies will do to you, and how innocent we may be of their baleful effects.

Take, for example, ordinary cough medicine. Did you know that Robitussin with dextromethorphan can give you quite a high? Teenagers competing to win a Darwin Award swill it down in industrial quantities. This stuff can cause such entertainments as irregular heartbeat, vulnerability to heat stroke, nausea and vomiting, itchy skin…and so on to infinity. Literally…

But you don’t have to take some of these things in off-the-label doses to experience some surprising effects. When M’hijito was a wee babe, a quack pediatrician we were using prescribed Sudafed for a minor cold. This was one of the first colds he’d had, and since he was our only child, we hadn’t a clue that his inability to sleep was not part of the cold. Three days and nights went by without his sleeping more than ten minutes at a time. He would scream and scream and scream, finally doze off if one of us laid on the bed next to him, but if you wiggled so much as to scratch your nose, he’d instantly pop awake and start to shriek again. The pediatrician shrugged and said “babies cry.” By the time we stumbled into an emergency room, all he could do was lay on the mattress and writhe. The ER doctor didn’t have a clue, either.

Meanwhile, I had also developed a galloping case of insomnia, which had been hanging on for several weeks. Even before the kid started keeping us up all night and all day, I’d been sleeping three, maybe at the outside four hours a night. As I was laying there next to the half-dozing infant trying not to move a hair, it suddenly struck me that there might be a connection.

What was the only odd thing we had going in common?

Prescription decongestants.

His father had hay fever and was taking pills for it. We’d had cats for several years. Although I found new homes for them before the baby was born, they’d slept on our beds, lived on the furniture, and infested the house irremedially with cat hair and dander. What I didn’t know is that I was allergic to cat fur. I did know my nose was stuffed up all the time, just like my husband’s. So I had been taking his decongestant so I could sleep at night.

I leapt from the bed, leaving the kid shrieking again and the husband mad as a hornet, and streaked to the bookcase where we kept the PDR. And lo! Both the Sudafed and the prescription contained pseudoephedrine, which has listed among its side-effects “central nervous system stimulant.” Videlicet: pseudoephedrine causes insomnia!

Within hours after we took him off the quack doctor’s meds and me off the husband’s pills, peace was restored to the house. I slept for two days, and so did the kid. We soon found another pediatrician.

Pseudoephedrine is sold over the counter, and it appears in a number of allergy, sinus, and cold nostrums.

Recently I made a similar discovery. With my doc’s complicity, I’ve been using Benadryl as a sleeping pill. The stuff knocks me for a loop, and when I can’t sleep at night—which is most of the time—it sometimes allows me to get six straight hours of shuteye. Sometimes. So it seems.

Exhaustion will do the same thing.

The other day when I was at the fancy Costco near the upscale community college, I picked up a mess of magnificent king crab legs. Naturally, one can’t have king crab without a glass of wine, right? So walked out of the place with a nice bottle of white wine.

My habit is to pour wine as long as food remains on the plate. Since breaking into crab legs and fishing out the meat is time-consuming, I topped off a few more glasses than I thought. Cleaning up after dinner, I looked at the bottle and realized I’d consumed two-thirds of it. That explained why I was weaving around the house like a drunk: I was drunk.

Any more than a glass or two of wine will set my internal alarm clock for 3:00 a.m. sharp. An all-day choir workshop was slated for the next morning. If I woke with a hangover at three in the morning, I was gunna be a zombie through the entire event. So, along about 11:00 p.m. I dropped two Benadryls, following the instructions on the label.

And fell asleep…for about twenty minutes.

Every time I closed my eyes, I had the most horrific nightmares! At my age, you pretty much quit dreaming—or if you do, you rarely remember it. Older people have less REM sleep (and, in my experience, less sleep altogether! Caveman tribes must have used the elders to guard the campfires at night). So a nightmare is a weird occurrence. I’d doze off, be jerked out of sleep by some hideous image, toss and turn for twenty minutes, and repeat. Finally turned on the light and got up: 1:00 a.m.! I’d been dozing fitfully and miserably for all of two hours. And the rest of the night never did get another wink of sleep.

The next day at the choir workshop, I was OK (I’m always functional the day after a sleepless night: it’s the following day I’m out of it), but along about 2:00 in the afternoon I had another of the damned anxiety attacks: pounding heart that feels like it’s skipped a beat, breathlessness, dizziness. These are very scary episodes. The only reason I don’t call an ambulance when they happen is that I’ve already spent a full day in the ER, where I learned they’re (probably) not heart attacks or impending strokes. I’d had several of these in the preceding two weeks, including one that happened while I was standing in the Apple store talking with a salesman.

Since I’m not particularly stressed, this has seemed odd. We have hardly any work at GDU—so little, as a matter of fact, I rarely go out to campus. The community college courses are easy and fun. No deadline pressure. No work pressure. No personal problems. Everything I’m doing in life right now is entertaining and pleasant. My overall mood: a general feeling of well-being. Sooooo…why am I having panic attacks?

Sitting here in front of the computer between the end of choir practice and the start of the evening party, it occurred to me to google benadryl side effects. And what should come up but this:

Diphenhydramine may also cause low blood pressure, palpitations, increased heart rate, confusion, nervousness, irritability, blurred vision, double vision,…

Holy mackerel! Palpitations and a speeding heart are the hallmark signs of these “anxiety attacks” I’ve been having. And irritability? Let me tell you irritability. Between my house and choir, I was cussing at other drivers who had the temerity to get in my way on the road. Double vision? Sumbitch. Last time that happened out of the blue, the opthamologist speculated I might have Parkinson’s disease. To keep the insurance companies at bay, he entered “ocular migraine” in the record…but that’s not what he thought.

Like most doctors, he never thought to ask me what OTC meds I take regularly and then to look up the side effects. They’ll ask you, and they’ll write down the drugs you say you take: they just don’t think about what the stuff can do to you.

Double-checking the Google search evokes this:

Serious Side Effects

Some Benadryl side effects are potentially serious and should be reported immediately to your healthcare provider. Although generally rare, some of these side effects may actually be fairly common, particularly in young children or the elderly. These include, but are not limited to:

Low blood pressure (hypotension)
Heart palpitations
A rapid heart rate (tachycardia)
An irregular heartbeat
Anemia
Low blood platelets
Confusion
Blurred vision or double vision
Loss of balance, especially if accompanied by ringing of the ears (tinnitus) or hearing loss
Seizures
Difficulty passing urine
Hallucinations or delirium
Worsening of ulcers or gastroesophageal reflux disease
Worsening of glaucoma

Signs of an allergic reaction, such as:

An unexplained rash
Itching
Hives
Swelling of the mouth or throat
Wheezing
Difficulty breathing.

Itching? My face still itches, in spite of the pints of olive oil I’ve used in lieu of soap for lo! these many months. Heart palpitations? Tachycardia? Loss of balance? Tinnitus? These are part of everyday life around here. So is Benadryl…

Even though the FDA rates Benadryl as a class B drug, meaning it’s supposedly safe for unborn babies, clearly this is not an altogether benign substance. Yea verily, the University of Maryland Medical Center lists among its potential effects:

Cardiovascular: Hypotension, palpitation, tachycardia

Central nervous system: Sedation, sleepiness, dizziness, disturbed coordination, headache, fatigue, nervousness, paradoxical excitement, insomnia, euphoria, confusion

Lovely. So all this time I’ve been trying to beat insomnia by dropping these pills, with my doctor’s approval, I’ve probably been making it worse and evidently have created the cardiac symptoms diagnosed as “stress attacks.”

Stress attacks, my ass. My Christian Scientist forebears were right! Don’t drink, don’t consume caffeine, and never take meds.

If you have unexplained or intransigent symptoms, think about what drugs you’re taking, including the over-the-counter variety. Look them up either on the Internet (avoid those whiny patient wailing walls, which are anecdotal and provide no real proof that the patients’ complaints have anything to do with the meds they’re taking), in the Physician’s Desk Reference, or in Worst Pills, Best Pills, the most accessible reference work on drugs and drug interactions you can buy.

3 thoughts on “OTC Drugs: Not necessarily harmless”

  1. With any drug, different people will experience different reactions. It might be the best drug ever for one person and kill another! And of course no substance is completely safe 100% of the time. I take benedryl nightly so I can sleep, actually so I can breathe at night so I can sleep. I am allergic to dogs but I have three of them sharing my bed. I’m sure your doctor was only trying to help with the benedryl, any other sleep aid has the risk of dependency. You have to weigh the cost of insomnia against the risk of what you take to treat it and benedryl has FEWER side effects than other treatments. I once took a medicine that has a 10% chance of causing parkinsons like tremors, turns out I was in that 10% group. Never took it again!

    • @ Miss M: Good words and true. My point is that we should all stay aware that just because we bought a drug off a grocery-store or drugstore shelf doesn’t mean it’s absolutely, positively safe for everyone. We can’t rely on busy doctors to think of cluing us to every possible reaction for any of the hundreds of possible pills and syrups we can buy. Every drug that works, even the caffeine in your soda or coffee, has side effects. It’s a good idea to know what they are, so that we don’t interpret them as symptoms of some new disease, which could lead to unnecessary worry and medical treatment.

  2. Good point, and sometimes STOPPING taking even an OTC med will give you re-bound symptoms. There are certain decongestiants and anti – mucous drugs that when they wear off cause my nose and throat to constrict in an asthma attack like way that is terrifying.

    (Can you tell that I’m fighting off a summer cold? ACHOOOO!!!)

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