Know your over-the-counter medicines

You can wait three weeks for a GP appointment, so we’re all being urged to treat less serious illnesses ourselves. However, it’s estimated that nearly half of us still visit the doctor or A&E with illnesses that we could deal with at home.

So, from cough remedies to headache tablets, which self-administered, over-the-counter (OTC) drugs are really effective, which ones are a waste of money and what’s safe? You may be surprised.

Pain relief

Common brands: Nurofen, Panadol, Anadin

The generic painkillers ibuprofen, paracetamol and aspirin are medicine-cabinet staples. You may think they all do very similar things, but that’s not the case.

Ibuprofen eases many types of pain, but it’s particularly effective for inflammation, helping about 50% of people who take it, according to a study co-led by Oxford University.

Paracetamol eases some mild pain, but not back or arthritic niggles. A mix with ibuprofen, however, combats these – and the likes of toothache and fever – for around seven in ten of us. Aspirin helps to reduce (usually mild) pain for only around one in ten.

Branded products are more expensive than generic ones, but they are often absorbed by the body faster. Ditto medicines containing caffeine, though drinking a coffee with your tablet may work just as well.

Serious harm from analgesics is considered rare, but a paracetamol overdose can fatally damage the liver. Research has also linked regular, long-term ibuprofen and paracetamol use with a slight increase in female hearing loss.

Find out more about painklillers

Sleeplessness

Common brands: Nytol, Boots’ Sleepeaze

Most OTC sleeping tablets contain a sedating antihistamine, such as diphenhydramine hydrochloride, and while they don’t have the potential to cause the dependence that prescribed sleeping tablets can, doctors still advise caution.

It’s unclear how well they work. What’s more, they don’t tackle the underlying causes of sleep problems, and can cause side effects into the next day such as dizziness, drowsiness, grogginess, anxiety and nausea.

Perhaps more worryingly, the results of a study undertaken by Indiana University last year suggested some preparations could increase the risk of dementia.

Strategies for a better night's sleep

Coughs

Common brands: Veno’s, Benylin, Covonia

OTC cough medicines come in three forms. Expectorants are for chesty coughs and supposedly make you expel material from your lungs. Suppressants try to stop dry, tickly coughs. Hybrids have added benefits, such as forming a soothing film over a sore throat, or decongestants.

However, according to the British Thoracic Society, there’s little evidence that cough medicines have any effect. Most coughs will clear up within a couple of weeks with rest, fluids, painkillers, and honey and lemon.

If you need to get through that film or presentation without coughing, find out which remedies might help

Sore throat sprays

Common brand: Ultra Chloraseptic

Antibiotics don’t work for sore throats. Meanwhile, experts warn that painkilling tablets, such as aspirin and paracetamol, may suppress the immune response prolonging cold symptoms. Ibuprofen and aspirin, meanwhile, dampen the body’s inflammatory response. That’s where a throat spray could come in handy.  Sprays containing benzocaine, a local anaesthetic, can bring almost instant relief.

Side effects are rare because the products act locally.

Colds

Common brands: Vicks Sinex, Sudafed

Antihistamine-based products are marketed as treatments for drying up runny noses and stopping sneezes, but they are ineffective at relieving your cold symptoms alone, according to US research. Instead, you should look for medicines that combine antihistamines with decongestants, although they won’t prevent or shorten your illness.

Side effects of cold-relieving products are usually mild, but they can interact with other medicines – causing a potentially dangerous rise in blood pressure if taken at the same time as certain antidepressants, for instance. Do check with your GP or pharmacist if you have any concerns.

How to get over a cold

Indigestion and heartburn

Common brands: Gaviscon, Rennie, Setlers

Remedies include antacids, which neutralise stomach acid, and alginates, which 

form a physical barrier to prevent stomach acid rising into the gullet. PPIs (proton pump inhibitors) and H2RAs (H2-receptor antagonists) stop acid being produced.
They can all ease the pain and discomfort of short-term, occasional indigestion or heartburn. Start with the simplest, cheaper medicines first – antacids, followed by alginates, then PPIs and H2RAs. PPIs have a delayed action but work for up to 24 hours. H2RAs kick in within an hour but are effective for only around 12 hours.

Research suggests OTC PPIs may increase the risk of vitamin B12 deficiency, especially in older people, by decreasing absorption. Overuse of PPIs also slightly increases the risk of fractures in the over-50s, so don’t use them long-term, unless advised by a doctor.

Indigestion: symptoms, causes and treatments

Hay fever, eczema and other allergies

Common brands: Piriton, Bendadryl, Clarityn

Antihistamine tablets, capsules, oral liquids, creams and nasal sprays can treat and soothe hay fever, skin allergies, insect bites and stings. First-generation varieties, such as those containing diphenhydramine and chlorpheniramine, are sedating, but second or third generation ones (with loratadine and cetirizine) have no sedative effect, though you should avoid alcohol. If itchiness is disturbing your sleep, however, a sedating version could help.

Oral antihistamines are widely used to soothe eczema, but there’s little solid proof that they work. Antihistamines may be unsuitable if you have liver or kidney problems, or if you have prostate enlargement or acute glaucoma. Check with a pharmacist.

Hayfever survival guide

Learn more about eczema

Diarrhoea

Common brands: Imodium, Pepto-Bismol, Dioralyte

Medications containing loperamide slow down gut action and reduce the number of bowel movements. Medicines contain bismuth coat irritated tissues in the stomach and intestine, as well as killing bacteria that cause diarrhoea. Rehydration fluids help replenish fluids and electrolytes (minerals and salts) that are lost when you have diarrhoea.

Talk to the pharmacist before taking loperamide-based medications - they can worsen diarrhoea caused by infection, which needs to be expelled.

For more on OTC medicines, see our article in the April issue of Saga Magazine.

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