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5 OTC Meds You Should Never Take At Once

Over-the-counter (OTC) medicines are convenient and cost-effective. They don’t require a prescription from a doctor, allowing you to avoid consultation fees and buy them quickly almost anywhere. However, they don’t come without risks. 

Since OTC drugs are non-prescriptive, many people “unintentionally” hurt themselves even if they only try to relieve their symptoms. One reason is their lack of understanding of how medicines work.  

But we’ve got you covered. Here are five OTC drug combinations you should never take.

Tylenol + Multi-Symptom Cold Medicines

Many cough, cold, and flu combos, called multi-symptom cold drugs, contain acetaminophen. This substance is also present in Tylenol, a fever reducer and pain reliever. Hence, avoid drinking these two drugs to avoid getting overdosed. 

Overdosing, in this sense, means exceeding the 4-gram (g) or 4,000-milligram (mg) daily upper limit for acetaminophen. The risk of this is damaging your liver. In the worst-case scenario, overdosing could require transplantation or even kill you. 

Note that an overdose is a medical emergency. A severe overdose happens if you consume 7g or more a day, but it can already be dangerous even in just one day of exceeding 4g. If you think someone is experiencing an overdose, immediately call 911 or any emergency hotline. 

Avoid overdosing by thoroughly reading the “Drug Facts” label. Focus on the drug name “acetaminophen.” If you can’t find it on the label, look for its other names, like paracetamol, APAP, AC, or Acetam. They’re all the same ingredients, so be careful with the dosing. 

The usual dose is 325-650 every 4-6 hours (as needed) in a day. The maximum should be four times in 24 hours, varying from 3,000 mg to 4,000 mg—anything more than these is considered overdosed. 

If you drink heavily (i.e., more than two drinks daily), don’t take Tylenol and other acetaminophen to treat hangovers. Research has shown that mixing acetaminophen and alcohol irritates the stomach and, in severe cases, causes ulcers, internal bleeding, and liver damage. Acetaminophen isn’t recommended if you have a liver disease. 

Antidepressants + Cough Suppressants 

Taking antidepressants, regardless of how natural it is, and cough medicines together may trigger a potentially life-threatening condition called serotonin syndrome. It’s a drug reaction caused by having too much serotonin in the body, which causes feelings of confusion, sweating, discomfort, difficulty controlling your movements, and, in rare cases, even death.

Cough suppressants affect brain signals that trigger the cough reflex, and so do antidepressants, only by increasing neurotransmitters. The problem is that taking them together results in too much serotonin, causing serotonin syndrome.

To prevent serotonin syndrome, know your symptoms and treat them accordingly. If you’re not even hacking, don’t reach for any drug with a cough-and-cold formula, specifically with dextromethorphan. If unsure of the drug’s formula, ask a pharmacist in person or over a call.

If you’re hacking, you can alternatively soothe it with home remedies. For example, stay hydrated and opt for lukewarm water, use a cool-mist humidifier, or swallow cough drops or one-half to 2 teaspoons of honey. 

If it’s a recurrent, lingering cough, immediately see a doctor. A cough that persists for weeks is caused by underlying medical problems, where, in many cases, more than one cause is involved.

Any Combo of NSAIDs

Advil, Aleve, Bayer, and Voltaren—which are Ibuprofen, Naproxen, Aspirin, and Diclofenac, respectively—are all non-steroidal anti-inflammatories (NSAIDs). Since they all fall into the same class, they work through the same underlying pathways. 

Combining any or all of these drugs is a way to overdose and boost side effects. The risks of combining NSAIDs can range from mild nausea to severe gastrointestinal bleeding. 

These risks aren’t fatal, and there are ways to reduce the medications for treatment, such as using a Prilosec Discount Coupon or card. However, they still require immediate medical help because they can quickly become serious. 

Overall, it’s still better not to take multiple NSAIDs at once. However, other medications may have already been combined with NSAIDs, such as opioids and cold remedies, so don’t take any NSAIDs anymore unless your doctor says otherwise. 

Antihistamines + Motion-Sickness Drugs

Be careful when taking antihistamines with nausea-busting treatments for motion sickness. Both contain similar active ingredients: (1) diphenhydramine to treat sneezing, sniffles, and red eyes, and (2) dimenhydrinate to relieve any sick feeling triggered by movement. 

Combining diphenhydramine and dimenhydrinate can add up to excess drowsiness. If you don’t want to sleep through any plan but have to treat your allergy and motion sickness, keep your antihistamine meds but opt for a non-drowsy motion sickness drug, like with the active ingredient meclizine.

Anti-diarrheal Drugs + Calcium Supplements

If you’re taking calcium pills to support your bone health but need to tame the trots, give the supplementation a rest first. Calcium only firms your stool, so even if you’re taking loperamide, your bowel issues will unlikely subside and continue to stop you up. 

Final Thoughts 

The key is—again—to read the drug information. More importantly, always seek professional advice from a pharmacist or doctor before taking OTC drugs. This is particularly critical if you also take prescription drugs since some OTC drugs may interact with them. 

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