How do Over-the-Counter (OTC) medications affect an employee?

By Suzanne Ball | Last updated: April 16, 2018

Got a headache? Suffering from a cold or cough? Chances are you’ll be one of the nearly three billion consumers that head to a local retail store to pick up something off the shelf. You and your family will do this about 26 times a year.

These over-the-counter (OTC) medications are available without prescriptions. Conditions such as allergies, colds, and headaches are easily and affordably treated with OTC medications. In fact, 81 percent of adults use OTC medications to deal with minor ailments. The Consumer Healthcare Products Association estimates that employers save $23 billion a year in productivity by keeping employees on the job by using OTC medications instead of visiting physicians or staying home (absent).

Over 90 percent of physicians agree that OTC medications are effective and safe when used as directed. A study showed that when taken appropriately, OTC medications can save billions of dollars each year that might be spent on time (both doctor and patient), prescriptions, and an overburdened healthcare system.

The U.S. Food & Drug Administration (FDA) approves drugs as OTC when they can be taken safely without the supervision of a healthcare provider. They work to relieve symptoms or stop a condition before it can develop. Often, medications that were originally available only by prescription become OTC drugs. Examples are Nicorette for smoking cessation; Zantac and Prilosec for excess stomach acid; and Claritin for allergy relief.

However, as with prescription drugs, there are OTC medications that can be misused or abused. Some drugs are also misunderstood and taken without knowing the potential harm. Some of the OTC medications that should concern employers are:

Cough medications that contain Dextromethorphan (DXM) are meant to suppress a cough from a cold or the flu. They don’t work with coughs from emphysema, asthma, or smoking irritation. When taken in large doses, DXM can produce a high and hallucinations. Although more commonly abused by teens and young adults, older adults may continue to use it after symptoms have passed.

Side effects from DXM include confusion, dizziness, drowsiness, shakiness, and an unsteady walk. Depending on the employee’s job duties, there is a possibility of injury or accident.

DXM can interfere with some important prescription drugs, such as MAO inhibitors that are used to treat depression. It can also harm an unborn baby. If the cough has not improved after seven days, the employee should see a healthcare professional.

Common DXM-containing cough medicine brands include many forms of Alka Seltzer Plus™, Comtrex™, Coricidin™, Delsym™, Dimetapp™, Mucinex DM™, Robitussin™, Theraflu™, Triaminic™, Tylenol Cough & Cold™, Vicks DayQuil™/NyQuil™, Vicks Formula 44™ and more, including store-brands.

Acetaminophen can be downright dangerous. Most people know it as Tylenol and use it to reduce pain or fever, or to treat a headache. However, it can cause serious liver failure when taken over a long time. The U.S. Poison Control Center gets more calls about acetaminophen than any other toxic substance; more than 50,000 people show up at the Emergency Department each year due to possible acetaminophen poisoning.

Side effects include signs of internal bleeding (black, tarry stools, or dark urine), rashes or hives, and lower back or side pain.

Anyone who takes acetaminophen for an extended period should be under the care of a doctor and have periodic liver function blood tests. People who use Tylenol (or a generic brand) for extended periods, or who take too much, should watch for diarrhea, sweating, nausea or vomiting, stomach pain, or tenderness in the upper abdomen. If these symptoms are present, the employee should seek emergency treatment.

Antihistamines are part of cold and allergy medications. They relieve annoying symptoms such as a runny nose watery eyes, and sneezing. They’re also helpful in treating motion sickness. Common ingredients include diphenhydramine (Benadryl), found in products like Tylenol PM, and pseudoephedrine, found in Sudafed. There are also 2nd generation anitihistamines that work for 24 hours and affect different histamine receptors.

Two important side effects to watch for are drowsiness and dizziness. Employees who drive or operate machinery should be especially aware of the hazard. Other side effects include increased blood pressure and heart rate, which can be dangerous for people with heart conditions.

Common OTC medications with antihistamine include Chlor-Trimeton™ , Actifed Cold™, Dramamine™, Nytol™, Sominex™, Vick’s NyQuil™, and Tylenol Cold & Cough™.

Guidelines for OTC use include

  • Carefully follow directions on the label.
  • Read the list of ingredients to avoid possible allergic reactions.
  • Watch for possible side effects and discontinue if any occur.
  • Do not take for a longer period than advised.
  • Check the expiration date before taking any medication.

While employers and supervisors have no oversight of an employee’s OTC use, it can be helpful to be aware of the most common medications and how they can impact job performance as well as overall health.

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Written by Suzanne Ball

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Suzanne Ball is an experienced Registered Nurse with a Masters Degree in Health Sciences. She has worked in a variety of settings, including acute care, quality improvement, and research. She is a freelance writer who specializes in writing about medical and health topics.

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