Understanding Over-The-Counter Medications
Pain
Tylenol is widely considered the only safe drug during pregnancy. Follow normal dosing (See Pain Pills tab for dosing). Don't take NSAIDs (Advil/Aleve).
Constipation
Miralax and colace are common stool softeners that are safe to use in pregnancy. Metamucil (psyllium husk) fiber supplement is a great daily strategy to prevent constipation. If these are not working after a few days then talk to you OBGYN about stronger options.
Diarrhea
Better to talk to your OBGYN rather than try anything over the counter. If it is bloody diarrhea or you have a fever over 100.4F go to the ER right away. If you have significant abdominal pain go to the ER right away. Remember to stay hydrated.
Acid reflux
Pepcid AC 20mg twice a day can provide relief in 1 hour and last up to 12 hours. Tums can provide relief almost immediately but won't last very long. Both are safe options during pregnancy. If it is not controlled with these options there are stronger medications but you should talk to your OBGYN first.
Pregnacy
Overview
Most over the counter medications are safe with breastfeeding but always talk to your child's pediatrician or your OBGYN first. Tylenol, Advil, allergy medications, constipation medications and flu and cold medications are commonly and widely used by breastfeeding women. If you child has a rare illness take extra caution and discuss with further with the pediatrician. Drinking alcohol while breastfeeding is done with caution. You do not need to pump and dump but should breast feed prior to drinking moderately. Do not feed again until fully recovered (without alcohol in your system). Never use any recreational drugs while breastfeeding. PLEASE mention you are breastfeeding at every doctor visits especially urgent care, emergency room visits and specialty care.
Difficulty producing milk
Common in newborn period. Your healthcare team will help you through the first 3-5 days until your milk comes in. Regular nipple stimulation through breastfeeding attempts is helpful. Severe anemia or blood loss can contribute to difficulty producing milk. It is very important that the mother has time to sleep for a few hours to boost production. Low stress environments can be helpful if possible. There are many herbal teas available to boost milk production. The most popular and widely available is Mother's Milk tea
Breastfeeding
NSAIDS
This is the best option. Ibuprofen/Advil works well but you will have to dose more often 4-8hrs (see Pain Pills tab for dosing). Naproxen/Aleve can provide longer relief for 12 hours. See which one works best for you. Adding heat can always help. Tylenol is an option but not as affective as NSAIDs
Periods
Tums
Fast relief almost immediately. It may not last more than a few hours though.
Pepcid AC
Works within an hour. Lasts up to 12 hours. 20mg twice a day or if you only get symptoms at night you can do just 40mg at night. If only 10mg twice a day works for you that is fine too.
PPI's (proton pump inhibitors)
The strongest option. Omeprazole/prilosec, Nexium are common brands. They last 24 hours but take up to 6 hours sometimes to work. Daily use for 4 weeks is common. Can do 20mg once a day but if that doesn't work needs 20mg twice a day or 40mg once a day. If needing it for more than 4 weeks you need to see a Gastroenterologist.
Reflux
Overview
You only have one heart, don't mess around with over the counter medications for your heart. See your primary care doctor or cardiologist for their recommendations. If you are looking for preventative heart health you already know that you need to eat healthy, exercise and maintain a healthy weight. There is no magic supplement that will replace that.
Heart Health
Daily care
Daily moisturizer and sunscreen is recommended by most dermatologists. Choose the brand you like best and the regimen that best fits your skin and environment.
Steroid creams
Hydrocortisone 1% anti-itch cream if available over the counter. It can be used for 1-2 weeks but not longer. It can have significant side effects to the local skin area and decreased efficacy if used every day non-stop. If your rash/itching isn't going away then see a Dermatologist. Remember that steroid creams don't work on fungal or bacterial skin infections. If it is eczema then you need a long term plan.
Skin
Overview
Many products advertise increased energy. There are many causes of decreased energy and it can be different for many people. Seeing a sleep specialist is helpful for undiagnosed Sleep Apnea. Seeing your primary care doctor is a great place to start. Simple blood tests for anemia or thyroid issues can be helpful. A healthy diet full of fruits and vegetables and getting daily aerobic exercise, avoiding excessive alcohol use all improve energy. Treating underlying depression or anxiety can also improve energy. If none of this helps or is available then you can try over the counter products as an alternative.
Superfood products
The only daily energy boosting products we recommend are superfood products without any other additives or caffeine. These are meant to be taken every day and you need to give it a month to work before giving up. It is a daily supplement not a short term fix. Most products have spirulina or a similar main ingredient with other supporting superfoods. It will boost your daily basal energy by 10-20 percent which is a huge boost. It will provide a deaper resiliance to stress, fatigue and illness. It will reduce sleepiness and need for afternoon caffeine boosts.
Caffeine containing products
We do not recommend these synthetic products such as energy drinks or other caffeine pills. They can be used rarely and in extreme moderation. They can cause heart rhythm problems in previously healthy individuals especially with excessive use. Coffee and Tea are not included here and can be used independently
Energy
Overview
If you have vision loss or severe persistent eye pain you need to go to the emergency room right away. Over the counter eye drops and allergy pills are effective for minor daily eye symptoms. Persistent symptoms should be treated by your eye specialist
Dry Eyes
Dry eyes in the elderly or with pre-existing eye disease can be more complicated and should be evaluated. Over the counter eye drops such as Visine have many variations and additives. Choose the one you like the best. They can be used by people with healthy eyes who have dry and itchy eye symptoms for quick relieve. If it is an every day problem then see an eye doctor. Saline eye drops are also available and don't have the medications in Visine. these are safer to use by anyone.
Eyes
Overview
If you are anemic please see a doctor. There are a multitude of reasons some are very serious or life threatening. If it is determined you need iron pills by your doctor please also have a discussion about high iron diet. Most iron pills should be taken with vitamin C to increase effectiveness.
Iron Pills
Any brand will do. There are many variations. As long as you take it with vitamin C you can choose any brand that fits your financial situation. All iron makes you constipated so add stool softeners if needed. It may turn your stool black or dark as well. For people who cannot tolerate iron pills liquid iron supplements are widely available
Anemia
Overview
Cough medications are popular but are all basically the same. Prescription cough medications can sometimes work better. Warm herbal tea with honey is often as effective. Throat lozenges are also a great alternative. Many products also have decongestants added to the cough medications in addition to pain relievers that are also mixed in. If you have a persistent cough see a doctor to rule out pneumonia, asthma or asthma-like wheezing/bronchitis. In these situations prescription medications are needed to treat the underlying cause
Cough
Overview
The common cold is common. It is reasonable to try and treat your cold symptoms at home with a few exceptions. The following are some but not all of the reasons to go to urgent care or your doctor: Fever over 100.4F without other cough/congestion symptoms. Fever above 100.4F after the first week of cold symptoms. A bad sore throat with fever over 100.4F (strep throat needs antibiotics to prevent risk of heart damage). If you are immunocompromised due to autoimmune disease medications, chemotherapy or have severe lung/heart disease and are prone to hospitalization. If you have respiratory distress, chest pain or fainting then call 911.
Advil and Tylenol
There are many fancy cold and flu products out there but don't overlook the use of Tylenol and Advil. Tylenol works great for fever reduction. It won't be as effective as Advil for the body aches and headaches. For adults with bad fever/pain you can alternate 500mg Tylenol then 3 hours later take 600mg of Advil (ibuprofen) then 3 hours later repeat the 500mg of Tylenol. This can be done for a day or two but not longer to avoid side effects
Decongestants
It is important you don't confuse allergy medications that are antihistamines (Claritin, Allegra, Xyzol etc...) with decongestants (such as pseudoephedrine, Sudafed or similar products). When you have a cold/flu the antihistamine/allergy medications are not effective. You need to use decongestants such as Sudafed pills. This is often the main ingredient in popular cold and flu medications. It increases your heart rate and blood pressure so patient with high blood pressure or heart disease cannot use Sudafed or other popular medications with it mixed in. You can use the decongestant nasal sprays which do not have the systemic side effects. Caution with use over 2-3 days for all decongestant products
Cold and Flu
Overview:
Use over the counter medications for short term problems. If this is a frequent occurrence than see your Doctor. Do you have sleep apnea, chronic pain, acid reflux. Is alcohol or caffeine affecting your sleep?
Sleep aids
Melatonin is a great first option. Some people are groggy in the morning. Dosing is 3,5 or 10mg 1 hour before bed, start with the lowest first. Do not use if pregnant. Not a great option at 2 am but it works at the beginning of the night.
Benadryl is an anti-itch/allergy medication but it is added to Tylenol PM and Advil PM to make you sleepy. A good option for short term use. Benadryl is safe during pregnancy, but caution with the elderly. It can cause confusion, dry mouth, urinary retention. Dose is 25-50mg 30 minutes before bed. Some people are groggy in the morning but the medication should be out of your system in 4-6 hours.
Sleep
Benadryl
This is a great option if you are trying to fall asleep. use with caution during the day as it makes some people drowsy. It can also be helpful with anxiety as a quick over the counter intervention.
Non-Drowsy antihistamines
This group of medicines is the most popular. It is basically Benadryl but it lasts longer (usually 24 hours) and is non-drowsy. Commercials will try to convince you one is better but everyone has there preference, just find the one that works for you. Common ones include Allegra, Claritin, Xyzal, Zyrtec.
Nasal sprays
Flonase is a localized nasal spray. It won't have systemic symptoms like the pills. It lasts 12-24 hours. Taken 1-2 times a day. It can be used everyday for prevention in severe cases but can thin the skin inside the nose increasing risk for nose bleeds in some. It is a steroid. DO NOT confuse with Afrin or other fast acting nasal sprays that constrict blood vessels and cause quick short term relief. Afrin or other decongestants are very effective for short term use but if used for more than 3 days you can become dependent on it. Saline nasal spray is used to moisturize the nasal passage for cold or dry weather which is for your comfort but also can prevent nose bleeds in some
Allergy
Tylenol and Motrin
Most infants do not need any medications. All medications including over the counter medications need to be discussed with your pediatrician. Motrin (ibuprofen) cannot be used until 6 months of age. Tylenol has no age restriction but in the first 2 months we don't use Tylenol because any fever over 100.4F needs to be evaluated right away by a pediatrician (if less than 1 month go directly to the ER). The dosing for Motrin and Tylenol is very complicated and is based on the weight. The dosing chart is widely available and is usually provided by your pediatrician if they did not prescribe you the medications itself. Remember as your child grows the dose may change. Remember to buy children's tylenol or Motrin. Do not try to crush adult pills.
Gas and upset stomach
Simethicone liquid is commonly used for infants. It is over the counter. Discuss it with your pediatrician first. It can sometimes calm a fussy infant if the cause if gas/bloating.
Infant
Topical gel
Diclofenac gel or Volteren gel is a topical NSAID. It is a great option to avoid the systemic side effects of NSAIDs but still get the local anti-inflammatory pain relief.
Topical patches and sprays
There are many topical sprays, rubs, and patches for pain. They won't have systemic side effects which make them great options for localized pain. They can't treat deep pain especially deep joint pain. There are many variations of the same concept. Lidocaine numbs the area and menthol provides the cooling feeling. Choose whatever brand you like the best.
Pain Topical
Chronic pain
This is too complex for over the counter medications. See your doctor to find an underlying cause to your pain and put together a good pain plan that usually included both prescription and over the counter medications
Tylenol
Also known as acetaminophen. Not always as effective as NSAIDs but it often is good enough for daily minor aches and pains. do not exceed 3 grams (3,000 mg) per day. Many people lease it daily. It will not damage your liver unless you exceed the daily dose. You can use 1,000mg every 8 hours or 500mg every 4 hours. The extra strength Tylenol pills are 500mg and the regular strength are 325mg. See what works best for you. This is not an "anti-inflammatory" but it does also treat fever in addition to pain. When used within the recommended dose it is a very safe daily option for pain. Patients with liver disease have a low daily dose threshold and should discuss this with their liver specialist.
NSAIDs
This class of medications has brand names of Advil, Aleve, and includes aspirin, ibuprofen, naproxen. It is an effective pain medication for almost anything and it has anti-inflammatory properties and treats fevers too. This is the most dangerous class of over the counter medications. Excessive or improper use can cause kidney disease and GI bleeding. If you have chronic kidney failure do not use these medications (except a baby aspirin) without first discussing with your kidney specialist. If you take prescription NSAIDs such as ketorelac, diclofenac, meloxicam then you cannot take any other over the counter NSAIDs with it. If you are on a blood thinner like Warfarin/Coumadin, Xarelto, Eliquis or many others then you cannot take NSAIDs due to risk of GI bleeding. If you use NSAIDs daily you need to discuss this with your doctor. Consider adding antacids such as Pepcid or omeprazole for protection from GI bleeding. Stay hydrated while using NSAIDs to protect your kidneys. For all users never exceed proper dosing. Normal dosing for advil/ibuprofen is 800mg every 8 hours or 600mg every 6 hours or 400mg every 4 hours. 200mg is actually effective for some people, use the lowest effective dose to avoid side effects. Aleve/naproxen is 220mg every 12 hours though you can double that dose if needed. Aspirin is a great blood thinner but not as effective for pain relief
Pain Pills
Overview
Chronic diarrhea should be treated with a GI specialist. Chronic mild loose stools can sometimes improve with high fiber diet or psyllium husk fiber supplements. New or sudden onset diarrhea associated with severe abdominal pain, fever, or rectal bleeding should be treated immediately by an in-person visit with a doctor. Imodium is the over the counter medication for diarrhea and it is effective. But only use it after talking to your doctor first. It can make an underlying infection/problem worse if used incorrectly.
Diarrhea
Senna
This is a plant based over the counter medications that acts as a stimulant rather than a stool softener. It can be combined with a stool softener in the form of Senna-docusate. It can cause explosive diarrhea in some. Do not use long term or you can become dependent on it
Fiber
Metamucil or other forms of psyllium husk are the best option for most people without severe GI illness. This is the great equalizer and helps with both constipation and diarrhea. But it is more preventative rather than fast acting. Take it everyday to regulate your stools and reduce risk of colon cancer (a high fiber diet will do the same). It comes in powder, pill and gummy form and is widely available.
Miralax
This is a stool softener. It can take a couple days to work. It is a powder mixed with 8oz of water. It can be taken once or twice a day usually. Long term use is done in special circumstances if a GI specialist recommends it. Most people are cautioned about every day use.
Constipation
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