OTC Drugs: Special Groups at Risk of Adverse Effects

• Children
• Women who are trying to get pregnant, are pregnant or are breastfeeding
• Older adults
• People who have health problems
• People who take prescription drugs

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• Acetaminophen (brand name: Children’s Tylenol Suspension Liquid and Soft Chews) is often a good choice for pain relief in children.
• Children who are allergic to aspirin (one brand name: Bayer Children’s Chewable Tablets) are also likely to have problems using ibuprofen (some brand names: Children’s Advil Suspension or Chewable Tablets, Children’s Motrin Oral Suspension and Chewable Tablets).
• Children who have asthma may have an allergic reaction to aspirin and ibuprofen. Talk to your doctor before giving one of these medicines to your child.
• Don’t give aspirin to children under the age of 18 if they may have the flu (influenza) or chicken pox because they have a higher risk of Reye’s syndrome (a drug reaction that can lead to brain injury).
• It’s very easy to give too much of an oral decongestant to a child. Before using one of these products, talk with your doctor. Decongestant nose drops should not be used for more than 3 days.

• Conception occurs about 2 weeks before your period is due. That means you may not even know you’re pregnant until you’re more than 3 weeks pregnant. Your baby is most sensitive to harm 2 to 8 weeks after conception. This is when your baby’s facial features and organs, such as the heart and kidneys, begin to form. Any medicine you take (or anything you eat, drink, smoke or are exposed to) can affect your baby. That’s why it’s best to start acting as if you’re pregnant before you are.
• If you need to take medicine often because of a health problem, talk with your doctor about your treatment before you try to get pregnant. There may be other ways to treat your health problem during pregnancy besides taking medicine.

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• Always talk to your doctor before taking any medicine or herbal health product when you’re pregnant.
• If possible, avoid using medicines during your first trimester. This is when the risk to your baby is highest.
• Acetaminophen (brand name: Tylenol) is usually safe for short-term pain relief during pregnancy.
• Avoid using aspirin (two brand names: Bayer, St. Joseph) during pregnancy. It can cause low birth weight and problems during delivery.
• Avoid using nonsteroidal anti-inflammatory drugs (NSAIDs), especially during the third trimester of pregnancy. NSAIDs can cause heart problems in your baby. NSAIDs include ibuprofen (two brand names: Advil, Motrin), ketoprofen (one brand name: Oruvail) and naproxen (one brand name: Aleve).

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• Talk to your doctor before taking any medicine or herbal health product when you’re breastfeeding.
• Acetaminophen and NSAIDs, such as ibuprofen, usually provide safe pain relief for women who are breastfeeding.
• While breastfeeding, avoid using aspirin. Aspirin comes out in your breast milk. It can cause rashes and bleeding problems in nursing babies.
• Limit long-term use of antihistamines. Antihistamines come out in your breast milk. They may cause side effects in nursing infants, such as drowsiness, crankiness, crying and sleep problems. Antihistamines may also decrease the amount of milk you produce. Antihistamines include brompheniramine (some brand names: Dimetapp Cold & Allergy Elixir, Robitussin Allergy & Cough Liquid), chlorpheniramine (one brand name: Singlet), dimenhydrinate (brand name: Dramamine), diphenhydramine (brand names: Benadryl Allergy, Nytol, Sominex) and doxylamine (two brand names: Vicks NyQuil, Alka-Seltzer Plus Night-Time Cold Medicine).
• If you need to take an oral medicine, take it right after nursing or before your baby’s longest sleep period.
• Watch your baby for signs of side effects. These signs can include a rash, trouble breathing, a headache or other symptoms that your baby didn’t have before you took the medicine.

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• If you use an NSAID, you may be at risk of kidney disease and gastrointestinal (GI) bleeding.
• The decongestant pseudoephedrine (two brand names: Contac Day and Night, Sudafed) can increase blood pressure in your eyes. This can lead to glaucoma. Pseudoephedrine also reacts badly with many other drugs, such as beta-blockers, indomethacin (brand name: Indocin), methyldopa (brand name: Aldomet), antidepressants, insulin and some products that treat low blood sugar.
• If you take any drugs for a seizure problem, you should not use pseudoephedrine.
• If you use a monoamine oxidase inhibitor (MAOI), avoid using pseudoephedrine or the cough medicine dextromethorphan (brand names: Delsym, Robitussin Maximum Strength, Vicks 44 Cough Relief). Pseudoephedrine and dextromethorphan can change the way MAOIs work in your system. MAOIs include isocarboxazid (brand name: Marplan), phenelzine (brand name: Nardil), selegiline (brand names: Eldepryl, Carbex) and tranylcypromine (brand name: Parnate). Note that pseudoephedrine and dextromethorphan may cause problems while you are taking an MAOI or within 2 weeks of taking one.
• Antihistamines can cause drowsiness and blurred vision, which may increase your risk of falling. These medicines can also cause dry mouth and trouble urinating.

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• Breathing problems, such as asthma, emphysema or bronchitis
• Bleeding disorders
• Diabetes
• Enlarged prostate gland
• Epilepsy
• Glaucoma
• Gout
• Heart disease
• High blood pressure
• Immune system problems
• Kidney disease
• Liver problems
• Parkinson’s disease
• Psychiatric problems
• Stroke
• Thyroid problems