Over-the-Counter Multi Symptom Medications: Overdose Risk!

This week the FDA released a report that it is considering warnings on over-the-counter multi symptom cold and flu products. The problem is one that I have had concerns about for years: many of these products contain acetaminophen, the pain reliever found in brands such as Tylenol and Exedrine. That alone is not a problem; however, when acetaminophen is an ingredient in many products that might be used together to treat such illnesses as a cold or flu, the potential for overdose is great. According to the FDA report, from 1998 to 2003, acetaminophen was the leading cause of liver failure in the United States. 48% of those cases were from accidental overdose.

Consider the average parent going to the drugstore hoping to find medication to help their child's cold symptoms. The child is coughing; has a stuffy, runny nose; is running a slight fever; and has a headache. He picks up some cough medicine, a decongestant, and some children's pain reliever for the headache and fever. Unless the parent is knowledgeable about the generic names for medications, what he did not see when he stared at the shelves and shelves of cold and flu products is that many of the medications he picked up were combination medications. These may have been labeled to address one of his child's symptoms, but had other ingredients in the formula.

Examples of generic names for symptom-relieving medications include: acetaminophen, a pain reliever; phenylephrine HCL, a nasal decongestant; guaifenesin, a medication to liquify thick mucus; diphenhydramine, an allergy medication; and dextromethorphan, a cough suppressant.

In my own medicine cabinet, I have found a children's cough medicine that has an additional label in small print "and nasal congestion". I also have a cough medicine that has in an additional label in small print "chest congestion, sore throat". So, liquid medication was purchased intending to control a cough, and in addition, expectorant, nasal decongestant, and acetaminophen were also included in these medications.

If I had not known the purpose of these additional medications, (or didn't have my reading glasses on), I probably would have treated my child with a pain reliever for the sore throat and maybe even a dose of nasal decongestant as well if the child was too stuffy to breathe! My child would have been double-dosed on both acetaminophen and decongestant.

The examples of these multi symptom medications are too numerous to list all here. Watch for labeling such as "cough and cold" (which could have all of the medications I listed above), "nighttime" (which might have an antihistamine product as well as a pain reliever), "daytime" (which may have a number of ingredients), "cold and flu" (which may have all the medications I listed above).

My recommendation would be to study the generic names of all the over-the-counter medications you purchase; know what they are and their intended purpose. Know the side- effects of each medication, and the dosage recommended for your child (or yourself for that matter). Consider purchasing only single-symptom medications, and give only those medications that address the symptoms that your child is experiencing.