5 Types of Over the Counter Medication to Avoid

One of WellBe’s primary goals is helping people get to the root cause of their health issues instead of just masking symptoms with medications that may carry serious side effects. Given this, we’re naturally cautious about most over-the-counter (OTC) medications. But just like prescription drugs, not all OTC meds are created equal — some pose far greater health risks than others. Read on to discover the five unhealthiest drugstore medications, including the alarming side effects of acid reflux drugs, concerns with Advil, and more.

You can also listen to an audio version of this guide on The WellBe Podcast. 

The five unhealthiest types of over the counter medications are (click to jump to each):

• Cold Medicine
• Sleep Aids
• Pain Relievers
• Acid Reflux and Heartburn Medication
• Digestive Aids

The Side Effects of Cold Medicine 

Colds are miserable. You feel congested, achy, feverish, and drained — but there’s no cure, only time and rest. OTC cold medicines don’t cure colds; they simply mask symptoms. This can be risky, as feeling artificially better may lead to overexertion, which can actually prolong your illness. Plus, many cold medicines introduce their own health risks and may be ineffective, according to a 2017 study published in The BMJ.

The decongestant pseudoephedrine — found in common brands like Sudafed — narrows blood vessels to relieve congestion but can cause increased blood pressure and narrowed arteries. This effect can last far longer than the adrenaline-related spike in blood pressure, raising risks of hypertension, heart attack, stroke, and neurological issues. Long-term use is linked to seizures and insomnia.

Other decongestants, like oxymetazoline (in nasal sprays such as Afrin), provide short-term relief but cause a rebound effect where congestion worsens over time. Oxymetazoline crosses the blood-brain barrier, potentially causing stimulant-like effects such as sleeplessness, dizziness, and high blood pressure. 

Dextromethorphan, a cough suppressant common in OTC meds, is associated with cognitive decline and liver damage in long-term use. Given the risks, it’s often not worth the trade-off just to suppress a cough. 

Common ingredients like acetaminophen (Tylenol) and diphenhydramine (Benadryl and other antihistamines) also come with notable side effects, which we’ll get into later in this article.

The Side Effects of Sleep Aids

With millions of Americans chronically underslept, it’s no surprise that OTC sleep aids like Benadryl or Tylenol PM are widely used. While sleep is crucial for health, these medications are among the least healthy OTC options.

Benadryl, an allergy medication, is widely used as a sleep aid due to its sedative effects. However, according to the U.S. National Library of Medicine, it can cause dry mouth, dizziness, digestive issues, and drowsiness. More alarmingly, it’s linked to increased risks of dementia and cognitive impairment. For safer alternatives, check out our article on natural sleep aids that really work.

Tylenol PM and Advil PM combine diphenhydramine with pain relievers (acetaminophen and ibuprofen, respectively), so they carry all these risks plus those associated with their pain-relieving ingredients.

The Side Effects of Advil and Other Pain Relievers 

Advil, Tylenol, and aspirin are household staples, often taken daily without much thought. Yet these common painkillers carry serious potential health risks.

Ibuprofen, the active ingredient in Advil, Motrin, and Aleve, can increase your risk of heart attack and stroke, though the exact cause remains unclear. It reduces prostaglandins — compounds involved in inflammation, blood flow, and blood clotting — which also regulate kidney pressure. This can lead to reduced kidney function. Additionally, long-term use is linked to intestinal bleeding and gut issues such as bacterial imbalance and leaky gut syndrome. And since gut health is core to every other aspect of your health, this is a major problem.

Acetaminophen (Tylenol) raises liver damage concerns, with long-term or high-dose use leading to toxic liver disease. It’s also connected to increased cardiovascular risks and may raise the risk of ADHD when used during pregnancy. The state of California is even considering labeling acetaminophen as a carcinogen based on emerging evidence.

As for aspirin, once promoted as a daily heart protector, studies now show it may increase risks of stroke and gastrointestinal bleeding, prompting reconsideration of its routine use. 

The Side Effects of Acid Reflux Medication and Heartburn Medication 

Medications for acid reflux and heartburn are extremely common but increasingly linked to serious risks. We strongly recommend lifestyle-based approaches for managing GERD symptoms instead of relying on these drugs. Check out our interview with the incredible Dr. Jonathan Aviv for guidance on managing acid reflux naturally. 

Proton pump inhibitors (PPIs) like Prilosec and Nexium have been associated with a 25% increased risk of death, stomach cancer, and a higher likelihood of contracting COVID-19, according to recent studies published in JAMA.

H2 blockers, such as Zantac, were recalled after the FDA found carcinogenic substances in them. Other drugs in this class share similar concerns.

Even popular antacids like Tums and Rolaids can disrupt your gut microbiome by drastically reducing healthy gut flora. To understand why gut health matters, and what you can do to optimize your gut health, download our free guide to improving gut health naturally. 

The Side Effects of Digestive Aids

Digestive issues can be frustrating, but OTC medications like laxatives and anti-diarrheal drugs aren’t the answer. They mask symptoms without addressing underlying causes and carry their own health risks.

Laxatives can interfere with nutrient absorption and cause electrolyte imbalances, potentially leading to serious problems like heart arrhythmias and seizures. Pepto Bismol may cause alarming side effects such as black stool and black hairy tongue — that’s a very hard pass from us!  Imodium (loperamide) can cause dizziness, headache, nausea, and ironically, constipation.

Ultimately, these medications prevent you from addressing the root causes of digestive distress. Holistic lifestyle changes and food sensitivity investigations are more effective long-term solutions. 

The WellBe Takeaway: What to Remember About Over the Counter Medication

At WellBe, we believe in addressing the root cause of your health concerns instead of just masking symptoms with medications that can carry hidden risks. While OTC drugs may seem like a quick fix, many come with side effects ranging from mild discomfort to serious long-term health problems. Here’s what to keep in mind:

• OTC medications are widely used: In 2015, Americans made over 3 billion retail trips to buy OTC drugs, reflecting a tendency to reach for quick symptom relief without fully considering risks.
• Almost all medications have side effects because they introduce synthetic substances your body hasn’t evolved to handle. Some effects are short-term and mild, but others can be long-lasting and severe.
• The five most dangerous types of OTC medications covered here are cold medicines, sleep aids, pain relievers, acid reflux/heartburn medications, and digestive aids.
• Cold medicines: Decongestants like pseudoephedrine raise blood pressure and can cause insomnia and seizures; oxymetazoline can worsen congestion and disrupt sleep; cough suppressants like dextromethorphan risk cognitive decline and liver damage.
• Sleep aids: Diphenhydramine, the active ingredient in many OTC sleep aids, can cause digestive issues and increase dementia risk.
• Pain relievers: Ibuprofen raises risks of heart disease, kidney damage, and gastrointestinal bleeding, while acetaminophen poses liver and cardiovascular risks, and aspirin may increase bleeding and stroke risks.
• Acid reflux medications: PPIs increase risk of death and cancer; H2 blockers like Zantac contain carcinogens; even antacids disrupt your gut microbiome, impacting overall health.
• Digestive aids: Laxatives interfere with nutrient absorption and electrolytes; Pepto Bismol and Imodium have uncomfortable side effects; all prevent you from addressing the root causes of digestive problems.

Instead of reaching for OTC medications as a first response, consider natural remedies and lifestyle changes. There are safe, effective options for sleep support, pain relief, acid reflux management, immune support, and gut health that don’t carry the same risks.

If you’re interested in diving deeper into natural medicine and learning how to advocate for your health, reach out to work with Adrienne 1:1 as your Holistic Patient Advocate. For vetted product recommendations, explore the WellBe Non-Toxic Product Lists.

Do you have any of these OTC medications in your medicine cabinet? Would you consider switching to natural alternatives? Share your thoughts in the comments below!

You can also listen to an audio version of this guide on The WellBe Podcast. 

Citations: 

1. Laccourreye, A. et al. Benefits, limits and danger of ephedrine and pse
2. Arroll, Bruce, et al. “Efficacy and Safety of Decongestants for the Common Cold.” The BMJ, vol. 357, 2017, doi:10.1136/bmj.j2148.
3. National Library of Medicine. “Diphenhydramine.” MedlinePlus, U.S. National Library of Medicine, 2024, medlineplus.gov/druginfo/meds/a682539.html.
4. Gao, Xia, et al. “Long-Term Use of Proton Pump Inhibitors Is Associated with Increased Risk of Death.” JAMA Network Open, vol. 3, no. 6, 2020, doi:10.1001/jamanetworkopen.2020.12551.
5. U.S. Food and Drug Administration. “FDA Requests Removal of All Ranitidine Products (Zantac) from the Market.” FDA, 1 Apr. 2020, www.fda.gov/news-events/press-announcements/fda-requests-removal-all-ranitidine-products-zantac-market.
6. California Office of Environmental Health Hazard Assessment. “Proposed Carcinogen Listing for Acetaminophen.” OEHHA, 2023, oehha.ca.gov/media/downloads/crnr/2023update.pdf.
7. Centers for Disease Control and Prevention. “Over-the-Counter Medication Use in the United States.” CDC, 2015, www.cdc.gov/medicationsafety/otcmedications.html.