5 Types of Over the Counter Medication to Avoid

One of our primary goals at WellBe is to help people get to the root cause of their health issues, rather than just treating the symptoms with medications that may have their own serious side effects. Given that, it should be no surprise that we’re generally wary of most over the counter medication. But, just as with prescription medications, not all OTC meds are created equal, and some are way worse than others for your health. Read on to learn the 5 unhealthiest drugstore medications, including the scary side effects of acid reflux medication, some concerning side effects of 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 the worst. You feel run down, congested, achy, feverish, and to make matters worse, there’s not a lot you can do about it. The common cold is famously incurable, and really all you can do is rest, stay hydrated, and let it run its course. That means that cold medicine isn’t actually making you better, it’s just masking the symptoms. This is bad in its own way, since you might feel artificially well enough to overexert yourself, which can in turn prolong your cold. But many cold medications also introduce new health risks and, according to research, don’t even work.

First there’s the common decongestant pseudoephedrine, found in over the counter medication like Sudafed and many others. To relieve congestion, pseudoephedrine causes blood vessels to constrict, which can have the unwanted effects of increased blood pressure and narrowed arteries. This effect is long-lasting (increased blood pressure from pseudoephedrine lasts 5 to 6 times longer than the increase caused by adrenaline) and can lead to hypertension episodes, heart attack, stroke, and various neurological issues. Long-term use of pseudoephedrine is associated with other serious problems, including seizures and insomnia. 

Other decongestants pose their own risks. Oxymetazoline, which is found in nasal sprays like Afrin, can relieve nasal congestion in the short-term, but have a long-lasting “rebound effect” in which you actually become stuffier in the long-term. It also crosses the blood-brain barrier, which can result in an amphetamine-like stimulant effect that can lead to sleeplessness (kinda counterproductive when the number one thing you can do for a cold is rest). It’s also been associated with blurred vision, pounding heartbeat, dizziness, and high blood pressure. 

Dextromethorphan, a cough suppressant commonly found in over the counter medication, has some more concerning long-term risks: it’s been associated with both cognitive deterioration and liver disease! If you ask us, not worth the trade-off to avoid some coughing.

Acetaminophen (the active ingredient in Tylenol) and diphenhydramine (the active ingredient in Benadryl and other antihistamines) are also commonly found in cold meds. See below for the issues both of those present…

The Side Effects of Sleep Aids

Americans are chronically underslept, so it should be no surprise that over 9 million of us take prescription sleep aids and countless more rely on things like Benadryl or Tylenol PM to fall asleep. Sleep is incredibly important for your health and well-being, so we totally get wanting to pop a pill and get some shut-eye, but the truth is that these sleeping pills are among the least healthy types of over the counter medication. 

While Benadryl is actually an allergy medication, it’s also notorious for making people super drowsy and is commonly used as a sleep aid. According to the U.S. National Library of Medicine, it’s associated with a long list of short-term side effects, including dry mouth, dizziness, drowsiness, and gut/digestive issues like nausea, vomiting, and lack of appetite. Even scarier, it’s also been linked to  an increased risk of dementia and impaired cognitive function. 

Both Tylenol PM and Advil PM make you sleepy with diphenhydramine, which is the active ingredient in Benadryl, so they carry all of the side effects listed above. But on top of that, you also get the side effects of their other pain-relieving active ingredient: for Tylenol, that’s acetaminophen, and for Advil, that’s ibuprofen. See below for the health risks of both of these.

The Side Effects of Advil and Other Pain Relievers 

Advil, Tylenol, and aspirin are so ubiquitous that people don’t think twice about popping them daily (in fact, it’s long been recommended that people take an aspirin a day as a protective measure against heart disease). That makes it all the more shocking when you learn their potential serious health risks.

Let’s start with the side effects of Advil and other pain-relieving drugs containing ibuprofen (for example, Motrin and Aleve). One of the most concerning side effects of Advil is that it can increase your risk of heart attack and stroke, and it’s not known why this side effect occurs. In addition, medications containing ibuprofen reduce your body’s production of a compound called prostaglandins, which control processes such as inflammation, blood flow, and formation of blood clots. Prostaglandins also help keep your kidney pressure at the right level, which means that Advil and other ibuprofen-containing drugs can reduce your kidney function. Oh, and one more little thing: studies have shown that over time, ibuprofen can actually cause bleeding in your intestine. Plus, NSAIDs like Advil and Motrin are linked to gut issues such as an imbalance in bacteria and leaky gut. Hard pass. 

Acetaminophen, the active ingredient in Tylenol, fares no better in the side effects department. Your liver is the biggest concern with acetaminophen, as long-term use can cause serious damage to the organ, and taking too much acetaminophen even over the short-term can lead to toxic liver disease. It’s also associated with increased risk of cardiovascular issues like high blood pressure, stroke, and heart attack, and research suggests that taking acetaminophen while pregnant puts the baby at a higher risk for developing ADHD later in life. What’s more, it may be linked to an increased cancer risk — so much so that the state of California is considering labeling it as a carcinogen. 

Oh, and that daily aspirin we’ve been told to take? Turns out it’s not that beneficial after all, and may actually increase your risk of stroke and gastrointestinal bleeding. 

The Side Effects of Acid Reflux Medication and Heartburn Medication 

Drugs for acid reflux and heartburn are incredibly common, and, as we’re learning through an influx of new research, incredibly dangerous. The side effects of acid reflux medication are serious enough that we highly recommend tossing any you might have in the garbage and using a lifestyle-based approach to heal any GERD issues you might be having. 

Medications for acid reflux and heartburn fall into a few different categories, one of the most common being PPIs, or proton pump inhibitors (Prilosec and Nexium are some common brands). PPIs have been in the news recently as a result of several concerning studies: they’ve been associated with a 25% increased risk of death, as well as an increased risk of stomach cancer and a greater chance of getting COVID-19! 

H2 blockers are the other main type of over the counter medication for heartburn, and they’re also pretty scary. In fact, in April 2020 the FDA requested that all Zantac (a common H2 blocker) be pulled from the market because it contains a carcinogen! What’s more, this cancer-causing substance is inherent to the active ingredient in this type of medication, so other H2 blockers carry the same risk. 

But what about those innocent, candy-like antacids like Tums? The side effects of acid reflux medication can’t possibly extend to them, right? Wrong. Yummy little antacids like Tums and Rolaids can dramatically reduce healthy gut flora, seriously screwing up your gut microbiome. 

The Side Effects of Digestive Aids

Having trouble with your number two situation is quite unpleasant — no argument on that here. But turning to an over the counter medication like laxatives or diarrhea remedies is definitely not the solution. Not only do they prevent you from getting to the bottom of your digestive issues (which is a big deal, since your gut is central to every aspect of your health!), they also carry some concerning health risks.

For their part, laxatives can interfere with your body’s absorption of certain nutrients, meaning that they’re actually exacerbating whatever dietary problems you may be dealing with already. If you use them for a prolonged period of time, they can also lead to an electrolyte imbalance, disturbing the sensitive levels of electrolytes like calcium, potassium, magnesium, and sodium in your body. Since electrolytes regulate many bodily functions, an imbalance can cause serious problems, including heart arrhythmias, confusion, and seizures. 

Then there’s Pepto Bismol, which can cause — are you ready for this? — black stool and black hairy tongue. Yes, black hairy tongue (whatever you do, do NOT Google this). Imodium, another common diarrhea remedy, can have short-term side effects like dizziness, headache, nausea, and, ironically, constipation! 

But the worst thing about this type of over the counter medication is that they simply paper over the symptoms you’re experiencing, which are your body’s way of communicating with you and telling you that something’s not right inside. Rather than taking a drug, take holistic, lifestyle-based steps to improve your gut health and suss out any food sensitivities. Once you’ve done that, you won’t have a need for digestive aids in the future. 

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

We’ve said it before, and we’ll say it a thousand times: if you care about your long-term health (and you should), you should always, always, look to address the root cause of any health issues you experience, rather than covering them up with medication. Of course, there are times when prescription or over the counter medication is an essential part of recovery, but quite often, they just provide a BandAid for the original issue while creating additional issues of their own. It becomes an endless game of whack-a-mole rather than a journey to long-term health. 

Furthermore, there are tons of virtually side-effect free options: There are great natural remedies that can help with things like inducing sleep, inflammation, and menstrual cramps that you might take an OTC painkiller for; there is a diet that nips acid reflux and heartburn in the bud; there are herbal remedies and supplements known to help with both immune-support to prevent and overcome colds more quickly; and there are many natural ways to improve bloating, gas, constipation, diarrhea and other digestive symptoms. 

Here’s what to remember about the health risks of over the counter medication:  

• Americans take a lot of over the counter medication. In 2015, Americans made over 3 BILLION retail trips to buy OTC drugs. This gives you a sense of how nonchalant many people are about popping a pill to deal with a health issue. 
• Almost all medications, OTC or prescription, have side effects because if you think about it, these are man-made things that don’t exist in nature. When you put a man-made thing in your body that it has never seen before, there’s a good chance there will be side effects as the drug may react poorly with different microbes in your body. Many of these are short-term and merely unpleasant, but some can have a more long-term and serious impact on your health. The five most dangerous types of over the counter medication are cold medicine, sleep aids, pain relievers, heartburn and acid reflux medications, and digestive aids. 
• Side effects of cold medicine: the decongestant pseudoephedrine can cause high blood pressure, insomnia, and seizures. The decongestant oxymetazoline can make you more congested in the long-term and have a stimulant effect. The cough suppressant dextromethorphan can lead to cognitive decline and liver damage.
• Side effects of sleep aids: the antihistamine diphenhydramine is the active ingredient in most OTC sleep aids. It’s been linked with gut and digestive issues as well as an increased risk of dementia and cognitive decline, among other issues. 
• Side effects of Advil, Tylenol, and other pain relievers: ibuprofen, the active ingredient in Advil, is associated with an increased risk of heart disease, as well as reduced kidney function and gastrointestinal bleeding, and mess up your gut health Acetaminophen, the active ingredient in Tylenol, is associated with liver damage, cardiovascular disease, and an increased risk of ADHD. Aspirin can increase your risk of stroke. 
• Side effects of acid reflux medication: PPIs like Prilosec and Nexium are associated with a 25% increased risk of death, among other issues. H2 blockers like Zantac contain a cancer-causing substance. Even antacids like Tums and Rolaids totally mess up your gut microbiome!
• Side effects of digestive medications: Laxatives can block the absorption of important nutrients and cause an electrolyte imbalance, impairing important body functions. Meanwhile, Pepto Bismol can cause a black, hairy tongue! 
• It’s always better to address the root cause of your symptoms rather than just treating them with medication. And if you do need to turn to medication, it’s important to take things that you’ve vetted and know won’t come with a price tag of short- or long-term side effects. To learn more about drug side effects, natural medicine options and much more, consider taking the WellBe Holistic Patient Advocacy & Navigation Certificate Program. Registration is open now but closing soon! If you want help finding WellBe-vetted natural medicine, check out the WellBe Non-Toxic Product Lists. 

Do you have any of these over the counter medications in your medicine cabinet? Are you willing to toss it and try a more natural option? Why or why not? Let us know 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 pseudoephedrine as nasal decongestants. European Annals of Otorhinolaryngology, Head and Neck Diseases. Volume 132, Issue 1, February 2015, Pages 31-34.
2. Graf, P. et al. Effect on the nasal mucosa of long-term treatment with oxymetazoline, benzalkonium chloride, and placebo nasal sprays. Laryngoscope. 1996 May;106(5 Pt 1):605-9.
3. Dokuyuku, R. et al. Systemic side effects of locally used oxymetazoline. Int J Clin Exp Med. 2015; 8(2): 2674–2678.
4. Hinsberger, A. et al. Cognitive deterioration from long-term abuse of dextromethorphan: a case report. J Psychiatry Neurosci. 1994 Nov; 19(5): 375–377.
5. Gray, S. et al. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia. JAMA Intern Med. 2015 Mar 1; 175(3): 401–407.