Over-the-Counter and Herbal Medications: How Safe Are They?

Caregivers are often concerned about the number of medications that their elderly loved ones are taking and how they interact with one another. It is recommended that the same precautions taken with prescription medications be taken with over-the-counter and herbal medications.

According to Dr. Paula Rochon, geriatrician and senior scientist at Baycrest Healthcare System in Toronto, “If your loved one is regularly taking herbal or over-the-counter medication it is very important to speak to his/her doctor about it. Herbal medications, in particular, have become more and more popular over the years. This may be because of the misconception that since they are natural, they are ‘safe’. This is not true.”

Herbal medicines can have pharmacologic activity and there are reports that they may interact with prescribed medications, leading to adverse drug reactions. For example, ginkgo biloba, frequently used by the elderly for improving memory, may interact with warfarin, a prescribed blood thinner, causing an increased risk of bleeding. St. John’s wart, another popular herbal medication, taken in combination with some forms of prescribed antidepressants, may make patients confused and agitated.

Surveys have found that adults over the age of 65 use four times as much non-prescription medication as those who are younger. These products include antacids, pain relievers, cold remedies and laxatives. People tend to consider them harmless but they can cause all sorts of trouble.

They can cause side effects, including drowsiness or nervousness
They may contain caffeine, alcohol and other extra ingredients which can cause side effects such as nervousness, sleeplessness or sedation
You can become dependent on products such as sleeping aids, laxatives and nose drops. They may also have a “rebound” effect, causing the very symptoms which led you to take them – for example, pain relievers can cause headaches and nasal sprays can cause chronic nasal stuffiness

As people get older, they may encounter age-related problems even with over-the-counter medications. Some of the reasons are:

Age-related changes in the body affect how various drugs are absorbed, used and eliminated. In some cases, absorption may be slowed down, making the drug less effective. Because older people may excrete drugs less quickly, they can build up in the body, causing unpleasant side-effects.
Older people are more likely to suffer from diseases and conditions which affect how the body uses drugs – for example, if your loved one has congestive heart failure, reduced blood flow to the intestines can reduce the absorption of medication.
Many of the drugs now in use were tested on younger people, most of them men. They may have subtly different effects on older adults, with special problems depending on whether they are used on women or men.
Older people may need to take a lower dose of certain drugs because of age-related changes in body weight and the distribution of body fat.

Before suggesting over-the-counter or herbal medication, you may want to encourage your loved one to wait and see if the symptoms pass or suggest a non-drug approach. If that fails, speak to the family doctor about the appropriate medication to take.

If herbal or over-the-counter medication is recommended, it is important to follow the directions on the package to determine how much medication to take, how often and for how long.

Remember, over-the-counter medications are not meant for long-term use. If you notice your loved one is taking one of these medications regularly, speak to him/her to find out what the problem is and suggest going to see the family doctor.

In order to avoid adverse interactions you should inform the physicians and pharmacists of all natural health products, over-the-counter medications and any other preparations your loved one may be taking. This is just as important as keeping your physician informed about all of your prescription medications.

Some of the information in this article has been taken directly from the Baycrest publication Look to This Day, A Complete Guide to Health and Well-Being in Your Later Years by Evelyne Michaels.