Before you buy: What to know about common OTC medications

Over‑the‑counter (OTC) medications can be incredibly helpful when you’re trying to manage symptoms at home. With many brand names, combinations, and look‑alike products, it’s easy to get confused or take the wrong one.

Nisarg Patel, MD, a Macon Family Medicine physician at Piedmont Primary Care at Bass Road, shares a simple guide to nine common OTC medications.

Acetaminophen

• Great for: fever, headaches, migraines, arthritis, and pain from viral illnesses like the flu or COVID.
• Important caution: Too much acetaminophen can cause liver damage. If you have liver disease, check with your doctor first.
• Brand names: Tylenol, DayQuil, NyQuil, Coricidin, Excedrin, Goody’s, BC Powder, and dozens more.
• Tip: Many cold medicines contain acetaminophen—so always check labels to avoid double‑dosing.

Ibuprofen

• Ibuprofen is a nonsteroidal anti‑inflammatory drug (NSAID), so it helps with pain, fever, and inflammation.
• Risks with excessive use: stomach ulcers, kidney damage, increased blood pressure, and longer bleeding times.
• Brand names: Advil, Motrin.

Naproxen

• Another NSAID, similar to ibuprofen but longer‑lasting—meaning fewer doses per day.
• Brand name: Aleve.
• Avoid doubling up: Because it works like ibuprofen, don’t take both together.

Diphenhydramine

• A first‑generation antihistamine commonly used for allergies—but also very sedating.
• It often shows up in “PM” products (like Tylenol PM).
• Possible side effects: drowsiness, blurred vision, confusion, urinary retention, memory issues, impaired concentration.
• Best for short-term use only, especially in older adults.

Oxymetazoline (Afrin)

• A nasal spray for congestion that works quickly and effectively.
• However: using it for more than three days can cause rebound congestion (rhinitis medicamentosa), making symptoms worse.
• Generally, avoid unless a doctor recommends it.

Caffeine‑containing medications

• Commonly paired with acetaminophen in products meant for headaches and menstrual pain.
• Examples: Excedrin, Midol, Fioricet.
• Caffeine can help with migraines—but it can also cause withdrawal headaches.
• Use with caution, especially if you drink a lot of coffee or other caffeinated beverages.

Guaifenesin

• Found in products like Mucinex, Robafen and Tussin.
• Misconception: It does not stop a cough.
• What it does: Thins mucus so you can cough it up more easily.
• Limited evidence that it significantly improves symptoms.
• Avoid using for more than seven days without talking to a doctor.
• Don’t pair it with cough suppressants like dextromethorphan or benzonatate—your body needs to cough to clear the loosened mucus. Products like Mucinex DM combine both, which can unintentionally make congestion worse.

ZzzQuil

• A sleep aid that is simply diphenhydramine in liquid form—with 10% alcohol.
• Can make you sleepy, but long‑term use increases the risks of diphenhydramine plus alcohol.
• Use sparingly.

NyQuil

• A combination of acetaminophen and diphenhydramine—again mixed with 10% alcohol.
• Risks: liver damage from the acetaminophen/alcohol combination + side effects from diphenhydramine.
• Use cautiously and avoid taking other acetaminophen-containing products at the same time.

Go to piedmont.org for more information or to schedule an appointment with Dr. Patel or another physician.