Should You Purchase These Drugs Without A Prescription?

We live in an era of easy access where everyone can access medical information and self-medication can seem like an easy option. It is easy to forget the wisdom of seeking professional help. Here we unpack the risks of self-medication and how they impact different organs. 

A doctor prescribes medication after a detailed consultation with a patient. A consultation includes a detailed medical history (both present and past), a physical examination and lab tests to make a diagnosis. Based on this information, a doctor will prescribe the medication after weighing the pros and cons and individual factors like age and comorbidities, familial history, and possible drug interaction with existing medications (including supplements) being taken. Adverse effects may be of many types, like side effects related to drugs, drug-with-drug interactions, food-with-drug interactions, and allergic reactions.

Remember, self-medication can cause harm!

Note: Self-medication includes taking medicines based on pharmacist/ chemist input

Risks of self-medication

There are many risks to self-medication or getting medication without a prescription:

1. The pharmacist or person suggesting the medication may not be familiar with the entire risk profile and related side effects.
2. The potential for drug interactions can result in adverse side effects and complications, especially when multiple medications are involved.
3. Overuse or abuse of certain drugs that are used commonly may cause long-term issues like kidney and liver issues and detrimental effects on the gut microbiome.
4. Unprescribed use of antibiotics may lead to antibiotic resistance.
5. There is also an increased risk of medication being:
   • Repetitive: Sometimes one may accidentally take two or more medications with similar salts that may cause an overdose. Taking any over-the-counter painkiller with some prescribed anti-inflammatory medicine may cause issues with the liver and kidneys.
   • Antagonistic: The interaction between medicines with active ingredients that have contrasting effects on the body is possible. The efficacy of either or both medicines may be decreased. OTC (over the counter) decongestants, for instance, can raise an individual’s blood pressure. This can work against (cause opposition to) medicines that lower your blood pressure.
   • Variable: Some medications may alter the absorption or metabolism of another medicine. For example, aspirin can change the way some prescription blood-thinning medicines work.
6. Food may alter the absorption, efficacy, and metabolism of some medications. E.g., thyroid medications are best absorbed on an empty stomach while pain medications are mostly meant to be taken after meals.

How To Take Medications Safely

1. Avoid overuse of over-the-counter medications. Take medications after reading the labels and store them as per the safety and storage instructions.
2. Avoid replicating medications from someone else’s prescriptions however similar your symptoms may be as medications needed may still vary as per age, weight, comorbidities, family history, etc.
3. Do not stop medications midway. Always take them for the full prescribed duration, or else there may be chances of recurrence or resistance to medication.
4. Do not take antibiotics frequently unless prescribed by your doctor.
5. Report any adverse effects experienced during treatment to your doctor as they may help to report potential allergic reactions and or may alter the treatment or dosage to meet your treatment goals and well-being.

Related Reading:

Diabetes Medications and drug interactions with other medicines 

Medications that impact blood sugar levels

Common Heart Medications - side effects and their drug interactions in 2 parts 

Some Commonly Used Medications and their Effect on your Health

Here we detail how some common medications impact various organs of the human body

Effect on Cardio-Vascular System:

• Aspirin: Commonly taken for headaches and prescribed to many patients with cardiac issues.
  Potential side effects: May cause gastritis, heartburn, increased risk of bleeding, etc. Frequent and prolonged use may cause potential damage to the liver.
• NSAIDs or pain relief medications: The most commonly used and overused medications are often used without consulting a doctor. They are often taken for body ache, headaches, fever, and many other painful issues or conditions.
  Potential side effects: They may boost the chances of heart failure as they cause retention of water and salt and hamper the work of diuretic medications prescribed for heart failure and high blood pressure.
• ACE inhibitors (BP medication): They’re used to treat hypertension and are often taken off and on once started without follow-up visits with the doctor.
  Potential side effects: About 10% of patients on treatment of BP with ACE inhibitors may develop persistent dry cough. Discussion and follow-up with the doctor is the right way to get it diagnosed early and get proper treatment.
• Some Heart Medications used for high BP and CAD: Medications like beta blockers may harm the lungs in certain conditions.
  Potential side effects: Beta-blockers when used in a person with Asthma may cause an exacerbation because of the propensity to narrow the airways therefore it’s imperative that any person with high BP or CAD must mention existing medications to their doctor if diagnosed with Asthma or other conditions of the lung.

Effect on Respiratory System:

• NSAIDs or pain relief medications:
  Potential side effects: Prolonged use of pain relief medications may lead to a reduced capacity of the lung to form antioxidants that help prevent damage and this may worsen conditions like Asthma.
• Codeine is commonly found in cough suppressant syrups: these medications may again be habit-forming and may cause severe detrimental effects and should not be used in children and adults without consulting a doctor.
  Potential side effects: Codeine may cause issues like excessive drowsiness, dizziness, and shallow breathing. With prolonged use, it may cause severe constipation.
• Bronchodilators like Levosalbutamol: It is very common to have a nebulizer at home if one lives in a metropolitan city. Because of pollution, almost every child and adult alike may have been prescribed bronchodilators through nebulization for a wheeze, but with every cough, the prescription is often repeated without consulting the doctor, which may cause unwanted side effects.
  Potential side effects: An overdose may sometimes cause palpitations and seizures. It may also worsen things for people with diabetes and CAD, as it causes low potassium and high blood sugar and therefore may need a dose adjustment based on a doctor’s discretion.

Effect on Neurological System:

• Sedatives and Antianxiety medications (commonly benzodiazepines): Many people use sedatives (sleeping aids) and antidepressants for a prolonged period to allay stress and get better sleep without intimating their doctor.
  Potential side effects: These medications may be habit-forming (likely to become addictive) and even cause breathing issues when consumed with alcohol.

Effect on Genitourinary System:

• Antihistamines (antiallergy medication): Very commonly taken medications, but in some instances may cause unwanted side effects related to the urinary system.
  Potential side effects: These medications may relax the urinary bladder and thus may lead to urinary retention.

Effect on Gastrointestinal System:

• Drugs for acidity (PPIs): Medications like Omeprazole, Pantoprazole, etc are known as PPIs and are often used without a prescription for acidity (heart burn), over-eating, chest pain and reflux.
  Potential Side effects: Long-term use or frequent use is known to be associated with changes in the gut bacteria which may increase the chances of infection. They also interfere with calcium absorption and may cause weakening of bones. PPIs are also known to interfere with the absorption of Vitamin B12 and Magnesium in the body and may accentuate an existing deficiency.
• Laxatives: They are a group of medications used to increase bowel movement and are usually prescribed for constipation. These medications are often misused as a tool for weight loss.
  Potential Side Effects: Laxatives when used frequently or for a prolonged period may cause an imbalance of electrolytes and water from the body leading to dehydration. After prolonged use one may experience constipation from withdrawal. They are also known to harm the colon and may cause bleeding. Other potential side effects are seizures, cardiac arrest (due to stimulants that are present in them).
• Digestive aids: Over the counter digestive enzymes are commonly used for symptoms like bloating and reflux. 
  Potential side effects: The digestive enzymes are regulated for exact dosage, enzymes, and potential side effects and therefore should not be taken without consulting with a doctor. Prolonged and frequent use may lead to cramps, oily stools, and sometimes unwanted weight loss.

Medications, when taken after seeking medical advice at the right dose and for the right duration, help to improve the quality of life and health and may also be lifesaving. Open communication with the treating doctor is the key to getting the most out of any consultation. Avoiding self-medication may help avoid prolonged illness, unwanted side effects, issues related to drug interactions, resistance to antibiotics, developing tolerance or addiction to medications, and potentially life-threatening side effects. It’s always better to be safe than sorry!

References:

1. Familydoctor.org editorial staff. “OTC Medicines: Know Your Risks and Reduce Them - Familydoctor.org.” Familydoctor.org, 23 May 2018, familydoctor.org/otc-medicines-know-your-risks-and-reduce-them/.
2. ‌Sánchez-Sánchez, Eduardo, et al. “Consumption of Over-The-Counter Drugs: Prevalence and Type of Drugs.” International Journal of Environmental Research and Public Health, vol. 18, no. 11, 1 Jan. 2021, p. 5530, https://doi.org/10.3390/ijerph18115530.
3. ‌“Non Prescription Drug - an Overview | ScienceDirect Topics.” Www.sciencedirect.com, www.sciencedirect.com/topics/medicine-and-dentistry/non-prescription-dr….
4. ‌Cristol, Hope. “Heart Failure and Medication: Is There a Link?” WebMD, www.webmd.com/heart-disease/heart-failure/meds-cause-heart-failure.
5. Cleveland Clinic. “Urinary Retention Causes & Treatment.” Cleveland Clinic, 2012, my.clevelandclinic.org/health/diseases/15427-urinary-retention.
6. ‌Goad, Kimberly. “5 Medications That Can Cause Lung Issues.” AARP, AARP, 12 Jan. 2024, www.aarp.org/health/drugs-supplements/info-2024/medications-that-damage…. Accessed 29 Apr. 2024.
7. “Physical Complications of Abuse of Laxatives, Diuretics & Diet Pills.” Insideoutinstitute.org.au, insideoutinstitute.org.au/resource-library/physical-complications-of-abuse-of-laxatives-diuretics-diet-pills.