Review

OTC analgesics and drug interactions: clinical implications

A Mark Fendrick¹ , Deborah E Pan² and Grace E Johnson³

¹Professor, Internal Medicine/Health Management and Policy, University of Michigan Medical Center, 300 North Ingalls Building, Room 7E16, Ann Arbor, MI 48109 USA

²Medical Director, Scientific Therapeutics Information, Inc., 505 Morris Avenue – 3rd Floor, Springfield, NJ 07081 USA

³Senior Medical Director, Scientific Therapeutics Information, Inc., 505 Morris Avenue – 3rd Floor, Springfield, NJ 07081 USA

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Osteopathic Medicine and Primary Care 2008, 2:2doi:10.1186/1750-4732-2-2

Published:	7 February 2008

Abstract

The risk of drug interactions with concurrent use of multiple medications is a clinically relevant issue. Many patients are unaware that over-the-counter (OTC) analgesics can cause potentially serious adverse effects when used in combination with other common medications such as anticoagulants, corticosteroids, or antihypertensive agents. Of particular significance is the increased risk of upper abdominal gastrointestinal adverse events in patients who take traditional nonsteroidal anti-inflammatory drugs (NSAIDs). This risk is dose dependent and further increased in patients who take more than one NSAID or use NSAIDs in combination with certain other medications. Some NSAIDs may also mitigate the antiplatelet benefits of aspirin and may increase blood pressure in patients with hypertension. Clinicians should be aware of potential drug interactions with OTC analgesics when prescribing new medications. Additionally, patients should be properly counseled on the appropriate and safe use of OTC analgesics.