Over-the-counter medicines are by no means safe for health. According to a study by the “Institut für Demoskopie Allensbach”, two out of three of those questioned obtain medicines without a prescription at their own expense in the pharmacy. Accordingly, no doctor is often the result of alleviating minor complaints. However, such self-medication is not without risk, since "over the counter" is not synonymous with "harmless", as the Vice President of the German Medical Association, Dr. Cornelia Goesmann, warns.
Painkillers purchased 50 percent without a prescription "If I feel sick and think that it is not too bad, I get medication in the pharmacy," said two thirds of the respondents in the Allensbach survey. The pain reliever paracetamol is at the forefront of the preparations purchased without a prescription. In over 50 percent of cases, patients paid for the medication out of their own pockets. But "even common and popular drugs like paracetamol can cause severe liver damage if overdosed," said Dr. Goesmann. Around every fifth case has serious problems, like Dr. Martin Schulz, Chairman of the Drug Commission of German Pharmacists, knows how to report. The specialist emphasized that the regular high consumption of painkillers can cause headaches. Therefore, patients should take painkillers for a maximum of ten days a month and never longer than three days in a row, Dr. Schulz.
In addition to over-the-counter pain relievers, preparations for the common cold are currently in high demand. And here too, every third person takes care of himself without a doctor's recommendation. Specialists like Dr. However, Goesmann are extremely critical of this type of self-therapy. Because even an initially harmless flu infection can, according to the experts, cause major health problems that should be urgently treated by the doctor. For example, in the case of pain in the forehead or eye area, with purulent or bloody expectoration or with painful coughing and breathing, a specialist should urgently be consulted. Fever that lasts longer than two to three days or rises to over 39 degrees when the temperature rises slightly must also be treated by the doctor, emphasized Dr. Goesmann.
Addiction risk and getting used to Dr. Goesmann and Dr. Schulz warned of the risk of getting used to certain agents within the scope of the self-determined dosage. The frequent or regular use of certain preparations can lead not only to serious side effects but also to drug dependencies. Decongestant nasal sprays or drops, for example, should not be used for longer than a week at a time, since they contain active ingredients such as xylometazoline, oxymetazoline, tramazoline or naphazoline, which constrict the blood vessels in the nasal mucosa. With permanent treatment of over a week, however, the opposite effect occurs. The mucous membrane swells even more and the nose seems permanently blocked. Many patients react with higher and higher doses in order to achieve any noticeable effects and thus run the risk of dependency. In most cases, however, the side effects of long-term drug consumption are far worse than the risk of addiction.
Herbal products also not necessarily harmless The Vice President of the German Medical Association said: "Prescription-free medication can be obtained without problems, but it is not unproblematic". And active ingredients declared as "purely herbal" can never be considered harmless. So Dr. explained Goesmann states that "St. John's wort products, for example (...) can (can) significantly change the chemical effects of other medicinal products and (...) should never be taken without consulting a doctor or pharmacist". Over-the-counter laxatives based on plants, for example with senna leaves, should not be taken for longer than two weeks, according to the expert, without medical supervision. Otherwise, chronic constipation could occur, since the electrolyte balance shifts and a lot of potassium is lost with the thin stool, which can lead to paralysis of the intestinal muscles and corresponding constipation.
Critical: increasing consumption of sleeping pills The experts are also concerned about the increasing consumption of over-the-counter sleeping pills. In any case, these should only be taken for a short time, since the active ingredients diphenhydramine, dimenhydrinate or doxylamine change the sleep rhythm and make sleep less relaxing. As soon as sleep problems last longer than a maximum of one month, occur at least three times a week or interfere with your everyday life, it is imperative to consult a specialist. Even if herbal supplements with valerian, hops or lemon balm are an almost side effect-free alternative, "those who suffer from permanent sleep disorders should definitely go to the doctor," emphasized Dr. Goesmann.
Risky interactions with other drugs In addition to the side effects, experts warned against the interactions of the over-the-counter preparations with other drugs. For example, myocardial infarction patients who take ASA must never use ibuprofen, because ibuprofen cancels the effects of ASA. Special care should also be taken when using over-the-counter medicines in children. For example, only around 20 percent of all currently available drugs are approved for young patients under the Medicines Act, with the correct dosage being a particular problem. In children, pharmaceuticals have so far been dosed predominantly based on experience, which are listed in so-called pediatric dose tables. Doctors also have considerable problems finding the right dose for little patients. For example, parents who treat their children at home with their own therapy are faced with almost insoluble tasks when dosing numerous preparations. For this reason, experts advise children to use only active substances that are explicitly identified as suitable for children and that contain the appropriate dosage information in the package insert. "A few decongestant nasal drops or a fever suppository can (quite) provide relief for a child," said the spokesman for the professional association of pediatricians, Dr. Ulrich Fegeler, however, added: "It is important, however, that they are given only once." If the symptoms do not improve afterwards, "you need a doctor and no other medication," emphasized Dr. Fegeler. Painkillers are particularly critical for children due to the numerous side effects and they should generally only be given when the cause of the pain has been clarified.
Advice in pharmacies is gaining in importance According to the Federal Center for Health Education (BzgA), Germans pay an average of around 70 euros per year out of their own pocket for medication that they take without consulting a doctor. Many prefer to pay for the costs themselves instead of having to pay the trip to the doctor and the associated practice fee and waiting time. Especially for colds, the patients are willing to take on some costs. Overall, the self-financed sums correspond to one sixth of the total per capita sales for pharmaceuticals - with an upward trend. Every sixth preparation is therefore taken without a previous medical examination. This means that consulting services in pharmacies are becoming increasingly important, not only with regard to advice on individual products but also with regard to the sensible treatment of existing diseases. "The pharmacy team can provide important information as to whether a doctor's visit is necessary", explained the President of the Federal Chamber of Pharmacists, Erika Fink. (fp, 18.10.2010)