Latest / Silver FM 100.6 / The dos and don'ts of taking over-the-counter pain medications

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The dos and don'ts of taking over-the-counter pain medications · Silver FM 100.6

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  Speaker 3: You're listening to Life Kit.
• 0:29
  Speaker 2: From NPR.
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  Speaker 3: Hey, everybody, it's Mary l. For a decade plus, when
• 0:36
  Speaker 3: I would get my period, I would have terrible cramps
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  Speaker 3: the first day, and I would just ride it out,
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  Speaker 3: like I'd be doubled over, unable to leave the house.
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  Speaker 4: Really.
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  Speaker 3: I tried heating pads, which to help, but for some
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  Speaker 3: reason I didn't think I should take a painkiller.
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  Speaker 2: I don't know, I guess I just thought it was
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  Speaker 2: safer to go natural.
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  Speaker 3: But then one day, when I was maybe twenty five,
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  Speaker 3: I popped an ibuprofen and then a short time later
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  Speaker 3: the pain was gone. It would start to creep back
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  Speaker 3: up again a little later, and then I took another
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  Speaker 3: and after that I was over the hump. My cramps
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  Speaker 3: were manageable. At that point I kind of regretted waiting
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  Speaker 3: that long I went through so much unnecessary pain. Pain
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  Speaker 3: is a part of the human experience. We get cramps
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  Speaker 3: and aches and migraines. We burn our hands cooking or
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  Speaker 3: trip and sprain an ankle, and when you're right in
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  Speaker 3: the middle of one of these moments and feeling that
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  Speaker 3: pain deep down in your bones. Painkillers, especially the over
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  Speaker 3: the counter kind that are easy to get, they feel
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  Speaker 3: like a miracle. Now, they are not without risks. If
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  Speaker 3: you take over the counter painkillers the wrong way, or
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  Speaker 3: take too many of them, you can have serious complications
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  Speaker 3: or even die, and they can mask your problems too.
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  Speaker 3: Pain is there for a reason. It's one of the
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  Speaker 3: ways our bodies warn us that something's wrong. Doctor Trisha
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  Speaker 3: Pasricha is an instructor at Harvard Medical School, and she says,
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  Speaker 3: we need to consider that when we're thinking about making painkillers.
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  Speaker 2: I think there's a question that we should ask ourselves
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  Speaker 2: when we have pain, which is that is this like
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  Speaker 2: sort of a one time thing or once in a
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  Speaker 2: blue type of moment that I'm having, or am I
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  Speaker 2: going to the director all the time for pain? And
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  Speaker 2: is it the same kind of pain? Because I think
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  Speaker 2: in my mind that really differentiates what we need to
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  Speaker 2: be doing about.
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  Speaker 3: It, because if this pain keeps coming up, it might
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  Speaker 3: be time to see a doctor make sure everything's okay.
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  Speaker 3: Life Kit reporter Andy Tagle has been looking into how
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  Speaker 3: we use over the counter drugs, and in this episode,
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  Speaker 3: we're going to talk specifically about painkillers like acetaminifin, and
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  Speaker 3: En says, non steroidal anti inflammatory drugs ibuprofen, nepoxy and
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  Speaker 3: aspirin and the like. These are some of the most
• 2:40
  Speaker 3: commonly used over the counter medications. Andy talked to doctor
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  Speaker 3: Pascrichia and to two pharmacists, including Blama tweg b at
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  Speaker 3: UCSF's outpatient Pharmacy at Mission Bay, who says, yeah, talk
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  Speaker 3: to your pharmacist. This is their world and they have
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  Speaker 3: the training to help you.
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  Speaker 4: And we can help you make a safe choice, and
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  Speaker 4: we'll ask you questions that you may not even think about,
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  Speaker 4: like what other medications are you taking. Oftentimes there can
• 3:05
  Speaker 4: be drug interactions with prescription medication and an over of
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  Speaker 4: a countermed so it's really to your benefit to ask
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  Speaker 4: a pharmacist about what you should use.
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  Speaker 3: Andy and I are going to talk about how to
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  Speaker 3: use these drugs safely, what they're each good at, and
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  Speaker 3: what you might consider if you're looking for an alternative
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  Speaker 3: that's coming up after the break. Okay to start, I've
• 3:30
  Speaker 3: always wondered why are some meds available over the counter
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  Speaker 3: while others require a prescription?
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  Speaker 2: Yeah, me too.
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  Speaker 5: It's a good question. So if a medicine is available
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  Speaker 5: over the counter, that means it's been deemed safe and
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  Speaker 5: effected by the FDA for most people if used correctly,
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  Speaker 5: and they have to meet three basic criteria in order
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  Speaker 5: for that to happen. One, you have to be able
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  Speaker 5: to self diagnose the problem like I have a headache
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  Speaker 5: from there, Two, you have to be able to self
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  Speaker 5: treat that headache. And then three, there has to be
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  Speaker 5: a low potential for meuse and abuse. All of these
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  Speaker 5: medications are tested and regulated through something called a drug monograph,
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  Speaker 5: and what those are are kind of a recipe book
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  Speaker 5: which cover acceptable ingredients, doses, formulations, and labeling. These are
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  Speaker 5: continually updated by the FDA to make sure that the
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  Speaker 5: public is safe and informed.
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  Speaker 3: But if you use over the counter meeds the wrong way,
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  Speaker 3: you could die. Right In some cases, they're not without risk.
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  Speaker 3: They can be fatal or addictive.
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  Speaker 5: Yeah, maryel, Just because an over the countermed is deemed
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  Speaker 5: safe doesn't mean they can't still be harmful. So doctor
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  Speaker 5: Trisha Pasricha, she's the physician we heard at the top,
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  Speaker 5: and she's also done a lot of research in neurogastro entrology, says,
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  Speaker 5: we all know we should take our medications as directed
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  Speaker 5: by the label and our medical provider, but that's just
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  Speaker 5: not always how it happens.
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  Speaker 2: There was a study in twenty eighteen which which I
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  Speaker 2: cite off in which is which on that more than
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  Speaker 2: a third of over the counter hyperpofen users we're taking
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  Speaker 2: other insets like asked brand approximate at the same time,
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  Speaker 2: and most of those people didn't realize all the products
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  Speaker 2: they were taking were and SAIDs in the first place.
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  Speaker 5: So what that means is you can easily enter this
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  Speaker 5: false sense of security that everything you get over the
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  Speaker 5: counter must be completely safe, and that's really not true.
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  Speaker 5: They can be safe and they can be effective, but
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  Speaker 5: you need to take the time to understand what it
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  Speaker 5: is you're treating, be confident that medication you're taking treats
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  Speaker 5: that thing, and be clear on the optimal way to
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  Speaker 5: take it. For example, Pasricha mentioned patients of hers who
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  Speaker 5: suffer from heartburn, so they would take proton pump inhibitors
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  Speaker 5: like prilosec, and would reach for that medication right before bed.
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  Speaker 2: Well, right before you go to bed is not a
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  Speaker 2: very helpful time to take it. It would have been much
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  Speaker 2: more efficacious if you've taken at thirty minutes before your meal.
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  Speaker 2: Sometimes that this entire instruction just gets lost in translation
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  Speaker 2: and they think that, well, the proton pump inhibitor isn't working,
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  Speaker 2: this medication isn't working for me, I have something else
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  Speaker 2: going on, or you know, my heartburn is refractory to medication.
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  Speaker 2: Actually that's not the case at all. It's just that
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  Speaker 2: we weren't taking the medication optimally, and sometimes having a
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  Speaker 2: conversation with your healthcare providers say this is what I've
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  Speaker 2: been trying could help clear that right up.
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  Speaker 3: Yeah, So who can we talk to about over the
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  Speaker 3: counter drugs and how to use them if we're not sure?
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  Speaker 5: Yeah, good news on that front, Marial. You don't have
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  Speaker 5: to make an appointment with your doctor. There are other
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  Speaker 5: trained professionals out there ready and willing to help with
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  Speaker 5: this exact problem. So, just like we heard at the
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  Speaker 5: top from UCS pharmacist Pluma Twegbee, you can walk into
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  Speaker 5: any local pharmacy and talk to your pharmacist. When you
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  Speaker 5: do that, they'll need to know what chronic diseases you have,
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  Speaker 5: what medications you're taking, and a note that should include
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  Speaker 5: any vitamins or supplements.
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  Speaker 3: All right, let's get into some of the specifics. One
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  Speaker 3: commonly used over the counter pain killer is a cedamnifin,
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  Speaker 3: also known by the brand name tail and All, and
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  Speaker 3: it's used for fevers and body pain.
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  Speaker 5: So, yeah, the experts we'd talk to would agree that's
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  Speaker 5: the go to reason, and they would also recommend reaching
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  Speaker 5: for a cedamnifin first because generally speaking, it's gentler on
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  Speaker 5: the body than en sids and the safer choice overall,
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  Speaker 5: with some caveats.
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  Speaker 3: Yeah, what are the risks if you're taking a cetamnifin.
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  Speaker 3: This is the one I know can cause liver damage
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  Speaker 3: if you take more than you're supposed to.
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  Speaker 2: Yeah, that's exactly right.
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  Speaker 5: So it's called acetaminifin toxicity, and according to recent data,
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  Speaker 5: it's one of the most common causes of liver transplantation in.
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  Speaker 6: The US and it is responsible for over fifty six
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  Speaker 6: thousand emergency room visits, over two thy six hundred hospitalizations,
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  Speaker 6: and five hundred deaths per year. Now, I know that
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  Speaker 6: it sounds horrible, but when used appropriately and safely, most
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  Speaker 6: people don't have to worry.
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  Speaker 5: This is Candy Serenus. She's a professor of Clinical Pharmacy
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  Speaker 5: also at UCSF, and some of her work entails educating
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  Speaker 5: providers and patients about the appropriate use of medicine.
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  Speaker 3: Okay, so what is the recommended dosage for a cetam
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  Speaker 3: minifin to keep your liver safe?
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  Speaker 5: The maximum dosage is no more than four grams or
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  Speaker 5: four thousand milligrams in twenty four hours. And you also
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  Speaker 5: want to be really careful of alcohol consumption because alcohol
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  Speaker 5: is also hard on your liver, so doing both increases
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  Speaker 5: your risk of severe liver damage. I asked her experts
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  Speaker 5: if they could give us any hard and fast rules
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  Speaker 5: around drinking and thailan. All you know, is there a
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  Speaker 5: time limit maybe or within a twenty four hour period
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  Speaker 5: a certain number of drinks And they said that's not
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  Speaker 5: really how it works. But Pasricha says, the thing about
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  Speaker 5: acetaminifin toxicity is it's often an acute presentation, meaning the
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  Speaker 5: damage hits hard and fast.
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  Speaker 2: It's awful because they're drinking heavily and you feel a
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  Speaker 2: little sick after you've had a lot to drink, and
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  Speaker 2: then you might start to kind of lose track of
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  Speaker 2: how much you're self medicating at that point.
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  Speaker 5: So clearly that's something you want to avoid. So Sarena says,
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  Speaker 5: there's no magic number here, but if you have any
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  Speaker 5: pre existing liver condition liver disease, best to avoid aceeda minifin.
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  Speaker 5: And then more generally, if you know you've been drinking
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  Speaker 5: and then say you're suddenly hit with a fever or
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  Speaker 5: you sprain your ankle, that's probably an instance to look
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  Speaker 5: for other pain relief options.
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  Speaker 6: The moral of the story is if you're a regular
• 9:00
  Speaker 6: or drinker of alcohol, that you might want to avoid
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  Speaker 6: using acetam indefinit as your primary pain reliever. But again
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  Speaker 6: I always would recommend that people talk to their farms, sister,
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  Speaker 6: their doctor about the details.
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  Speaker 3: Any other drug interactions we should know about with acetamenifin.
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  Speaker 5: You know, alcohol is a biggie. If you're on bloodinners
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  Speaker 5: like warfarin, that's the only other major one often mentioned.
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  Speaker 5: Any other prescription meds you have will likely come with
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  Speaker 5: a warning label saying you shouldn't take it with a cetamnifin,
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  Speaker 5: But of course, talk to your doctor, talk to pharmacists
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  Speaker 5: if you have concerns.
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  Speaker 2: All right.
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  Speaker 3: Another commonly used over the counter pain killer is the
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  Speaker 3: n SET, which stands for non steroidal anti inflammatory drug.
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  Speaker 3: I'm assuming these work by lowering inflammation in the body.
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  Speaker 5: Yeah, exactly. So these drugs do what they sound like
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  Speaker 5: they do. They reduce pain by limiting your body's production
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  Speaker 5: of certain chemicals that cause inflammation. So you want to
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  Speaker 5: reach for these if you're dealing with any type of swelling, bruising,
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  Speaker 5: muscle aggs and pains, you know, a headache, a sprain, ankle,
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  Speaker 5: muscle soreness after a big workout. A seed of menifin,
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  Speaker 5: on the other hand, works differently. It's a bit of
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  Speaker 5: a black box, but we know it works on different
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  Speaker 5: pain receptors and helps reduce and regulate body temperature. That's
• 10:12
  Speaker 5: why your doctor pharmacist will often steer you in one
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  Speaker 5: clear direction for fever, but for pain, it's not so clear.
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  Speaker 2: Cut depending on the kind of pain, and it can
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  Speaker 2: sometimes be hard to know when you're just like, well,
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  Speaker 2: I have a headache or my back hurts. It's hard
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  Speaker 2: to know sometimes exactly what's driving it maybe muscular skeleton injury.
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  Speaker 2: It may not be. Pain often has an inflammatory component
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  Speaker 2: to it, in which case people often find that end
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  Speaker 2: SAIDs are just much more efficacious for pain than a
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  Speaker 2: seed of menafin.
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  Speaker 3: And then it's also confusing when you're walking through the
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  Speaker 3: medicine aisle, right, because with a seed of menifin, there's
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  Speaker 3: just the one drug, But there are lots of different
• 10:45
  Speaker 3: types of n sads, So how do you know which
• 10:47
  Speaker 3: one to choose? Is there one that's stronger than the
• 10:50
  Speaker 3: others are more effective for certain kinds of pain?
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  Speaker 5: Yeah, So let's compare just two of the most popular,
• 10:55
  Speaker 5: well known end SAIDs ibuprofen brand names like advil or
• 10:59
  Speaker 5: motrin and nepoxen brand name A leave. Neproxin or a
• 11:03
  Speaker 5: leave is longer lasting, so you only have to take
• 11:06
  Speaker 5: it every eight to twelve hours, and there's a maximum
• 11:08
  Speaker 5: daily dose of six hundred and sixteen milligrams. So if
• 11:11
  Speaker 5: you're someone who doesn't like taking pills, that might be appealing,
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  Speaker 5: But some people find that nepoxyon makes them drowsy, so
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  Speaker 5: you have to make sure that's the side effect that
• 11:20
  Speaker 5: you can plan for. Yboprofen, on the other hand doesn't
• 11:23
  Speaker 5: last as long. You take them every four to six
• 11:26
  Speaker 5: hours as needed, and you can take up to twelve
• 11:28
  Speaker 5: hundred milligrams a day. So if you're looking for more regular,
• 11:31
  Speaker 5: quicker hits of relief throughout the day, maybe you're dealing
• 11:34
  Speaker 5: with newer pain, like from a break or a fall,
• 11:36
  Speaker 5: this type of end said might make more sense for you.
• 11:39
  Speaker 6: Okay.
• 11:39
  Speaker 5: Also, it seems safe over the counter for the twelve
• 11:41
  Speaker 5: and younger crowd, while nepoxym isn't, so any parents can
• 11:45
  Speaker 5: take note there. Bottom line, best is relative and importantly,
• 11:50
  Speaker 5: each medication comes with risk and potential side effects.
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  Speaker 3: Okay, and what are the risks of taking and sets?
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  Speaker 5: Yeah, so you know a lot of people will choose
• 11:57
  Speaker 5: end sets over a set of minifin because they find
• 11:59
  Speaker 5: them more effective. The thing about that is they can
• 12:02
  Speaker 5: also be riskier. So with a lot of nseads there
• 12:06
  Speaker 5: are potential effects on the kidneys and the GI tract,
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  Speaker 5: which is why it's important not to take these meds
• 12:11
  Speaker 5: on an empty stomach. You want to give yourself some buffer.
• 12:15
  Speaker 5: Taking ncens could lead to minor uncomfortable side effects like gas, heartburn, nausea, diarrhea,
• 12:21
  Speaker 5: up to more serious complications. Specifically, they could have an
• 12:24
  Speaker 5: impact on the blood flow and the stomach and the
• 12:26
  Speaker 5: small intestines that might lead to gastro intestinal ulcers or bleeding.
• 12:31
  Speaker 5: So Pasricia says, if you feel sudden, sharp, stabbing pains
• 12:34
  Speaker 5: in your gut or if your stool is black after
• 12:37
  Speaker 5: taking these meds, those are emergency room situations because they
• 12:40
  Speaker 5: could be signaling some of those more serious gastrointestinal problems.
• 12:44
  Speaker 5: And her big problem with n SNS is that, she says,
• 12:46
  Speaker 5: sometimes even if you're following the recommended dosage and usage,
• 12:49
  Speaker 5: you can still experience negative side effects if you take
• 12:52
  Speaker 5: them over a longer period of time.
• 12:54
  Speaker 2: There are many formulations, but you can stick to the
• 12:56
  Speaker 2: exact instructions. But if you do that single day and
• 13:00
  Speaker 2: you do it chronically, even sort of going by the book,
• 13:05
  Speaker 2: you have put yourself at higher risk of damage. And
• 13:07
  Speaker 2: that's just because of the nature of the medication. Okay,
• 13:10
  Speaker 2: and are there any drug interactions we should know about
• 13:13
  Speaker 2: when it comes to n sets.
• 13:15
  Speaker 5: Yeah, there are a few more than acetamnofin. So if
• 13:17
  Speaker 5: you're somebody who's taking a regular blood thinner, if you
• 13:20
  Speaker 5: have atrial fibrillation, or if you're on heart medications, also corticosteroids.
• 13:24
  Speaker 5: Those are all conditions in which experts say to reach
• 13:27
  Speaker 5: for acetaminifin instead of endsets.
• 13:30
  Speaker 3: We'll have more life kit after the break. What about
• 13:40
  Speaker 3: switching between different pain relievers, like when you have the
• 13:43
  Speaker 3: flu or something?
• 13:43
  Speaker 2: Is that okay?
• 13:44
  Speaker 5: Short answer, This is okay for both kids and adults.
• 13:48
  Speaker 5: Both Twegbe, the pharmacist from UCSF and doctor post Richa
• 13:51
  Speaker 5: signed off on alternating between acetaminifin and end SAIDs with
• 13:55
  Speaker 5: the caveat that you should always take the smallest amount
• 13:58
  Speaker 5: that you need for the or does interval possible to
• 14:01
  Speaker 5: get the job done? And if you're not feeling better
• 14:04
  Speaker 5: after a few days, Pasricha says, certainly within three or four,
• 14:08
  Speaker 5: talk to your doctor. Now, if you're in a lot
• 14:10
  Speaker 5: of pain or you're treating a flu with a high fever,
• 14:13
  Speaker 5: what should your schedule look like? Pasreca says, you still
• 14:16
  Speaker 5: want to follow the guidelines on the back of the
• 14:17
  Speaker 5: ENDS head box, but if needed, it's okay to supplement
• 14:20
  Speaker 5: with a ceda minifin about halfway through, so let's say
• 14:23
  Speaker 5: he takes some madvill forggs and pains and fever. At
• 14:26
  Speaker 5: about noon, you're trying to hold off until six PM
• 14:29
  Speaker 5: till your next dose, but at three PM your fever spikes.
• 14:33
  Speaker 5: It's okay to take a dose of time at all.
• 14:35
  Speaker 3: And is the idea here that you just want to
• 14:36
  Speaker 3: limit your use of N sets as much as possible.
• 14:39
  Speaker 5: Yeah, that's definitely part of it. But there's also been
• 14:41
  Speaker 5: some recent research that alternating between a SEDA minifin and
• 14:44
  Speaker 5: ibuprofen is a really effective pain relief method, especially for
• 14:48
  Speaker 5: a cute pain.
• 14:49
  Speaker 3: I'm also wondering about combination pain relief meds like eccentrin
• 14:53
  Speaker 3: or mit all PM. Where do they fit in with
• 14:57
  Speaker 3: this conversation. Is there anything people should keep in mind
• 14:59
  Speaker 3: before reaching for one of these?
• 15:01
  Speaker 5: Maryll, I'm so glad you brought that up. I get
• 15:03
  Speaker 5: migrains fairly often, and if I don't take et cetera
• 15:05
  Speaker 5: in time, I am completely out of commission. So this
• 15:08
  Speaker 5: was a big question for me. I asked Miss Richo
• 15:11
  Speaker 5: about this, and she had a couple of tips. The
• 15:13
  Speaker 5: first very similar to what she said at the very
• 15:15
  Speaker 5: top of the episode. Know what's in your medications and
• 15:18
  Speaker 5: be very careful that you're not accidentally over medicating yourself,
• 15:22
  Speaker 5: and also think about your specific health needs.
• 15:25
  Speaker 2: Are you somebody who you know you take a daily
• 15:28
  Speaker 2: ask for in every day anyway because of your heart health?
• 15:31
  Speaker 2: Think about that when you're grabbing an etc. And you
• 15:34
  Speaker 2: have a headache, are you already on a blood thinner
• 15:37
  Speaker 2: and now you're grabbing one or two more? And says,
• 15:39
  Speaker 2: you're putting yourself at a much higher risk than somebody
• 15:41
  Speaker 2: who doesn't take a blood thinner every day anyway. So
• 15:44
  Speaker 2: they're fine, they're good medications, they get the job done,
• 15:47
  Speaker 2: but just try to be very very careful that you
• 15:49
  Speaker 2: know what is in the ingredients of everything that you're
• 15:51
  Speaker 2: putting into your body.
• 15:53
  Speaker 5: And the other tips she had here about end SAIDs
• 15:55
  Speaker 5: was to be aware of your timing. Sometimes people want
• 15:58
  Speaker 5: to hold out on a headache or mentional cramps. They
• 16:00
  Speaker 5: want to you know, write it out, go to the
• 16:02
  Speaker 5: stoic route. But she says, sometimes it makes more sense
• 16:05
  Speaker 5: to take a small dose when you start to feel
• 16:07
  Speaker 5: the pain.
• 16:08
  Speaker 2: As opposed to now you're you know, you've let two
• 16:10
  Speaker 2: or three hours go by, got this raging headache, then
• 16:14
  Speaker 2: the medicine has like a lot more catch up work
• 16:16
  Speaker 2: to do. And then and then then I find that
• 16:18
  Speaker 2: that's when people they take that first dose, so it
• 16:21
  Speaker 2: doesn't work, So then you know, half an hourlier, well
• 16:23
  Speaker 2: let me just try one more. Does that doesn't work too?
• 16:25
  Speaker 2: They keep and then suddenly you end up taking more
• 16:28
  Speaker 2: medicine than if you had just taken it at the
• 16:30
  Speaker 2: start of the problem, because it's just much easier to
• 16:32
  Speaker 2: you know, turn off the faucet than it is to
• 16:34
  Speaker 2: plug a leek later, and that's sort of the situation
• 16:36
  Speaker 2: people end up in.
• 16:37
  Speaker 3: Yeah, that also sounds like it could be dangerous.
• 16:39
  Speaker 5: You're absolutely right, you know, Mary Ell. When you're in
• 16:42
  Speaker 5: a lot of pain, it can be really tempting to
• 16:45
  Speaker 5: just throw whatever you've got at it, maybe just pop
• 16:47
  Speaker 5: a few extra advil. But Pasricha says that's a really
• 16:50
  Speaker 5: bad idea because, depending on how you do it and
• 16:53
  Speaker 5: what you're trying to treat, doubling down like that not
• 16:56
  Speaker 5: only increases your risk of experiencing side effects, but it
• 17:00
  Speaker 5: also won't necessarily provide you any more pain relief. That's
• 17:04
  Speaker 5: because ensets have a ceiling effect.
• 17:06
  Speaker 2: After which you know you've taken a certain amount of
• 17:08
  Speaker 2: that medication and you're not actually getting any more bang
• 17:11
  Speaker 2: for your buck.
• 17:12
  Speaker 5: So she says she's seen patients come into the emergency
• 17:15
  Speaker 5: room bleeding from an ulcer because they took too much
• 17:17
  Speaker 5: pain medication.
• 17:18
  Speaker 2: And probably whatever was causing the problem in the first place,
• 17:22
  Speaker 2: you know, wasn't going to respond fully to you know,
• 17:25
  Speaker 2: n sids in general. Like they probably hit that effect,
• 17:28
  Speaker 2: but then they just kept going and so all they
• 17:30
  Speaker 2: were getting then were the side effects of the medication
• 17:32
  Speaker 2: and they were like stopped receiving any benefit from it.
• 17:35
  Speaker 5: So, you know the takeaway here, as we've said, I
• 17:37
  Speaker 5: feel about a million times at this point, talked to
• 17:40
  Speaker 5: your pharmacist, talked to your doctor early and often, make
• 17:43
  Speaker 5: sure the pain you're feeling can and should be treated
• 17:46
  Speaker 5: with an OTC medication. And bonus tip from pas Richa
• 17:49
  Speaker 5: here if it does, you can always buy generic versus
• 17:53
  Speaker 5: branding and pills because she says they will always have
• 17:56
  Speaker 5: the same active ingredient they have to and they've gone
• 17:59
  Speaker 5: through the same fdapprovals, So why not save yourself a
• 18:01
  Speaker 5: few bucks?
• 18:02
  Speaker 3: I guess that's worth saying here. As we talk about painkillers,
• 18:06
  Speaker 3: over the counter medication isn't the only option, right there
• 18:10
  Speaker 3: are things you can do that don't involve taking a pill.
• 18:12
  Speaker 5: Yeah, maryl you know the thing about over the counter
• 18:14
  Speaker 5: medication is because it's so readily available, because it's so
• 18:18
  Speaker 5: easy to reach for often patients just don't even consider
• 18:22
  Speaker 5: talking about what other options might be available for their
• 18:24
  Speaker 5: back pain, their period cramps, they're migraines, you know. But
• 18:28
  Speaker 5: we have other ways that we can treat ourselves first
• 18:30
  Speaker 5: when we're in pain. If it's a migraine, maybe it's
• 18:33
  Speaker 5: hot packs or cold packs. Maybe a little yoga and
• 18:35
  Speaker 5: another option you might try, depending on what it is
• 18:37
  Speaker 5: you're treating. Topical pain medication. There are many endsets available
• 18:41
  Speaker 5: over the counter in cream, gel or patchform, so you
• 18:44
  Speaker 5: can pick up ipoprofen as a cream. For example. Serunus
• 18:47
  Speaker 5: mentioned diclothinac popular farthritis pain, and Pasreacha mentioned kept Season,
• 18:52
  Speaker 5: which fun fact uses the spicy elements of chili peppers
• 18:55
  Speaker 5: to help relieve pain. It's kind of like a fight
• 18:57
  Speaker 5: fire with fire approach. And while some of these may
• 19:00
  Speaker 5: cause some skin irritation to some people, overall, Pasricha is
• 19:04
  Speaker 5: a big fan of avoiding oral end sids where you can,
• 19:06
  Speaker 5: and says topical end sets can be really effective for
• 19:09
  Speaker 5: pain relief.
• 19:10
  Speaker 2: I think sometimes people just don't think to try it,
• 19:13
  Speaker 2: and because it's like way less common. But it's all
• 19:15
  Speaker 2: there sitting in the drug store for you.
• 19:17
  Speaker 3: All Right, Here's a question that I think comes up
• 19:20
  Speaker 3: a lot for folks who have over the counter meds
• 19:22
  Speaker 3: in their cabinet. When do I have to throw them away?
• 19:26
  Speaker 3: Because like sometimes I'll realize I have a headache and
• 19:30
  Speaker 3: I go to reach for the tile and all, but
• 19:32
  Speaker 3: then it expired last year.
• 19:36
  Speaker 5: Yes, I am very guilty of this. I have done
• 19:38
  Speaker 5: it a lot. Tugy says, don't do it. Stop doing it.
• 19:41
  Speaker 4: The active ingreen starts to degrade once you know the
• 19:44
  Speaker 4: expiration date hits, and particularly with your expired prescription medications,
• 19:49
  Speaker 4: you can now drop that stuff off at your local
• 19:51
  Speaker 4: pharmacy and they'll dispose of it for you. That you know,
• 19:54
  Speaker 4: you're throwing it into the toilet and damaging you know,
• 19:57
  Speaker 4: the water system. But in terms of over the your
• 20:00
  Speaker 4: medications that are expired, do not use them. They're not
• 20:03
  Speaker 4: going to help you.
• 20:04
  Speaker 5: So what Twigbee says here is if this is something
• 20:07
  Speaker 5: you've done before, you likely have it harmed yourself. If
• 20:10
  Speaker 5: you've taken a pain killer that was a few months old,
• 20:12
  Speaker 5: just might not have been as effective as you'd want
• 20:14
  Speaker 5: it to be, but it's still just not a good practice,
• 20:17
  Speaker 5: not something you want to make a habit of. So
• 20:19
  Speaker 5: check those medicine cabinets regularly, do a sweep anything that's expired,
• 20:23
  Speaker 5: take it to your local pharmacy. Before reporting this episode, Maryel,
• 20:27
  Speaker 5: I'll be honest, I would just toss old pills in
• 20:29
  Speaker 5: the trash. Yeah, me too, But you don't want to
• 20:32
  Speaker 5: do that for a couple of reasons. If you have
• 20:34
  Speaker 5: any pets or small kids at home, that's a big
• 20:36
  Speaker 5: safety risk. You wouldn't want any littles accidentally ingesting those
• 20:39
  Speaker 5: expired meds if they somehow get into your garbage, and
• 20:43
  Speaker 5: it can also be bad for the environment if those
• 20:45
  Speaker 5: medications end up in your local landfill. So just bring
• 20:47
  Speaker 5: them to your nearest drug take back location, or you
• 20:50
  Speaker 5: can mail them using prepaid drug mailback envelopes.
• 20:53
  Speaker 3: All right, Andy, thank you for looking into this, Thanks Maryel.
• 20:58
  Speaker 3: All Right, it's time for a recap. Over the counter
• 21:01
  Speaker 3: pain medications can be really helpful and effective, but remember
• 21:04
  Speaker 3: they're not without risk, so aim to take the smallest
• 21:06
  Speaker 3: amount you need for the shortest time possible to treat
• 21:09
  Speaker 3: your pain. In general, acetaminifin works well for fevers, but
• 21:13
  Speaker 3: you should steer clear of it if you've been drinking
• 21:15
  Speaker 3: alcohol and n set's work better for pain plus inflammation.
• 21:19
  Speaker 3: Think about a sprained ankle, for instance, but they can
• 21:22
  Speaker 3: be hard on the stomach, so it's best to take
• 21:24
  Speaker 3: them with food and be aware of any possible side effects.
• 21:27
  Speaker 3: Think about your lifestyle, chronic conditions, and other medications before
• 21:31
  Speaker 3: you reach for an over the counter medication, like do
• 21:33
  Speaker 3: you have a heart condition, liver condition, are you on
• 21:36
  Speaker 3: a blood thinner? Understand any potential complications before you decide,
• 21:41
  Speaker 3: and don't stray from the directions on the box or bottle.
• 21:45
  Speaker 3: Pharmacists are a great resource when you have questions about
• 21:48
  Speaker 3: over the counter drugs, and if you find yourself continually
• 21:51
  Speaker 3: reaching for an over the counter pain reliever, talk to
• 21:54
  Speaker 3: your doctor. By the way, just a reminder, you can
• 21:58
  Speaker 3: sign up for Lifekit Plus to support at our work
• 22:00
  Speaker 3: at NPR and get curated playlists on popular Lifekit topics.
• 22:05
  Speaker 3: Start listening today at plus dot npr dot org slash
• 22:09
  Speaker 3: life Kit. This episode of Like Kit was produced by
• 22:13
  Speaker 3: Claire Marie Schneider. Our digital editor is Malica garib Our
• 22:17
  Speaker 3: Visuals editor.
• 22:18
  Speaker 6: Is c J.
• 22:18
  Speaker 3: Rikolon. Megan Kane is our senior supervising editor, and Beth
• 22:22
  Speaker 3: Donovan is our executive producer. Our production team also includes
• 22:26
  Speaker 3: Margaret Cerino and Sylvie Douglas. Engineering support comes from Quacy Lee.
• 22:31
  Speaker 3: I'm Mariel Segara. Thanks for listening.