How to take over‐the‐counter medication

Over-the-counter (OTC) medicines are drugs you can buy without a prescription. Some OTC medicines relieve aches, pains, and itches. Some prevent or cure diseases, like tooth decay and athlete’s foot. Others help manage recurring problems, like migraines and allergies.

In the United States, the Food and Drug Administration decides whether a medicine is safe and effective enough to sell over-the-counter. This allows you to take a more active role in your health care. But you also need to be careful to avoid mistakes. Make sure to follow the instructions on the drug label. If you don’t understand the instructions, ask your pharmacist or health care provider.

Also keep in mind that that there are still risks to taking OTC medicines:

  • The medicine you are taking could interact with other medicines, supplements, foods, or drinks
  • Some medicines are not right for people with certain medical conditions. For example, people with high blood pressure should not take certain decongestants.
  • Some people are allergic to certain medicines
  • Many medicines are not safe during pregnancy. If you are pregnant, check with your health care provider before taking any medicine.
  • Be careful when giving medicines to children. Make sure that you give your child the correct dose. If you are giving your child a liquid medicine, don’t use a kitchen spoon. Instead use a measuring spoon or a dosing cup marked in teaspoons.

If you have been taking an OTC medicine but your symptoms don’t go away, contact your health care provider. You should not take OTC medicines longer or in higher doses than the label recommends.

Video: How to Safely Dispose of Unused or Expired Medicine

Drug disposal options to consider and instructions for getting rid of unused or expired medicines

How to Safely Dispose of Unused or Expired Medicine

  • The best way to dispose of most types* of unused or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or programimmediately.
  • If you cannot get to a drug take back location promptly, or there is none near you, and your medicine is
    • on the FDA flush list, your next best option is to immediately flush these potentially dangerous medicine down the toilet.
    • not on the flush list, you should follow these instructions to discard the medicine in your trash at home.

    *Check out the Medication Disposal Q&A for more information including how to dispose of needles and syringes.

    How to take over‐the‐counter medication

    How to take over‐the‐counter medication

    Use our Safe Opioid Disposal – Remove the Risk Outreach Toolkit, which contains public service announcements (PSAs), social media posts and images, fact sheets, and more, for talking with others about safe opioid disposal (Updated 10/1/2020) NEW

    Common OTC medicines like fever reducers, decongestants, and expectorants can help treat mild COVID-19 symptoms. Here are 6 you can buy online.

    Since the pandemic began in early 2020, it's no secret that the novel coronavirus (COVID-19) has brought with it a lot of confusion and questions about the mechanism of the virus, like how it’s spread, who it affects, what the symptoms are, and perhaps most importantly, how to treat it. While there is currently no cure for it, the good news is that medical experts say many cases—especially "breakthrough" infections among fully vaccinated individuals, which are typically asymptomatic or mild—can be treated from the comfort of your home, similar to how you’d handle the common cold or flu. 

    “Most people with coronavirus have a mild illness and will recover on their own,” Edward Fisher, MD, PhD, a preventive cardiologist at NYU Langone, tells Health. “Often, their illness will feel like a common cold, and can be treated the same way as that with over-the-counter medications.” 

    Stephanie Hopkins, a Nurse Practitioner at NYU Langone, agrees that most healthy individuals can manage their symptoms at home. “Over-the-counter medications won’t shorten the length of the illness but may be helpful for mild upper respiratory symptoms, including fever, cough, sore throat; and nasal and sinus congestion,” she said, adding that it’s also a good idea to contact your healthcare provider for individual advice.

    Dr. Fisher recommends looking for cold medicine that contains acetaminophen to reduce minor fever and aches, a decongestant to minimize nasal pressure, and throat lozenges for irritation. Hopkins notes that it’s often suggested to use acetaminophen, like Tylenol, as a fever reducer in suspected or confirmed coronavirus cases. “If you have chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your health care provider before using these medicines, “ she adds. 

    According to Hopkins, other over-the-counter medicines that can help alleviate symptoms include cough expectorants like Mucinex or the generic version for the ingredient guaifenesin, cough suppressants like dextromethorphan or Robitussin, and decongestants like Sudafed or pseudoephedrine—though anyone with high blood pressure, glaucoma, or thyroid conditions should avoid decongestants. 

    Dr. Fisher and Hopkins stress that if your symptoms worsen or become severe—for example, if you have a fever over 100.4 degrees Fahrenheit (for adults) or difficulty breathing—you need to call your doctor or get medical help immediately. 

    With this input in mind, we found the best over-the-counter medicines that are available to buy online and be shipped right to your door. Here are 6 doctor-approved options on Amazon, plus the specific symptoms they can be used to treat:

    • Best for Fever and Body Aches: Tylenol Extra Strength Rapid Release Gels
    • Best for Cough: Mucinex 12-Hour Maximum Strength Expectorant Tablets
    • Best for Nasal Congestion: Sudafed PE Sinus Pressure + Pain Nasal Decongestant Tablets
    • Best Multi-Symptom: Mucinex Sinus-Max Severe Congestion Relief Caplets
    • Best for Day and Night Relief: Mucinex Sinus-Max Day & Night Liquid Gels
    • Best for Sore Throat: Chloraseptic Maximum-Strength Sore Throat Lozenges

    Below, shop these expert-recommended OTC picks—including pain relievers, fever reducers, cough suppressants, throat lozenges, and expectorants—so you can treat your mild symptoms and be on your way to feeling like yourself again.

    Most cold and flu drugs attack symptoms, not the specific viruses that cause the illnesses. They aren’t a cure, but they can make you feel better or shorten your illness.

    There’s no one right way to treat a cold or the flu. But here are some questions you can ask your pharmacist to get the correct over-the-counter medication for you.

    1. Should I take a decongestant or an antihistamine?

    This depends on your symptoms. If you have nasal or sinus congestion, then a decongestant can help. If you have drainage — either a runny nose or postnasal drip or itchy, watery eyes — then an antihistamine could work.

    Over-the-counter antihistamines could make you drowsy. Decongestants might make you hyper or keep you awake. Antihistamines can thicken mucus, which can be a problem for people with asthma.

    Both of these medications may mix poorly with other drugs, like those that treat heart disease, and they may worsen some conditions, like high blood pressure. Ask your doctor or pharmacist which one is best for you.

    2. Is it safe to take a decongestant if I have high blood pressure?

    This type of medicine can increase blood pressure and heart rate, and raise the risk of heart attacks and strokes.

    Pseudoephedrine is the main decongestant taken by mouth that’s available. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn’t be a problem as long as you closely watch your BP. This may not be true with certain types of blood pressure drugs, so check with your doctor or pharmacist about what may be best for you.

    3. How often should I use nasal spray?

    Nasal decongestants work fast to open your airways. But if you use them for more than 3 days in a row, you may end up more stuffy than you were at the start.

    Some doctors suggest using a saline spray instead of a medicated spray. It may take longer to work, but you won’t have problems down the line.

    4. What’s the deal with cough medicine?

    An occasional cough clears the gunk from your lungs. But one that goes on and on needs treatment.

    On the shelf you’ll find tons of cough medicines with a zillion combinations of decongestants, antihistamines, analgesics/antipyretics, cough suppressants, and expectorants. Ask your pharmacist which, if any, would be right for you.

    5. What should I take for fever and aches?

    A fever can be a good thing. It kick-starts your immune system and helps your body fight off an infection by torching bacteria and viruses.

    Doctors no longer suggest you try to lower it, except for people who are very young or old, and those with certain medical conditions such as heart disease or lung disease. If you’re uncomfortable, though, it’s fine to take a fever-reducer medication.

    Young people, including those in their early 20s, should avoid aspirin. Medicines with acetaminophen and ibuprofen are best. Each type has its own set of risks, so talk to your doctor or pharmacist about which is best for you.

    Be careful not to overdose. These drugs are often mixed in with cough and cold and flu remedies. Read the labels, and don’t take a separate pain remedy if your cough or cold medicine includes one. If you’re not sure what’s in it, talk to your pharmacist before you take it.

    6. What’s best for my sore throat?

    Drink lots of fluids, and use a salt-water gargle for relief. To make it, mix a cup of warm water and a teaspoon of salt. Some medications you take by mouth like acetaminophen, medicated lozenges, and gargles can also temporarily soothe a sore throat.

    Get your doctor’s OK before you take anything, even over-the-counter drugs. Don’t use lozenges or gargles for more than a few days. The drugs could mask signs of strep throat, a bacterial infection that should be treated with antibiotics.

    How to take over‐the‐counter medication

    Over-the-counter (OTC) medicines are used to treat a variety of conditions, from headaches to stomachaches. These medicines are easily accessible because you do not need a prescription from a doctor to purchase them. Therefore, OTC medicines are an appealing treatment option.

    However, it is important to remember that just like prescription medicines, OTC products can cause serious side effects especially if they are taken wrong or with other medicines. Here are a few tips to help you make safe choices and reduce your risk of harm when using OTC medicines.

    1. Consult your doctor or pharmacist before purchasing an OTC product. Your doctor and pharmacist can help guide you in selecting an appropriate OTC medicine based on your medical history. They should be aware of any allergies you have or other prescription or OTC medicines you are taking. Be sure to tell them about any herbal supplements, vitamins, or alternative products you may be using. Your doctor or pharmacist will use this information to recommend an OTC product for you.

    2. Read the label carefully. The US Food and Drug Administration (FDA) requires drug manufacturers to include specific information on OTC medicines. This important information is found in the Drug Facts label on the medicine package or container. The label includes active ingredients; purpose (what it is for); uses; warnings; directions – when, how, and how often to take; age restrictions, and other information including inactive ingredients. 1 If you are unsure how to read the Drug Facts label, ask your pharmacist for help. For more information on how to read an OTC label, see ISMP’s article, Anatomy of an OTC Medicine Label.

    3. Do not take medicines with the same active ingredients. The active ingredient is the component in the drug that works to treat the problem. The active ingredient is listed on the Drug Facts label. The active ingredient may be in a number of different OTC medicines. For example, OTC pain relievers such as Advil and Motrin both have the active ingredient ibuprofen, so they should not be taken together. Taking medicines with the same active ingredient can lead to serious side effects or a life-threatening overdose. So, when purchasing OTC products, always compare labels. Once home, check the new product’s active ingredients against any OTC or prescription medicines you already have. If you are unsure, ask your pharmacist if it is okay to take the OTC product with the other medicines you take.

    4. Only treat the symptoms you have. Some OTC products contain more than one ingredient. Each active ingredient treats a different symptom. For example, Tylenol (a pain reliever/fever reducer) and Tylenol Cold & Sinus (often used to treat a cold and sinus congestion) both contain the active ingredient acetaminophen, so they should not be taken together. Tylenol Cold & Sinus also contains another active ingredient, pseudoephedrine which helps relieve congestion. To avoid taking unnecessary medicines and reduce your risk of side effects, chose a product that only treats the symptoms you have.

    5. Keep a current list of medicines you take. OTC medicines, vitamins, supplements, and herbal products can interact with each other and some prescription medicines. By having a current list of medicines you take, your doctor and pharmacist will be able to accurately check for interactions before prescribing or dispensing new medicines to you. They can also tell you which OTC products are safe to take with your other medicines, and which OTC products to avoid.

    6. If you are pregnant or breastfeeding consult with your doctor before taking an OTC medicine. Some OTC medicines are harmful to a developing baby. Some medicines a breastfeeding mom may take can pass through her breast milk and may harm her baby. It is always best to ask your doctor before taking any medicine while you are pregnant or breastfeeding.

    7. Remember herbal supplements are not the same as OTC medicines. Herbal supplements can be found in the OTC aisle, but unlike OTC medicines, FDA does not review them for safe use before they are marketed. 2 Herbal supplements can cause side effects, interact with other medicines you may take, and worsen a health condition. Many herbal supplements are labeled “natural,” but natural does not mean safe. Remember to always talk to your doctor or pharmacist before starting any herbal supplement.

    8. Always check the expiration date. Never use medicines that are expired. According to FDA, a medicine can become less effective or more potent after its expiration date. 3 Set aside a few days each year to throw away the expired medicines in your home. For information on how to properly dispose of expired or unused medicines, see FDA’s article, Where and How to Dispose of Unused Medicines.

    9. Only use the measuring device that comes with the OTC product. Household measuring spoons and other kitchen utensils (e.g., teaspoons) should not be used to measure a dose of medicine. Using these items can result in taking more or less of a medicine than is recommended. Instead, always use the measuring device that comes with the OTC product. For more information, see ISMP’s Tips for Measuring Liquid Medicines Safely.

    10. Seek medical attention if your symptoms get worse or you experience side effects. If your symptoms do not improve or if you feel worse after taking a few doses of an OTC medicine, contact your doctor. Continuing to self-treat can delay you from receiving the medical treatment necessary for what may be a serious health condition.

    ISMP thanks Kimberly M. Gibson, Pharm D for her contribution to this Top Ten list.

    Angelica Bottaro is a writer with expertise in many facets of health including chronic disease, Lyme disease, nutrition as medicine, and supplementation.

    Jamin Brahmbhatt, MD, is board-certified in urology. He is an assistant professor at UCF College of Medicine and chief of surgery at Orlando Health South Lake Hospital.

    Yeast infections, though commonly associated with women, can happen in men too. Most male yeast infections occur on the penis, but they can also extend to the groin. The most common cause of yeast infection in a male is the fungus Candida. There are over 150 species of Candida, with Candida albicans being the most common cause of infections. Both men and women have small amounts of Candida naturally present on their bodies. Problems occur when the yeast multiply and overgrow in certain parts of the body.

    Having condomless sex with a partner who has a yeast infection, poor personal hygiene, excess moisture in the groin, and medical problems like diabetes can contribute to an overgrowth of Candida in men, causing redness and itchiness on the penis. When the inflammation and infection are on the head of the penis, it is called balanitis. Thankfully, most male yeast infections can be treated with over-the-counter antifungal medications.

    How to take over‐the‐counter medication

    andresr / Getty Images

    Symptoms of a Penile Yeast Infection

    Men with a yeast infection may not experience any symptoms or see any changes in the penile skin. The symptoms are common in uncircumcised males. Some of the symptoms that can occur with a penile yeast infection include:

    • Redness and inflammation at the head of the penis
    • Trouble pulling back the foreskin
    • Cracking or bleeding of the foreskin
    • Itchiness
    • White, foul-smelling discharge
    • Small rash-like bumps on the penis that may contain pus
    • Pain during urination (dysuria) or sex

    Over-the-Counter and Prescription Treatments

    Common topical treatments (ones you apply directly to the penis) for penile yeast infections include ketoconazole and clotrimazole. These medications are applied directly on the affected part of the penis or foreskin. These treatments generally work over seven to 21 days. Refraining from sexual activity or masturbation is recommended to allow proper healing when using topical treatments.

    Another common topical is nystatin, which can be used to treat a male yeast infection but may be less effective than the medications mentioned above.

    Preventing Male Yeast Infections

    Obesity and diabetes are linked to an increased risk of yeast infections in men. Maintaining a healthy weight and avoiding diabetes are key to preventing male yeast infections.

    Proper hygiene of the penis can also help prevent yeast infections. Daily hygiene tips for the penis include washing it carefully with warm water, avoiding the use of irritating soaps or gels, ensuring the penis is completely dry after washing, and avoiding excess moisture in the groin by wearing breathable underwear.

    When to See a Healthcare Provider

    If your OTC treatments don’t work or the infection recurs, it’s important to see your healthcare provider for an evaluation and to rule out any underlying conditions that may be leading to recurrent yeast infections or undiagnosed cancers of the penis. If this is your first suspected yeast infection, you should see your healthcare provider before self-diagnosing and self-treating. If the problem is directly related to a tight foreskin, a circumcision may be recommended.

    Why You Should Refrain From Sex

    Although it’s more common for a man to contract a yeast infection from a woman through intercourse, it is possible for a man to give a woman his yeast infection. To avoid spreading it to your partner, avoid sex and make note of any symptoms they may be experiencing as well. It’s likely that both you and your partner may need to receive treatment to avoid passing it back and forth.

    A Word From Verywell

    Yeast infections are quite common even among men, and if treated early on, they do not pose any serious health risks. Over-the-counter medications and changes in hygiene practices may be able to help you get rid of your yeast infection quickly, but if they don't work and your infection persists, contact your healthcare provider for diagnosis and treatment. They may be able to prescribe a stronger medication that can help you get rid of your yeast infection.

    Jay Yepuri, MD, MS, is a board-certified gastroenterologist and a practicing partner at Digestive Health Associates of Texas (DHAT).

    No single medication can alleviate all symptoms of irritable bowel syndrome (IBS). This leaves you dealing with lingering symptoms and trying to choose among the wide variety of over-the-counter (OTC) products that are advertised for IBS relief.

    To help you in your search for symptom relief, it’s important to learn which treatments are supported by research. Don’t forget to get the go-ahead from your healthcare provider before trying any new treatment option.

    Products for Overall Digestive Health

    How to take over‐the‐counter medication

    Stigur Karlsson / Vetta / Getty Images

    Some products can help relieve digestive distress regardless of whether your primary symptom is diarrhea or constipation. Some of them may aid ​gut motility, improve the bacterial balance in your digestive tract, or soothe hypersensitive or inflamed gut walls.

    Popular OTC treatments include:

      : Peppermint oil, aloe vera, and slippery elm are among the top choices. : “Friendly” bacteria may balance out “unfriendly” bacteria, reducing pain and severity of symptoms. : Beta-glucan fiber and inositol supplements may significantly reduce abdominal pain, bloating, and flatulence.
    • Vitamin D: A deficiency may be linked to IBS symptoms in some people.

    Of these, in its 2021 guidelines, the American College of Gastroenterology only recommends peppermint oil and probiotics for treating IBS symptoms.

    Constipation Remedies

    How to take over‐the‐counter medication

    Echo / Cultura / Getty Images

    Constipation can cause a lot of suffering. For some people, an over-the-counter IBS medicine can clear it right up. Others find that OTC drugs are only one part of a comprehensive treatment plan. You have several OTC options to consider.

    • Magnesium: This mineral is a natural laxative that can relax intestinal muscles and attract water to soften the stool.
    • Laxatives: Several types are available that work in different ways.
    • Stool softeners: Designed for short-term use, they may get things moving again.
    • Flaxseed: Studies show it relieves constipation and diarrhea, thanks to its fiber and anti-inflammatory compounds.
    • Triphala: A combination of three fruits purported to be good for the gut, research suggests it can restore the epithelial lining of the digestive tract.
    • Atrantil: Designed specifically for constipation-predominant IBS, limited studies suggest it may reduce bloating and constipation.

    The ACG guidelines specifically recommend against the OTC laxative polyethylene glycol (PEG) and don't mention any of the other treatments in this list.

    Diarrhea Remedies

    How to take over‐the‐counter medication

    BSIP / UIG / Universal Images Group / Getty Images

    The unpredictable and intrusive nature of chronic diarrhea lends itself to the very human desire to “make it stop now!” Although they're not the miracle cure you may hope for, a couple of products may provide some relief, either alone or as part of an overall treatment strategy.

    • Calcium: Calcium is slightly constipating, and many people with IBS swear by it. Discuss taking supplemental calcium with your healthcare provider, though, because you can get too much calcium.
    • Imodium (loperamide): This drug is often easy to tolerate but can cause side effects including dizziness, drowsiness, nausea, and stomach cramps.

    The ACG recommendations don't mention calcium. They recommend against loperamide as a first-line treatment for IBS-D because it only addresses diarrhea and doesn't improve other symptoms, as some prescriptions drugs do.

    Have a hangover or a sprained ankle? Use these tips from a drug information expert to safely choose the correct pain medication for your symptoms.

    How to take over‐the‐counter medication

    Acetaminophen, ibuprofen, aspirin — or another option. It can be difficult to know which type of pain medication will best help what ails you.

    Margo Farber, Pharm.D., director of drug information services at the University of Michigan Health System, explains the basics to picking the proper option. First, there are two general categories when it comes to over-the-counter pain medications for adults: acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).

    “Both types of pain medications are usually safe and effective when taken at the recommended dosage level for short time periods,” Farber says. “However, there are some differences between the two, in terms of what type(s) of pain they treat.”

    Farber explains the main differences between the most common over-the-counter pain medications, including which pain to treat with what in the table below.

    How to take over‐the‐counter medication

    Farber adds it’s important to read the active ingredient label on the package to know the exact strength of the pain medication, which ingredients are included (especially for combination products) and to see the exact symptoms the ingredient should be relieving. In addition, she recommends not relying on the brand names, as they may change, and sometimes, the active ingredients can switch even if the brand name remains the same.

    Remember: Consult your pharmacist before using any over-the-counter painkillers when taking other medications. A pharmacist can help you determine if there are potential drug interactions, or if you’re in the clear.

    How to take over‐the‐counter medication

    Over-the-counter (OTC) medicines are those that can be sold directly to people without a prescription. OTC medicines treat a variety of illnesses and their symptoms including pain, coughs and colds, diarrhea, constipation, acne, and others. Some OTC medicines have active ingredients with the potential for misuse at higher-than-recommended dosages.

    How do people use and misuse OTC medicines?

    Misuse of an OTC medicine means:

    • taking medicine in a way or dose other than directed on the package
    • taking medicine for the effect it causes- for example, to get high
    • mixing OTC medicines together to create new products

    “Behind-the-Counter”

    Pseudoephedrine, a nasal decongestant found in many OTC cold medicines, can be used to make methamphetamine. For this reason, products containing pseudoephedrine are sold “behind the counter” nationwide. A prescription is not needed in most states, but in states that do require a prescription, there are limits on how much a person can buy each month. In some states, only people 18 years of age or older can buy pseudoephedrine.

    What are some of the commonly misused OTC medicines?

    There are two OTC medicines that are most commonly misused.

    Dextromethorphan (DXM) is a cough suppressant found in many OTC cold medicines. The most common sources of abused DXM are “extra-strength” cough syrup, tablets and gel capsules. OTC medications that contain DXM often also contain antihistamines and decongestants. DXM may be swallowed in its original form or may be mixed with soda for flavor, called “robo-tripping” or “skittling.” Users sometimes inject it. These medicines are often misused in combination with other drugs, such as alcohol and marijuana.

    Loperamide is an anti-diarrheal that is available in tablet, capsule, or liquid form. When misusing loperamide, people swallow large quantities of the medicine. It is unclear how often this drug is misused.

    How do these OTC medicines affect the brain?

    DXM is an opioid without effects on pain reduction and does not act on the opioid receptors. When taken in large doses, DXM causes a depressant effect and sometimes a hallucinogenic effect, similar to PCP and ketamine. Repeatedly seeking to experience that feeling can lead to addiction-a chronic relapsing brain condition characterized by inability to stop using a drug despite damaging consequences to a person’s life and health.

    Loperamide is an opioid designed not to enter the brain. However, when taken in large amounts and combined with other substances, it may cause the drug to act in a similar way to other opioids. Other opioids, such as certain prescription pain relievers and heroin, bind to and activate opioid receptors in many areas of the brain, especially those involved in feelings of pain and pleasure. Opioid receptors are also located in the brain stem, which controls important processes, such as blood pressure, arousal, and breathing.

    Opioid Withdrawal Symptoms

    These symptoms include:

    • muscle and bone pain
    • sleep problems
    • diarrhea and vomiting
    • cold flashes with goose bumps
    • uncontrollable leg movements
    • severe cravings

    What are the health effects of these OTC medicines?

    DXM
    Short-term effects of DXM misuse can range from mild stimulation to alcohol- or marijuana-like intoxication. At high doses, a person may have hallucinations or feelings of physical distortion, extreme panic, paranoia, anxiety, and aggression.

    Other health effects from DXM misuse can include the following:

    • hyperexcitability
    • poor motor control
    • lack of energy
    • stomach pain
    • vision changes
    • slurred speech
    • increased blood pressure
    • sweating

    Misuse of DXM products containing acetaminophen can cause liver damage.

    Loperamide
    In the short-term, loperamide is sometimes misused to lessen cravings and withdrawal symptoms; however, it can cause euphoria, similar to other opioids.

    Loperamide misuse can also lead to fainting, stomach pain, constipation, eye changes, and loss of consciousness. It can cause the heart to beat erratically or rapidly, or cause kidney problems. These effects may increase if taken with other medicines that interact with loperamide. Other effects have not been well studied and reports are mixed, but the physical consequences of loperamide misuse can be severe.

    Can a person overdose on these OTC medicines?

    How to take over‐the‐counter medication

    Yes, a person can overdose on cold medicines containing DXM or loperamide. An overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death (Read more on our Intentional vs. Unintentional Overdose Deaths webpage).

    As with other opioids, when people overdose on DXM or loperamide, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage and death.

    How can these OTC medicine overdoses be treated?

    A person who has overdosed needs immediate medical attention. Call 911. If the person has stopped breathing or if breathing is weak, begin CPR. DXM overdoses can also be treated with naloxone. Read more about naloxone at our Naloxone webpage.

    Certain medications can be used to treat heart rhythm problems caused by loperamide overdose. If the heart stops, health care providers will perform CPR and other cardiac support therapies.

    Can misuse of these OTC medicines lead to addiction?

    Yes, misuse of DXM or loperamide can lead to addiction. An addiction develops when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home.

    The symptoms of withdrawal from DXM and loperamide have not been well studied.

    How can people get treatment for addiction to these OTC medicines?

    There are no medications approved specifically to treat DXM or loperamide addiction. Behavioral therapies, such as cognitive-behavioral therapy and contingency management, may be helpful. Cognitive-behavioral therapy helps modify the patient’s drug-use expectations and behaviors, and effectively manage triggers and stress. Contingency management provides vouchers or small cash rewards for positive behaviors such as staying drug-free. Read more about drug addiction treatment in our Treatment Approaches for Drug Addiction DrugFacts.

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