The Medicine Cabinet: Side-Effects, Expired Medicine and Beyond

By Dr. Matt Sage, Pharm D

Expired medicine, side effects, effectiveness and more: your medicine cabinet may be packed full– but is it with the right stuff?

When it comes to your health, you’ll always want to be prepared (especially in these unprecedented times). Having your medicine cabinet stocked with the basics will keep you from a last-minute rush to the drug store and will allow you to be ready for the expected (and non-expected) speed bumps that life might throw at you.

A quick disclaimer: nobody should have anything in their medicine cabinets that they’re allergic to or that is contraindicated to them. That’s why it’s always important to consult a doctor or pharmacist before trying any new over-the-counter medications and adding them to your medicine cabinet stock.

What are some OTC meds that everyone should keep handy in their medicine cabinet?

Bandaids and antibiotic ointments.

It’s usually not if, but when you’ll need these staple medicine cabinet items.

Allergy medication (Benadryl, Zyrtec, Claritin, Allegra).

These are a great way of staying prepared for when allergy season comes or when an allergic reaction occurs, but there is a caveat.

Although used by many, I don’t typically recommend “combination products,” meaning allergy medications like Claritin D, which contains both the anti-histamine and a decongestant. I think at all costs, eliminating any unnecessary medications that could cause unwanted side effects is a wise choice. The solution? Instead of getting a combination product like Claritin D, I recommend getting the two individual products within it: Claritin itself, and a separate nasal decongestant. If you are experiencing allergy symptoms with congestion you can take them together, but if you aren’t congested, there’s no reason to take an extra medication. This change doesn’t only keep your body from unneeded medications, but it also helps your wallet from over-purchasing those pricey allergy meds. 

Anti-inflammatories.

This can include things like Ibuprofen and Aleve and is used for inflammation, pain and headaches.

Gastrointestinal products.

This can include things like Tums as an antacid, and Imodium for an anti-diarrheal to help with intestinal issues.

Pill cutters.

Always ask your doctor or pharmacist what pills you can be crushed. Some can’t be, but nonetheless, these devices are handy to have around.

Measuring devices. 

This is especially handy if you have children around. There are so many times that medications will say to use a teaspoon, a tablespoon, or to measure in milliliters, so it’s good to have an oral dosing syringe or cup as a method of measuring out dosages.

Related: Advanced Rx: A Pharmacy You Can Trust

What are some side effects of commonly used OTC drugs?

Remember; most over-the-counter drugs are not meant for everyday use unless your doctor is telling you otherwise.

Now here are some side-effects of some common OTC drugs:

For anti-inflammatories (Ibuprofen, Aleve): ulcers and other stomach issues are common with long-term use of anti-inflammatories. 

Allergy medications are designed from an OTC perspective, meaning they’re meant to be taken as a short-term solution.

Your doctor may recommend that you take an antihistamine for a long period during allergy season. That’s fine because they’re typically monitoring you to make sure you’re not having any issues with it. The problem is, if you’re using it too often, you could develop a perceived tolerance to it. Rotating brands could help combat this, like switching to and from Claritin and Zyrtec.

Again, aside from specific doctor recommendations that state otherwise, these medications shouldn’t be used daily for prolonged periods.

For other allergy medications like Benadryl, a common side effect with our elderly patients is balance issues and sedation problems, so Benadryl needs to be used with caution, especially with senior citizens.

With decongestants like Sudafed, or pseudoephedrine, or phenylephrine products, many people take these every day. The problem is that they can be dangerous, specifically for patients who have cardiovascular disease or diabetes, because they cause an increased heart rate, elevated blood pressure, and blood sugar issues. All of these issues further show why speaking with your doctor or pharmacist before adding these medications is crucial.

When do OTC meds stop being effective? What’s the reliability of their expiration date?

Expiration dates are the best guides, so it’s important to stand by them. 

For some medications, expiration dates indicate a decreased effectiveness in the expired medicine. For others, the expired medicine can go bad and be quite dangerous if ingested after the expiration date.

In liquid medications, preservatives usually give out after the medication reaches its expiry. In tablet medications, it can be pretty dangerous to ingest them after they’ve expired. The best rule of thumb is if you hit the expiration date, just get rid of the medication.

How do you get rid of expired medicine?

It’s a commonly asked question and one that may seem different than what people have done for years. People have been flushing expired medicine down the toilet for years, but it’s not at all good for the environment. Many might not know that lots of pharmacies now have drug destruction boxes, but that’s the best way to dispose of them.

We have a drug destruction box here at Advanced Rx, in which you can drop off literally any type of expired medication, even if it’s not OTC and even if it wasn’t prescribed by our doctors. We make sure to deposit them in an environmentally-friendly way, too!

If you don’t want to deal with going to a pharmacy for disposing of expired medicine, you can also safely dispose of them in your trash. Although it’s not the preferred method, it’s better than flushing it down the toilet. If you are planning on getting rid of them in your home, cover it with something like coffee grounds or kitty litter to prevent others from being able to tamper with it.

You can also always go on the DEA’s website to find a drop box in your area.

What medical interactions should we be aware of?

There are a lot of drug interactions out there, and probably too many to list. That’s why it’s always important to make sure that your pharmacy knows everything you’re taking. If you’re using two pharmacies, you need to make sure both pharmacies know what you’re taking at the other respective pharmacy, in both the prescribed medicines and in the OTC ones. Pharmacists will use this information when evaluating your drug regimen to ensure there aren’t any dangerous drug interactions.

One common drug interaction I will mention is antacids and thyroid medications and antibiotics. What happens is that the medications will bind to the antacids in your stomach, you’ll get decreased absorption, and they won’t work as well.

Aspirin can also be very dangerous from a drug interaction perspective if not used correctly. Because it can increase your risk of bleeding, if you’re taking any blood thinners like Warfarin or Coumadin on top of your Aspirin, you can be at risk for a high amount of bleeding. 

Remember, your first step in adding any new drug regimen is checking in with your pharmacist to make sure it’s safe.

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Here at Advanced Rx, we know the importance of holistic wellness.

We’ll encourage those to live a healthier lifestyle on their own by establishing a well-balanced diet implementing more exercise into their daily routines. 

I’m a great example of this. I used to have borderline high cholesterol and through changes in diet and exercise, I was able to decrease my cholesterol levels safely. In doing this, it’ll be important to always consult your doctor before making changes to any medications you may be using when you’re in the process of making changes to your lifestyle.

Related: The APC Difference: Our Multidisciplinary Approach to Patient Care

How does the APC Pharmacy staff help patients navigate their medication plan and other questions?

We take into account all of the medications that patients are taking– including any OTC medications– and input them all into their medication profile on the system. This way, our computer can auto-check for drug interactions and can immediately track any changes in a patient’s medication usage.

As far as communication, we always ensure our patients can get the best treatment and counseling through their journey to a pain-free life.

It’s as simple as that. We can easily bring up information and help guide patients to the best possible trajectory.

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When it comes to your medicine cabinet, it’s important to get a bigger picture view of how different medications can interact together if you’re not careful. As always, consulting with your doctor is the best way to know what medications are best for you and which ones you should avoid.

We always ensure our clients achieve the best medical results without having to suffer. It’s never too late to seek guidance on how to use your medication in the best possible way to promote your health and wellbeing. Reach out to us today to begin your journey to a pain-free life.