The Allergy Clinic
Specialists in Allergy & Asthma Care
No Prescription ≠ No Risk
Use of the wide array of over-the-counter (OTC) allergy and asthma medications is becoming increasing popular. OTC
medications are convenient, fairly inexpensive, and can be picked up right at the grocery store along with some milk and bread;
so they must be safe, right? Not so fast.
OTC medications are not free from side effects or interactions. Decongestants are a prime example of this. Most OTC
decongestants contain pseudoephedrine or phenylephrine, potent decongestants that can also be very stimulating. This can
lead to increased blood pressure, a dangerous situation if you high blood pressure. Even patients with normal or borderline
blood pressure can experience hypertension while taking decongestants. They can also cause insomnia.
The fast acting decongestant nasal sprays, like Afrin and Neo-Synephrine, also have risks. Long term use of these sprays can
result in your nasal lining becoming “addicted” to them. This leads to rebound swelling of the nasal lining which leads to worse
congestion than you were treating in the first place and an increasing need to use the medication. These nose sprays are useful,
but should not be used more than 3-5 days without medical supervision.
Herbal remedies can have their own risks. Echinacea is a popular herbal supplement readily available in forms ranging from teas
to lozenges. Its most common use is as a treatment for colds and an “immune booster.” While it is generally regarded as safe,
allergy sufferers beware. Echinacea is related to ragweed, the bane of the allergy sufferers’ existence in the fall. If you are
allergic to ragweed, you may actually get allergy symptoms from Echinacea. Some patients who are allergic to grasses, a spring
allergen, also get symptoms from Echinacea.
The message is not that OTC medications are bad. But you cannot assume that they are free from risk just because they do not
require a prescription. These medications are best used in consultation with a medical professional.