How do you choose your OTC drugs? (1 Viewer)

[DaveF]

I pulled or strained (or something) my shoulder muscles earlier, so I went in today to get some drugs. I'd planned on getting "Alleve" since I knew that would help, but Ibuprofen also would have been good.
Now, I rarely buy OTC medications, so I was unprepared and overwhelmed by my choices.
Just looking at Alleve, I had about five different choices, of varying sizes (50 ct, 100ct, 200ct) and type (caplets, gel-caps). And there are generics of Profen Sodium (or whatever). And there are other brand-name versions.
Ibuprofen, I think? Generics, brand-names (Advil), and a multitude of sizes, types, EZ-open bottles, etc!
And I don't even know what the functional difference is between these two drugs are!
I finally pulled myself together, grabbed a bottle of Alleve, and fled the scene
So how do you do it? How do you choose what to get? And people say buying computers is hard...

 

[Andrew W]

I describe my symptom to my wife and she tells me what to buy.

 

[Tim Hoover]

find the one with the coolest side effects

 

[Dave Morton]

I try to look at the label for the indication and take the appropriate medication. Always read the label. Similar drugs can have different side effects. So if you are prone to certain side effects then stay away from that particular drug.

 

[SteveA]

I'm with Tim - I look for some indication on the label that the medication might cause drowsiness, euphoria, or hallucinations and pick that one whenever possible!

 

[DaveF]

Dave - Thanks.

The rest of you :p)

Reading instructions is for wimps, though. I a total of four Alleve in 24 hours (worked wonders). Then I read the instructions, and found you're not supposed to have more than 3 in any 24 hours.

At least that explains those pink elephants, last night.

 

[Jeff Ulmer]

The best buzz for the buck!

Also, it should be cherry or grape flavored and chewable. And in animal shapes.

 

[RicP]

For headache and general muscle pain, the best thing out there is the new Advil Migraine. They call it Migraine to sell more I guess, but all it is is 200mg of Ibuprofen in a solubized capsule. That means that it's in liquid form and is delivered into your bloodstream that much faster.

I swear by the stuff.

Tylenol - Acetaminophen can damage your liver if you take too much. I think Ibuprofen may have side effects as well after a mass dosage.

 

[Jim_F]

Ask your pharmacist. In the case where your pharmacist is always too busy to talk with you, find another pharmacist.

 

[ace peterson]

Or if your lucky enough, a good pharmacist will come to you on this forum!

Basically ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) work exactly the same way to help reduce pain and inflamation associated with sore joints, muscles, etc. The main difference is that naproxen lasts a few hours longer than ibuprofen does. Therefore you don't have to take as many each day. If this is a big deal to you *shrug*. Usually naproxen is more expensive, too. You would be just as well off taking 3-4 ibuprofen 200mg tablets with each meal on a regular basis. (By the way, the maximum daily dose of ibuprofen is 3200mg!)

Yes, you are right about all the choices. There are many different size packages, different dosage forms (tabs, caps, geltabs, geltabs, etc), easy-open bottles for arthritis patients. The reason for this is simple: the more packages and facings of Advil there are on the shelf, the more likely a person is to buy a package of Advil!

Take care!

 

[DaveF]

Ace - thanks! I love getting that sort of solid info!
Mmmm... Better living through chemistry.

 

[ikiru]

OTC drugs are regulated by the government and 200mg of ibuprofin is 200mg of ibuprofin. Just go with the most inexpensive, generic brand. They all work the same.
My body doesnt respond as well to naproxen sodium as it does to ibuprofin.
Try to start an OTC drug discussion and a wire discussion breaks out
-ikiru

 

[Dave Morton]

Actually, different formulations are out there for different types of people. I know some people that can't swallow those chalky tablets, but can wash down a capsule quite easily. It's called ease of use. Also, the liquid forms do not absorb into your system more than tablet forms. Pharmaceutical companies do studies to determine the bioavailability of each type of formulation and they must be bio-equivalent to get FDA approval. So you can be assured that when you take 200 mg in tablet form then the appropriate volume of liquid indicated on the label will have a similar absorption rate and similar total amount of drug absorbed.

No, they do not all work the same way. They may get a similar result, but the mechanism is different. It depends on which enzyme the drug is working on/blocking.

One of the reasons why they limit the amount is because of the half life of the drug. If you take too much, you will get a toxic effect. Another reason, especially for NSAIDs(Non-Steroid Anti-Inflammatory Drugs) like acetominophen and ibuprofen, is that too many of them will cause bleeding in your stomach and intestines.

But of course, because of the variability in nature, some drugs are more effective than others for different people. That is why you will hear some people say one drug works better than others. Remember that when drugs are approved, the numbers are averaged. You may be an outlier on either side of the scale.

 

[ace peterson]

Dave

You obviously didn't or have not yet graduated pharmacy school.

 

[Bill Catherall]

Here's a related question... How strictly should one follow the expiration dates on OTC drugs? Specifically cough or cold medicines and pain killers?

My mother-in-law is a pharmacy tech at a hospital and will often send us big bulk bottles of Advil or childrens Tylenol. Sometimes the bottles are close to expiration, but she says they are fine. Even after expiration my wife wants to continue using them, but I want to through them away. What's the real deal?

 

[Dave Morton]

Ace,
I work for a pharmaceutical company. I am a statistician for pharmacokinetic drug trials. I see all sorts of different formulations and have some knowledge on how drugs work in the system. I've been doing this for over 10 years and think I have some idea on how certain drugs work and how they are absorbed in the system and at what rates. I see a whole bunch of variability in the data.
Bill,
The worst thing that could happen is that there is chemical breakdown of the drug that's been sitting on the shelf for years. It will lose it's effect.
Similarly, I won't drink beer that's been sitting in the basement for years.

 

[DaveF]

You obviously didn't or have not yet graduated pharmacy school.

Nope I'm in Optics - but I'm working with some lovely organic chemicals, so I also know that you can get Worser Living Through Chemistry

 

[Joseph S]

Dave is right on. We just had our block on these drugs, so here is what I've learned.
All the NSAIDs block COX-1 AND COX-2 essentially shutting off the ability to make prostaglandins and thus suppress your immune response. All those that block Cox-1 and Cox-2 will lead to GI bleeding eventually since prostaglandins also have a protective function in the GI tract. (which is lost when you eliminate COX-1 derived PGs)
Aspirin irreverisbly blocks COX-1 AND COX-2, requiring new COX enzymes to be formed in nucleated cells and new platelets to be formed because they lack a nucleus. (

 

[Dave Morton]

Joseph,

Great job. I work on COX-2 inhibitors and you're right on the money. Celecoxib=Celebrex. These drugs basically bond to the COX-2 enzyme and make a different chemical structure. COX-2's are the enzymes that cause inflamation, this is why there is a big market for them. Although there is some effects that are being noticed that were not prevalent in the clinical trials. Vioxx is having some cardiac issues. It's not yet seen in Celebrex but that could be because it is more of a fast onset drug.

 

[MatthewA]

I choose the over-the-counter drugs that are least likely to kill me.