When you buy cold, fever and stomach medicine yourself, which ones can't be taken together, and what should children, pregnant women and older people avoid?
Tips from this section that apply in the United States. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription.
Many cold medicines contain acetaminophen (paracetamol, 对乙酰氨基酚). Taking two boxes together means a double dose, and too much damages the liver. In the U.S., of the acute liver failure patients it causes, nearly 30% died before they could get a liver transplant. Chinese package inserts advise taking no more than 2 g a day, and no alcohol while taking it.
For a child's fever, don't use any of these three drugs. Aspirin is linked to Reye's syndrome, a disease that damages the brain and liver; in U.S. statistics about 30% of the children with it died, and after the warning was issued cases fell by more than 90%. Nimesulide (尼美舒利) is banned under age 12, and metamizole (安乃近) is banned under age 18.
Painkillers such as ibuprofen, naproxen and aspirin can damage the stomach. In trials at high doses, people taking ibuprofen had about 4 times the risk of stomach bleeding or perforation of those not taking it. People who are older, have had stomach bleeding, take blood thinners or steroids at the same time, or drink alcohol every day are at higher risk.
The National Medical Products Administration (国家药监局) required 14 combination cold medicines for children to carry a warning: parents are advised not to give them to children under 2 on their own, and they should be used only under the guidance of a doctor or pharmacist. In trials in children, cough medicines and antihistamines (allergy drugs) worked no better than placebo.
After 20 weeks of pregnancy, most of the amniotic fluid is made by the baby's kidneys. Taking ibuprofen-type drugs then may harm the baby's kidneys and reduce the amniotic fluid. Among the reports received in the U.S., there were cases of newborn death. Low-dose aspirin prescribed by a doctor is not included.
Omeprazole enteric-coated tablets (奥美拉唑肠溶片) have been available without a prescription since 2022, but the insert says to take them yourself for no more than 7 days and not to take them again within two months. If you have trouble or pain swallowing, vomit blood, or have blood in the stool or black stools, don't take them on your own; these can be signs of a serious condition. The drug may also cover up the symptoms of stomach cancer and delay diagnosis.
Taking antibiotics for a cold doesn't make you better any faster than not taking them. Adults who took them had more than twice the risk of side effects of those who didn't. For a runny nose with pus lasting under 10 days, antibiotics also have no definite benefit.
The most important thing in diarrhea is replacing fluid, not stopping the diarrhea. Mix oral rehydration salts (口服补液盐) with water as the instructions say and drink it; don't substitute fruit juice or soft drinks, because too much sugar actually makes you more dehydrated. Don't give anti-diarrhea drugs such as loperamide to children under 5, because in serious cases they can cause a bowel obstruction that can be fatal.
If you have frequent headaches and take painkillers every day, the headaches may get worse the more you take. The international headache classification calls this medication-overuse headache. Taking ordinary painkillers on 15 or more days a month, or combination painkillers on 10 or more days, for more than 3 months in a row, is enough to qualify. Most people improve after stopping the overused drug.
Among medicines young children swallow by mistake behind adults' backs, nearly half are prescription tablets. About 30% of the prescription medicines swallowed by mistake belonged to grandparents. Clearing out medicines you don't need leaves one less thing a child can find. Put the cleared-out medicines, packaging and all, in the hazardous waste bin (有害垃圾), or hand them to a drugstore that collects old medicines.
When some cephalosporins (头孢), metronidazole (甲硝唑) and similar drugs meet alcohol, they can cause flushing, a pounding heart, chest tightness and vomiting, and in serious cases a drop in blood pressure. It is not only liquor and beer: alcohol-containing medicines such as Huoxiang Zhengqi liquid (藿香正气水) and cough syrup can set it off too. Stay away from alcohol during the medicine and for 7 days after stopping.
