Over-The-Counter Cold Medicines and Asthma

Sunday, July 26, 2009, 2:02
Asthma
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Andrew:

Let’s talk about treatment. Many people see [and hear] commercials on TV or on radio, and head to over-the-counter [OTC] medications. How far can those OTC medications go if you have a chronic condition, and how should [people] proceed as far as seeing if they need something more like [prescription] medication or combination therapy?

Dr. Lieberman:

Well, over-the-counter medications have their good side and their bad side. They have their good side because they’re convenient, they’re not terribly costly. For patients who rarely take medications, they serve a purpose. It’s estimated that perhaps 35 percent of people who suffer from rhinitis never seek care from a physician and treat themselves only with over-the-counter medication.

Now, as long as that over-the-counter medication doesn’t produce a side effect and one doesn’t have to take it more than two to three times a month, there’s probably nothing wrong with that.

One has to be careful, however, because some of the side effects produced by over-the-counter medications are, in essence, hidden from the patient.

For example, we know that over-the-counter antihistamines produce drowsiness, but what we don’t understand is that you can be impaired without being overtly drowsy. That is, [you might not be aware of it but] your performance on tests [and] driving can be impaired.

So it’s a two-edged sword. Over-the-counter medicines can serve a useful purpose, but they can also be somewhat dangerous.

Now, that should stimulate patients to seek medical care because we do have drugs that are superior to over-the-counter medications [since they] cause less side effects. [Also], we have drugs that are far more effective.

Itís true that a combination of drugs is more effective than a single agent is [for] many people.

Andrew:

So, should there be a fear of taking more than one medication if you have one of these chronic conditions? People often say, “I don’t want to take all these medications. I want a natural approach,” or “I just want to breathe steam.”

You’ve been in research and seen the development of your armamentarium for rhinitis and for asthma. How confident are you that these can provide long-term, effectiveness and that there’s a benefit for people using them?

Dr. Lieberman:

I’m so confident that I’m a user myself. And I prescribe these drugs to my family. I have three allergic children who inherited their allergies from [me]. I gave them, throughout their childhood, the drugs that I give my patients. We have very effective drugs that are almost totally innocuous for the most part. Itís unreasonable not to avail yourself of these agents because even though the conditions that we treat in terms of rhinitis aren’t life-threatening, we know that they exert a profound effect on [your] quality of life.

They affect your sleep. They affect your capacity to work. They affect kids’ capacityto learn. They affect personality development.

So not to treat them maximally with drugs – which we know are effective and safe – is really unreasonable. The side effects are almost nonexistent, and these drugs have been approved for use in children down to age three.

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