II. Precautions

  1. OTC Drug Naming is Confusing
    1. Manufacturers exploit well known product trade names to market different combination agents
    2. Flonase Headache and Allergy Relief is NOT fluticasone, but rather: Acetaminophen, Chlorpheniramine, Phenylephrine
    3. Zantac 360 is NOT Ranitidine, but rather Famotidine, and the 360 is unrelated to dosing
    4. Dramamine is often NOT Dimenhydrinate, but often rather Meclizine
    5. Dulcolax is either Bisacodyl (tabs), Docusate (liquid gels) or Magnesium Hydroxide (soft chews)
  2. Combination products often contain a mix of agents with increased adverse risks (often without significant benefit)
    1. Acetaminophen with risk of cummulative Overdose (combining multiple agents)
    2. Decongestants (e.g. oral Phenylephrine) which may exacerbate Uncontrolled Hypertension
    3. Sedating Antihistamines (Fall Risk in older adults, see STOPP)

III. References

  1. (2023) Presc Lett 30(4): 23

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