It's Not Just Tylenol That Can Be Seriously Overdosed

Tylenol poisoning sends 33,000 Americans to the hospital every year. Some need liver transplants. About 150 die. However, it's not just pain relievers that can cause serious OTC overdosing problems. Common allergy medications are also problematic.

An eight-year-old informs his mother, to her horror, he has suddenly gone blind. He had spent the day at home from school because of his allergies. He had taken half a box of Benadryl (diphenhydramine) when suddenly he felt sick. The mother calls EMS.

The emergency medical technician remembers the diagnostic for Diphenhydramine poisoning "Dry as a bone, red as a beet, hot as a hare, mad as a hatter, and blind as a bat." The eight-year-old is understandably upset He's also flushed and feverish but he isn't sweating. When the EMT sees the half-empty box of Benadryl, she understands the situation. The boy is taken to the hospital for emergency treatment.

Catastrophic Overdose of Cough Syrup

Cough syrups are among the most popular of all OTCs. A Consumer Healthcare Products Association survey found that 70 percent of American parents give their children cough syrup as the first line of defense against colds. The survey also found that 66 percent of American adults take cough syrup themselves.

A problem can arise, however, when the anti-tussive (cough-stopping) ingredient is a chemical called dextromethoraphan. In low doses, it stops cough. Take a little more, and there is a sense of awakeness, intense emotion, but euphoria. Take still more, and the user becomes "stoned." There may be a sense of detachment from the outside world along with hallucinations and loss of memory. Keep on taking cough syrup, and there is clearly altered consciousness. The user may not understand what people are saying or doing and express highly "abstract" thinking. If consumption continues, there can be life-like delusions, recall of events buried in the memory, seizures, and even death.

READ Is children's coughing medicine safe?

All of this can happen just from overdosing cough syrup. While there are people who intentionally abuse cough syrup for its psychological effects, the problem is more likely to occur in a child or stressed-out adult who simply needs to stop coughing and get back to school or work. Typically, about 4 ounces (half a bottle) of Robutussin causes symptoms of overdose.

Other problem OTCs include:

• Laxatives. Taking too many laxatives can, paradoxically, make constipation worse, as well as cause serious imbalances in electrolytes
• Sleep aids. Medications that contain Diphenhydramine (mentioned above) and other allergy medications can lose their effectiveness over time so that users take more and more, with increasing risk of side effects.
• Acid blockers. Overuse of Nexium and Pepcid can lead to calcium deficiencies severe enough to cause osteoporosis, and sometimes also to pernicious anemia, which occurs when the body is not able to absorb vitamin B12.

How can you avoid overdosing OTCs? The most important rule to remember is that "More isn't better." If you need more and more of an over the counter medication to get the same effect, you are taking the wrong medication, and it likely won't do you any good.

The second, equally important rule is to read the label and follow directions. Never take more of a medication than is recommended. It will work as well as it is going to work in the dose that the manufacturer tells you that is safe. 

Finally, don't take an entire shelf full of OTCs. In fact, it's even best to avoid combination products, for instance, the "stops your cough so you can sleep medicines." Take just one medication for one problem in just the dosage that you need, and avoid taking multiple OTCs in any dosage.