10 Tips to Use Over-the-Counter Medications Safely with Diabetes

Have you ever gone to the pharmacy to purchase something for your cold and found yourself overwhelmed by all the options available? Which one should you choose, and does it really matter? Well, if you have diabetes, it definitely matters.

At first glance, over-the-counter (OTC) medications may seem safe since you don’t need a prescription to use them, but they can affect your blood glucose and other aspects of diabetes. The good news is that you can make informed choices in selecting OTC medications related to their effect on your diabetes.

Key Ingredients to Look For – Read Those Labels!

First – read the label! Don’t be fooled into thinking the brand name of an OTC product contains the same ingredients it always has in the past. Manufacturers can change ingredients without notifying consumers, and, most importantly, without changing the brand name. Even more confusing, many manufacturers sell several products with the same or slightly different brand name, but the active ingredients are entirely different in each product and are used for different indications. So, it is wise to focus on the active ingredient, not the brand name.

When reading the label, look for the “active ingredient”, “inactive ingredient”, and “warning” sections for clues to see if the medication is right for you. Is sugar listed as an ingredient? Also, beware of words like “fructose”, “sorbitol”, or “mannitol”. These are all different forms of sugar.

Instead, consider using sugar-free alternatives. For example, Metamucil fiber supplements and Tums antacids offer sugar-free varieties. Beware of common products that contain large amounts of sugar, such as cough syrups and anti-nausea syrups. Some cough syrup brands do offer sugar-free versions, and there are several sugar-free cough drop options on the market as well. Look for products with the least amount of sugar, or ask your pharmacist for another alternative.

Does the product contain alcohol or caffeine? Some common medicines used to treat cough and cold symptoms have a high alcohol content. Alcohol consumed on an empty stomach may cause low blood sugar. Alternatively, alcohol in large amounts can increase your blood glucose concentration.

Many common weight loss medications contain caffeine, which may increase blood sugar. Some common brand names that contain caffeine (up to 200 mg!) or caffeine derivatives such as guarana and cola nut include Metabolife, Hydroxycut, Xenadrine EFX, and Zantrex-3. Avoid these products if caffeine has an impact on your blood sugar. Contact your doctor for other alternatives for weight management.

Other OTC Products That Can Affect Diabetes

Other things to watch out for include corn and callus removers which contain salicylic acid, a harsh chemical that is used to peel away the outermost layers of your skin. This can be a dangerous product for people with diabetes because too much peeling of the skin could lead to infections. Contact your medical provider or podiatrist and ask for alternative options.

Other products to avoid are decongestants such as pseudoephedrine or phenylephrine, commonly used for a stuffy nose. These are found in products such as Sudafed. These drugs act by constricting blood vessels, which may increase your blood pressure, an unwanted side effect. Instead, use a local nasal decongestant such as Afrin (oxymetazoline). This product helps reduce congestion directly in your nose and not in the rest of your body, making it a safe alternative for people with diabetes and high blood pressure. However, these products should only be used for a maximum of 3 -5 days. If you are still experiencing congestion after 3-5 days, you should contact your medical provider.

OTC medications can sometimes negatively impact complications. For instance, if you have kidney complications (CKD= chronic kidney disease), avoid using pain relievers in the NSAIDs (nonsteroidal anti-inflammatory drugs) which can worsen the kidney function. NSAIDs include Aleve (naproxen sodium) or Motrin (ibuprofen).  Tylenol (acetaminophen) may be used as an alternative. However, if you have liver complications, you’ll want to ask your medical provider before using.

Becoming “Med-Wise”

Now that you know what to look out for when choosing a product and which products to avoid, follow the 10 tips below to ensure that you use OTC medications wisely:

1. Always start by reading the product label (all of it), especially the active ingredients, inactive ingredients and warnings.
2. Look for an OTC medicine that will treat only the symptom(s) you are experiencing.
3. Know what to avoid while taking an OTC medicine. Look for drug interactions and adverse effects.
4. When in doubt, ask your pharmacist or doctor before you buy or use an OTC medicine.
5. Follow the directions on the label. More is not always better!
6. Use extra caution when taking more than one OTC product at a time to make sure that the same ingredients are not contained in both products, or to make sure that the two products do not interact with each other.
7. Don’t combine prescription medications and OTC drugs without talking to your medical provider first.
8. Make sure that each of your doctors has a list of all the medications, OTC products and supplements you are taking.
9. Always give infants and children OTC medicines that are specifically formulated for their age and weight.
10. Don’t use OTC medicines after their expiration date.

Additional Resources

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