Over-the-Counter (OTC) Medications Helpful Tips • Choose products that target your specific symptoms, rather than combination products that treat many symptoms that you may not have. See below. • Be cautious of doubling up on the same ingredients (for example, Tylenol is in many products). • Take extra care when using “PM” products, as they may have serious side effects. • Always read the product labels for important dosing and precaution information. - Doses may differ for adults and children

- Many products have age limitations - Most products have a maximum number of days that they should be used OverO-thever--counterthe-counter options options Over-the-Counter Options CombinationCombination Products: Products: treat multipletreat multiple symptoms symptoms

Combination products often results in overtreating because you’re taking medications for Combination Products: Treat multiple symptoms Combination• products often results in overtreating because you’re taking medications for • symptoms that you do not have. • Combination products often result in overtreating because you’re taking medications for symptoms that you do not have. Instead,Over choose-the- counteran over-the options-counter p roduct that targets your specific symptoms with symptoms that you do not have. •Instead, choose an over-the-counter product that targets your specific symptoms with • ingredients only for those symptom • Instead, choose an over-the-counter product that targets your specific symptoms with Combination Products:ingredients treat multipleonly for thosesymptoms symptom ingredients only for those symptoms. • Combination products often results in overtreating because you’re taking medications for symptoms that you do not have. OTC Products for Pain & Fever: OTC Products for Pain & Fever: OTC Products for PainInstead, & Fever: choose an over-the -counter product that targets your specific symptoms with • Acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin can be • Acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin can be ingredients onlyAcetaminophen for• those symptom (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin can be • used for fever and pain used for fever and pain. used for fever and pain • They are often found in many combination products • They are often found in many combination products. OTC Products for Pain & •Fever:They are often found in many combination products • Avoid using multiple products with the same ingredient • Avoid using multiple products with the same ingredient. • Acetaminophen• Avoid using (Tylenol), multiple ibuprofen products (Advil, with Motrin), the same naproxen ingredien (Aleve),t and aspirin can be • Follow dosingused for recommendations fever and pain on the label. • Follow dosing recommendations on the label. • Follow dosing recommendations on the label. • They are often found in many combination products PM Products: Nighttime products contain sedating antihistamines, such as diphenhydramine PM Products: • Nighttime products contain sedating antihistamines, such as diphenhydramine PM Products: • Avoid• using multiple(Benadryl) products or with doxylamine the same ingredien (Unisom)t and are generally labeled with “PM” • Follow dosing recommendations(Benadryl) on the label. or doxylamine (Unisom) and are generally labeled with “PM” • Nighttime products contain sedating antihistamines, such as diphenhydramine (Benadryl) or doxylamine Be cautious when using PM products, as they may cause serious side effects, (Unisom) and are generally labeled with “PM”. PM Products: • NighttimeBe •cautious products whencontain using sedating PM antihistamines, products, as theysuch asmaydiphenhydramine cause serious side effects, (Benadryl)• orespecially doxylamine when (Unisom) used and long are- termgenerally or iflabeled you are with older “PM” than 65. • Be cautious when using PM products, as they may cause serious side effects, especially especially when used long-term or if you are older than 65. when used long-term or if you are older than 65. • Be cautious• whenSide using effects PM products, may include as they dizziness, may cause confusion serious side and effects increase, risk of falling. especially• whenSide used effects long may-term include or if you dizziness,are older than confusion 65. and increase risk of falling. • Side effects may include dizziness, confusion and increase risk of falling. • Side effects may include dizziness, confusion and increase risk of falling.

Examples of OTC Products and their active ingredients ExamplesExamples of OTC of OTCproducts products and andtheir t heiractive acti ingredientsve ingredients ProductExamples Name of OTCActive products ingredients and their active ingredientsProduct Name Active ingredients Cough (product name, active ingredient) Runny Nose / Allergies (product name, activeProduct ingredient) Name Active ingredients Product Name Active ingredients Product Name Active ingredients Product Name Active ingredients Robitussin Chest Congestion, Guaifenesin Claritin, Loratadine CoughCough RunnyRunny Nose/Allergies Nose/Allergies -RobitussinCough Chest Congestion Guaifenesin RunnyClaritin Nose/Allergies Loratadine Mucinex Benadryl, Diphenhydramine -Robitussin Chest Congestion Guaifenesin Claritin Loratadine Delsym, Dextromethorphan Allegra, Fexofenadine -Robitussin-Mucinex Chest Congestion Guaifenesin Claritin BenadrylLoratadine Diphenhydramine -Mucinex Benadryl Benadryl DiphenhydramineDiphenhydramine Robitussin Cough Zyrtec, Ceterizine -Mucinex Allegra Fexofenadine Allegra Allegra Fexofenadine Fexofenadine Zyrtec Ceterizine Congestion / Stuffy Nose (product name, active ingredient) Headache / Pain / Fever (product name, active ingredient) Zyrtec Zyrtec Ceterizine Ceterizine Delsym Delsym DextromethorphanDextromethorphan Sudafed, Pseudoephedrine* Tylenol, Acetaminophen Delsym Dextromethorphan Headache/Pain/FeverHeadache/Pain/FeverHeadache/Pain/Fever Robitussin Cough *Included in products that include a “D” in their name Advil and Motrin, Ibuprofen RobitussinRobitussin Cough Cough Sudafed PE, Phenylephrine Aleve, Naproxen Congestion / Stuffy Nose Tylenol TylenolAcetaminophen Acetaminophen Congestion / Stuffy Nose Tylenol Acetaminophen Bayer, Aspirin Congestion / Stuffy Nose Sudafed Sudafed Pseudoephedrine*Pseudoephedrine* Advil AdvilIbuprofen Ibuprofen Sudafed * IncludedPseudoephedrine* in products that Motrin Advil Ibuprofen Ibuprofen * Included in products that Motrin Ibuprofen include* Includeda “D” in their in products name A thatleve Motrin Naproxen Ibuprofen include a “D” in their name Aleve Naproxen Sudafed PE Phenylephrineinclude a “D” in their nameBayer A leve Aspirin Naproxen Sudafed PE Phenylephrine Bayer Aspirin

Sudafed PE Phenylephrine Bayer Aspirin

Choose an OTC product based on your symptoms Generic Name (Brand Name) Important Tips Congestion (plugged ears, nose or head congestion)

Oral Decongestants (pill form): - Decongestants may disrupt your sleep Phenylephrine (Sudafed PE) - If you have high blood pressure, speak with your doctor Pseudophedrine (Sudafed) before taking these medications. - Coricidin HBP products are specially Nasal Decongestants (nasal spray form): formulated to be safe for those with high These are the treatment of choice for nasal congestion blood pressure. Oxymetazoline (Afrin Sinus) - If you have a thyroid disorder, diabetes, heart disease, Fluticasone propionate (Flonase) glaucoma, or an enlarged prostate make sure you speak with your Mometasone (Nasonex) doctor before taking any of these medications. Triamcinolone acetonide (Nasocort) - Excessive use of nasal decongestants may cause rebound congestion. Cough

Dry, hacking cough: - Avoid cough medications in children younger than 4 years old. Dextromethorphan (Delsym) - Hydration helps to naturally loosen and thin mucus to help with cough. Wet, mucousy cough: Guaifenesin (Mucinex) Runny Nose or Sneezing Antihistamines: - Many of these medications will make you tired and can Sedating impair performance. Diphenhydramine (Benadryl, Sominex) - Do not use in newborns/infants, if you are lactating, or if you Chlorpheniramine (Chlor-Trimeton) have narrom-angle glaucoma. Doxylamine (Unisom) - Although cetirizine is considered non-sedating, it may be Non-Sedating sedating in some patients. Loratadine (Claritin, Alavert) Cetirizine (Zyrtec) Fexofenadine (Allegra) General Aches and Pains or a Fever

Pain and Fever Medications: - Pay attention to dosing limitations which are different for Acetaminophen (Tylenol) children and adults. Ibuprofen (Advil, Motrin) - NSAIDS (Ibuprofen and Naproxen) can have dangerous side Naproxen (Aleve) effects - make sure you talk to your doctor before using these Aspirin (Bayer) on a regular or long-term basis for pain. - Due to the risk of Reye’s Syndrome, aspirin should not be used in children under 19 years old. - Aspirin can increase the risk of bleeding, especially if used with other blood thinners. Speak with your doctor before using this, especially if using it long-term. Asthma

Primatene Mist - Always speak with your healthcare provider before using. - Does not treat asthma, only temporarily lessens symptoms. - Should not replace your regular asthma inhalers. - Not for cough, allergies, or cold symptoms. InterMed - February 2019