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Mixing Over the Counter and Prescription Medications? Here’s What You Need to Know

by The GoodRx Pharmacist on February 24, 2017 at 5:00 pm

Americans’ use of supplements, prescriptions and over the counter (OTC) medications has been steadily increasing over the past couple of years. This increase can sometimes put patients at risk for complications and interactions. Believe it or not, a lot of over-the-counter medications can actually interact with your prescription medications (and affect how they work) without you even realizing it. Understanding how OTC medications, vitamins, supplements and prescriptions medications interact is important for your health and safety.

First off what is an OTC medication?

An over the counter medication, according to the Food and Drug Administration (FDA), is a medicine that you can buy without a prescription. These medications are considered safe and effective when you follow the directions on the label, or as directed by your health care professional.

The beauty of OTC medications is the convenience and ability, as a patient, to select a medication for your specific symptoms without a trip to the doctor. However, if you take any prescription medications, it is always recommended to check with your doctor or pharmacist before perusing the OTC aisles to ensure that it wont interact with any prescription medications.

What about vitamins, minerals, supplements?

Many people consider vitamins, minerals and supplements as “natural,” thinking that they won’t cause any problems or interactions. It may come as a surprise to some, but just like other OTC medications, vitamins, minerals and supplements can also interact with prescription medications.

It is important to understand the risks associated with the use of OTC medications, including those that give the illusion that they are natural or safe.

What are some common OTC and prescription drug interactions that I should know of?

  • Blood Thinners like Coumadin (warfarin), Pradaxa, Eliquis, Xarelto and Plavix can interact with the following and cause an increased risk of bleeding:
    • Vitamin E
    • Ginkgo biloba
    • Alka-Seltzer products
    • Supplement drinks containing vitamin K (like Ensure or Boost)
    • Nonsteroidal anti-inflammatories (NSAIDS) like ibuprofen (Motrin, Advil), (naproxenAleve, and aspirin.
  • Birth control like Loesterin Fe, Ortho-Tri Cyclen, Seasonale and Yaz can become less effective in combination with St. John’s Wart. In fact, mixing these two products could lead to possible pregnancy
  • SSRI Antidepressant Medications like Celexa, Lexapro and Prozac also interact with St. John’s Wort. Mixing these could increase your risk for serotonin syndrome, which can cause symptoms like diarrhea, seizures or even death.
  • MAOI antidepressants like Parnate, Nardil and Marplan interact with the following and can also increase your risk for serotonin syndrome.
    • Robitussin DM
    • Mucinex DM
    • Nyquil Cold & Flu
    • Coricidin HBP Products
  • Pain Medications like Norco, Vicodin, Percocet, Tylenol with Codeine and Ultracet don’t mix well with other products containing Tylenol, like Tylenol PM, Nyquil, Dayquil, and Mucinex. The maximum daily amount of Tylenol (acetaminophen) is now 3,000 mg per day, so mixing pain medications that contain acetaminophen with other Tylenol products can mean that you are taking more than the recommended amount of Tylenol without realizing it.

These are just a few of the common interactions between prescription and OTC medications! Remember, if you are concerned about any interactions between your medications, you can always check with your doctor or pharmacist.


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