How dangerous can medicines like paracetamol and nasal spray be?

Over-the-counter medications like paracetamol, nasal sprays, and antacids, which you can buy at the drugstore or supermarket, are often dismissed as "harmless." Yet, such medications can be just as dangerous. Paracetamol is even the leading cause of poisoning in the Netherlands.

European medicines authorities are launching a campaign: "Medicines are not candy." Over-the-counter medications are medicines, and every medication carries risks, warns the Medicines Evaluation Board (MEB), among others. If you use over-the-counter medications incorrectly, you can experience unpleasant side effects. You can also become addicted. The MEB therefore advises reading the package insert carefully, following the instructions, and using over-the-counter medications sensibly.

Paracetamol overdose has already been shown to be the most common poisoning in the Netherlands. If you take more than 150 milligrams per kilogram of body weight, you run the risk of harmful effects. Too much paracetamol can slowly destroy liver cells and cause liver dysfunction.

Previous research by Nivel, commissioned by the CBG (Dutch Medicines Evaluation Board), showed that 45 percent of Dutch people don't read the package inserts for over-the-counter medications. Furthermore, 14 percent use a medication for as long as they deem necessary, even though over-the-counter medications are ideally suited for short-term use.

"The package insert contains important information about the proper use of medications. And because we are constantly acquiring new knowledge, the information it contains can change. For example, with new side effects or updated instructions for use. That's why it's important to check the package insert every time," says CGB chairman Ton de Boer.

Family doctor Janneke Bel gives an example : "The incorrect use of xylometazoline nasal spray. I regularly see people who have used this nasal spray for longer than the maximum duration of use of 7 days stated in the package insert. The possible result: damaged nasal mucosa and addiction." Nasal spray contains an "addictive" substance that causes you to crave another dose when used regularly and for extended periods.

According to Bel, painkillers are even more dangerous. "What I hear from patients is that they don't necessarily consider ibuprofen to be the same type of medication as diclofenac and naproxen. Because of this, they're easily combined. And that can cause side effects." She also increasingly sees children being given ibuprofen oral solution, even though they are particularly sensitive to it.

Family doctor Leonard van Egmond emphasizes the importance of being aware of the medication you're taking. "A patient told me she'd used a drugstore medication for a vaginal yeast infection. That didn't help. Could it be something else? A culture revealed it was indeed a yeast infection. The result? The patient hadn't used the correct over-the-counter medication. It just goes to show: there's so much on the shelves at the supermarket or drugstore that we're not always aware of it."