Self-medicating Responsibly

While self-medication can seem empowering for your health, you need to play it smart by making informed choices for your well-being.

When you feel unwell, your first instinct may be to pop down to the nearest pharmacy to purchase over-the-counter (OTC) medicine or simply grab the phone and order it. We take the medicine and are relieved of our headache or sore throat in what seems like no time at all.

The reality, however, is not so simple. OTC medications such as cough and cold remedies, painkillers, and anti-allergy medicines are readily available without requiring a doctor’s prescription. Although these medications could alleviate symptoms of minor illnesses like a cold, there is a risk that these symptoms could point to more serious conditions. Even common conditions may have accompanying symptoms and considerations that should not be ignored.

According to Ms Kok Hui Qi, Pharmacist, Department of Pharmacy, Sengkang General Hospital, these include:

• Symptoms like fever, cough and runny nose can often be self-treated if you are suffering from a common cold and flu, but episodes of breathlessness, chest pain and wheezing may indicate something more serious that requires medical attention
• Mild gastric flu symptoms such as nausea, diarrhoea and vomiting can be managed at home if the patient is able to tolerate food and is otherwise well
  
• Mild vaginal infections can be treated with pharmacy-only medications, but it is essential to consult a pharmacist to differentiate between a mild fungal infection and a bacterial infection that requires physician-prescribed antibiotics
  

Exercising caution with chronic conditions

Some medical issues may not be fully resolved with OTC medications, especially for those with chronic conditions. “Patients with chronic conditions should seek advice from their physician or the pharmacist on duty before self-medicating,” reminds Ms Kok, as even seemingly harmless OTC medications can have adverse effects on these patients

Examples include:

• Ibuprofen: may not be suitable for those taking multiple blood pressure medications
• Paracetamol: those with liver conditions should take a reduced dose rather than the dosage recommended on the medication box
  
• Decongestants: may raise blood pressure slightly, making them unsuitable for those with certain heart or eye conditions
  

People with chronic conditions should also avoid sharing their medications with others for self-medication, even if they have similar conditions. “Different people require different medications based on their body and existing medical conditions,” emphasises Ms Kok.

The other side of supplements

Aside from OTC medication, you may be tempted to try herbs and supplements to improve your health. However, the use of some supplements could still fall under self-medicating practices as they may have drug-like properties that produce similar effects. For instance, red yeast rice may appear to be a supplement, but can have effects similar to cholesterol-lowering medications, potentially causing harm, especially if patients are also taking other cholesterol-lowering medications.

Another risk in self-medicating with herbs and traditional medicines, especially traditional Chinese medicine (TCM), is their potential to have counterproductive interactions with Western medication, especially for those on long-term medication for chronic conditions.

Ms Kok shares the example of warfarin, a common blood thinner, that could interact with herbs like St. John’s wort and gingko biloba extract. “Patients on warfarin may not be aware that TCM can interact with warfarin in many ways, such as increasing the risk of bleeding,” adds Ms Kok.

“I do not discourage the use of TCM in chronic conditions except for certain groups of patients who are very sensitive to any medication or herb use, such as those with chronic kidney disease,” advises Ms Kok. “The best approach is to consult your doctor or pharmacist on the TCM you intend to consume to check for any potential interactions.”

Learn to self-medicate in a responsible manner:

• Follow the recommended dosage stated on medication labels.
• Always check if the medication and supplements you purchase have been registered under the Health Sciences Authority on their website to avoid products that have been adulterated (containing undeclared potent ingredients) and disguised as supplements.
  
• Buy supplements and TCM only from registered stores and licensed practitioners. Avoid suspiciously ‘cheap’ products from online and unknown sources.
  
• For prolonged medication use, such as two weeks or more, please consult a doctor.
  
• Seek medical attention for more serious conditions, such as breathlessness, abnormal leg swelling, eye pain, traumatic injury, red and inflamed skin with pus.
• Contrary to popular belief, refrigeration does not extend medication shelf life or improve their quality. Keep them refrigerated only if this is stated on its packaging or as advised by the pharmacy.
  
• Store medication in a cool, dry place and avoid places with direct exposure to sunlight or humid areas like the bathroom or kitchen.