There’s safety in the prescription pad: Doctor’s orders remove all doubt about which pill to pop. But without the chicken scratch on that scrip to guide you, do you know which meds are best?
More than 100,000 are available over the counter and contain over 1,000 active ingredients—which you probably ignore. In fact, a new Northwestern University study reveals that 59 percent of people don’t always check the contents of their OTC drugs. “Most people shop by symptom, not ingredient,” says study author Michael Wolf, Ph.D., M.P.H.
It’s time to stop buying blind. We hit the drugstore, talked to the experts, and decode the labels. Below are the best over-the-counter remedies for 8 of your most common symptoms.
Your OTC solution: Loratadine
Allegra, Claritin, and Zyrtec are equally effective at fighting allergy symptoms. But Claritin still wins by a nose, says Lauren Schlesselman, Pharm.D., a pharmacy professor at the University of Connecticut. Zyrtec can make you sleepy, and while both Claritin and Allegra are labeled “non-drowsy,” Claritin is slightly less likely to cross the blood-brain barrier and cause sleepiness. Dose up daily at the same time to keep blood levels steady. Sinus pain? Opt for Claritin-D.
Your OTC solution: Guaifenesin
Feel like rubber cement is coating your lungs? Grab guaifenesin. This ingredient thins mucus, making it easier to expel, and may even halt mucus production. Take the maximum number of doses for 3 or 4 days, even if you feel better, says W. Steven Pray, Ph.D., D.Ph., a professor of pharmacy at Southwestern Oklahoma State University. But skip guaifenesin/cough suppressant combos; these make it tough for you to expel thinned out mucus, say Wake Forest University researchers.
Your OTC solution: Ketoconazole
Try: Nizoral A-D
If it snows wherever you go, you can blame a fungus called Pityrosporum ovale. Change the forecast with Nizoral A-D, the only nonprescription shampoo that contains the anti-fungal ketoconazole, says Pray. Just limit your lathering to once every 3 days; any more can cause irritation. The rest of the time, Pray recommends shampooing with Head & Shoulders, which contains zinc pyrithione, a compound that slows the shedding of skin cells on your scalp.
Your OTC solution: Dextromethorphan
To quell a cough, you need to target your brain, not your lungs. “Dextromethorphan acts on your brain’s medulla to raise the cough threshold, so it requires more irritation to produce a cough,” says Stefanie Ferreri, Pharm.D., a pharmacy professor at the University of North Carolina at Chapel Hill. To avoid hacking at 2 a.m., take the extended-release stuff—it lasts for up to 12 hours. Take it with honey to boost saliva production and lubricate your airway, suggest British scientists.
Your OTC solution: Immediate-Release Omeprazole
Apparently all acid-reflux drugs must begin with a P or a Z: Prilosec OTC, Prevacid, Zantac. Now there’s Zegerid, possibly zee best yet. It contains a quick-release form of the omeprazole found in Prilosec OTC. Taken before breakfast, it was more effective than lansoprazole (Prevacid) at quelling acid over 24 hours, a Northwestern University study found. A word of caution: Zegerid has 304 milligrams of sodium per pill, so if you have to restrict your salt, stick with Prilosec.
Your OTC solution: Doxylamine
Try: Unisom SleepTabs
Insomnia doesn't have to keep you up at night. First, try these natural remedies: 6 Foods that Will Help You Sleep Better Tonight! But if they don't work, pop an antihistamine. Benadryl and other diphenhydramine-based drugs can help you drift off; however, the antihistamine doxylamine is more sedating. Plus, it’s less likely to cause “paradoxical wakefulness,” when your sleeping pill leaves you wide awake, says W. Christopher Winter, M.D., the Men’s Health sleep advisor. Take a 25-milligram tab about a half hour before bedtime, he says.
Your OTC solution: Ibuprofen
Whether you need it for pain or fever, ibuprofen has the edge on acetaminophen, a 2010 Wake Forest University review concluded. It also beats out other NSAIDs; aspirin is now recommended almost exclusively for cardio protection. And while Dr. Schlesselman suggests limiting naproxen (Aleve) to once every 12 hours, you can swallow ibuprofen every 4 hours, reducing the chance of between-dose pain. Ibuprofen may trigger GI trouble, so always pop your pill with a meal.
Your OTC solution: Calcium Carbonate
Most heartburn meds will douse the flames in your esophagus, but at what cost? Calcium carbonate rapidly neutralizes stomach acid with fewer side effects than sodium bicarbonate (Alka-Seltzer), which can cause gas and bloating, or magnesium hydroxide (Maalox), which can cause diarrhea. Dr. Schlesselman recommends chewing the tablets thoroughly and then chugging a glass of water to help them dissolve.