Over-the-Counter Medication
According to the National Transportation Safety Board, many accidents have occurred as a result of the casual use of licit medications by a vehicle operator. Due to possible similar symptoms between substance abuse and over-the-counter (OTC) medicines, it is important for employees to be aware of the possible adverse reactions that OTC medications can cause.
When a doctor prescribes medication, he or she explains the possible side effects of the medication the patient is about to take. A pharmacist also outlines the side effects when filling the prescription. However, when an individual treats him or herself with a non-prescription medication, he or she becomes his or her own doctor and pharmacist.
Underlying Medical Condition
In general, when employees are not feeling well, they may choose to stay home. At other times, they may feel they must report to work in spite of an illness and decide to take OTC medications. It is good to remember that OTCs only hide symptoms for a short time. They do not "cure" the condition. Further, employees will not be in peak physical condition to drive.
Some Adverse Reactions to OTCs
There are two main areas of concern about unwanted reactions to medications.
1. Possible Allergy. Allergy is a rare and unpredictable reaction to a substance. If an employee knows that he or she is allergic to something, he or she should read the list of ingredients of OTCs carefully to assure that allergens are not included in its formulation.
2. Possible Unexpected Side Effects. Side effects take many forms including drowsiness, impairment of judgment, upset stomach or bowels, disturbance of vision, or even itching. Any of these could cause an impairment that might lead to incapacitation while driving.
Decongestants and caffeine (contained in coffee, tea, cola, and chocolate) are both strong stimulants in some individuals. Taken together, they can make a person hyperactive. Note also that some cough syrups contain a decongestant.
Summary Advice for Employees
- READ and follow label directions for appropriate use of medication.
- If the label warns of side effects, do not drive until twice the recommended dosing intervals have passed. So, if the label says, "take every 4-6 hours," then wait at least 12 hours to drive.
- Remember that the condition you are treating may be as disqualifying as the medication.
- When in doubt, ask your physician or pharmacist.
- An employee is responsible for his or her own well-being and should be aware of any illness that requires medicine to make him or her feel better.
- If an illness is serious enough to require medication, it is also serious enough to prevent an employee from getting behind the wheel.
- Avoid mixing decongestants and caffeine.
- Beware of medications that use alcohol as a base for the ingredients.
OTCs, Side Effects, and Interactions
The following table is a list of common OTCs but is not inclusive. It is simply an outline of the possible side effects that could affect an employee's driving ability. As with all drugs, side effects may vary with the individual.
| Symptom |
Medication |
Side Effect |
Interactions |
Pain Relief/Fever |
Aspirin Alka-Seltzer Bayer Aspirin
|
Ringing in ears, nausea, stomach ulceration, hyperventilation |
Increase effect of blood thinners
|
Acetaminophen Tylenol
|
Liver toxicity (in large doses) |
|
Ibuprofen Advil Motrin Nuprin
|
Upset stomach, dizziness, rash, itching |
Increase effect of blood thinners |
Colds/Flu |
Antihistamines Actifed, Dristan, Benadryl, Drixoral, Cheracol-Plus, Nyquil, Chlortrimenton, Sinarest, Contact, Sinutab, Dimetapp |
Sedation, dizziness, rash, impairment of coordination, upset stomach, thickening of bronchial secretions, blurring of vision |
Increases sedative of other medications |
Decongestants Afrin Nasal Spray, Sine-Aid, Sudafed
|
Excessive stimulation, dizziness, difficulty with urination, palpitations
|
Aggravate high blood pressure, heart disease, and prostate problems
|
Cough Suppressants Benylin, Robitussin CF/DM, Vicks Formula 44
|
Drowsiness, blurred vision, difficulty with urination, upset stomach |
Increase sedative effects of other medications |
Bowel Preparations |
Laxatives Correctol Ex-Lax |
Unexpected bowel activity, rectal itching |
|
Anti-Diarrheals Imodium A-D Pepto-Bismol |
Drowsiness, depression, blurred vision (see Aspirin) |
|
Appetite Suppressants |
Acutrim Dexatrim |
Excessive stimulation, dizziness, palpitations, headaches |
Increased stimulatory effects of decongestants. Interfere with high blood pressure medications |
| Sleeping Aids |
Nytol Somined |
Contain antihistamine, prolonged drowsiness, blurred vision |
Cause excessive drowsiness when used with alcohol |
| Stimulants |
Caffeine Coffee, tea, cola, chocolate |
Excessive stimulation, tremors, Palpitations, headaches |
Interfere with high blood pressure medications |