University Human Resource Services

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