Millions of people rely on medications every day to control pain, heartburn, allergies, blood pressure, anxiety, insomnia and other common health problems.
Most of these medicines provide important benefits and are generally safe when used correctly.
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But “common” doesn’t necessarily mean risk-free.
Some medications can affect the kidneys, liver, stomach, heart, brain or electrolyte levels, particularly when taken at high doses, combined with other medicines or used for longer than medically necessary.
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Here are 10 common medication groups worth knowing about.
- Ibuprofen and Other NSAID Pain Relievers
Ibuprofen is one of the most familiar over-the-counter painkillers.
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It belongs to a group called nonsteroidal anti-inflammatory drugs (NSAIDs), which also includes naproxen and several prescription medications.
NSAIDs can be useful for pain and inflammation, but they aren’t harmless.
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FDA-approved NSAID labeling warns about an increased risk of heart attack, stroke, stomach ulcers and gastrointestinal bleeding. Longer use and higher doses can increase certain risks.
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The kidneys deserve attention too.
NIDDK warns that NSAIDs can damage the kidneys when taken for long periods and can contribute to acute kidney injury when someone is dehydrated or has low blood pressure.
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Older adults and people with kidney disease, heart disease or certain other medical conditions may require particular caution.
- Naproxen
Naproxen is another NSAID commonly used for arthritis, muscle pain, back pain and other painful conditions.
Because it’s available without a prescription in some formulations, people may assume it’s safe to use continuously.
But its medication guide carries the same major NSAID warnings, including cardiovascular and gastrointestinal risks.
The goal with NSAIDs is generally to use the lowest effective dose for the shortest appropriate duration, unless your healthcare professional has instructed otherwise.
- Acetaminophen (Paracetamol)
Acetaminophen—also called paracetamol in many countries—is different from NSAIDs.
When taken as directed, FDA describes it as safe and effective.
The problem is accidental overdose.
Acetaminophen appears in hundreds of prescription and OTC products, including some cold, flu and combination pain medicines.
Someone might therefore take a cold medicine and an additional pain reliever without realizing that both contain acetaminophen.
Taking too much can cause severe liver damage, liver failure and even death.
Always check the active ingredients of combination medicines rather than relying only on the brand name.
- Proton Pump Inhibitors for Heartburn
Proton pump inhibitors, or PPIs, include medications such as omeprazole and pantoprazole.
They reduce stomach acid and can be extremely useful for conditions such as gastroesophageal reflux disease and ulcers.
But long-term treatment deserves periodic review.
Prescription information for pantoprazole warns that long-term or high-dose PPI therapy has been associated with an increased risk of certain fractures. Rare cases of significant low magnesium levels have also been reported, particularly after prolonged treatment.
However, this shouldn’t be interpreted as evidence that PPIs are inherently dangerous.
A review of the evidence notes that several proposed long-term risks come primarily from observational studies and that PPIs remain recommended treatments for appropriate medical indications.
If you’ve taken a PPI for months or years, ask whether you still need it rather than abruptly discontinuing it yourself.
- Decongestants
Cold and sinus products may contain decongestants such as pseudoephedrine.
These medicines constrict blood vessels to reduce nasal congestion.
That mechanism can also increase blood pressure in some people.
This becomes particularly important for people who already have hypertension or cardiovascular disease.
Read the active ingredients carefully because decongestants can be included in multi-symptom cold and flu products.
- Antihistamines
Antihistamines are widely used for allergies and sometimes as ingredients in nighttime medicines.
Older, sedating antihistamines can cause problems such as drowsiness, dry mouth, blurred vision, constipation and difficulty urinating.
Sedation can also increase the risk of falls, particularly in older adults.
Not every antihistamine has the same effects, so don’t assume they’re interchangeable.
A pharmacist can help identify an option appropriate for your age, medical conditions and other medications.
- Sleep Medicines and Sedatives
Prescription sleep medicines and sedatives can be useful for specific conditions.
But some can cause daytime drowsiness, impaired coordination, confusion and dependence.
These concerns become particularly important when sedating medications are combined with alcohol, opioids or other drugs that depress the central nervous system.
Older adults can also be more sensitive to sedative effects.
If you’ve been using a prescription sleep medicine regularly for a long time, don’t suddenly stop it without medical guidance because some drugs require gradual dose reduction.
- Corticosteroids
Corticosteroids such as prednisone can be essential for controlling inflammatory and autoimmune diseases.
Short courses and long-term treatment have very different risk profiles.
With prolonged or repeated systemic use, corticosteroids can contribute to problems such as higher blood sugar, bone loss, increased infection risk, fluid retention and other complications.
That doesn’t make prednisone a “bad” medication.
For many conditions, its benefits can be substantial.
But long-term users generally need appropriate medical monitoring.
And corticosteroids should not always be stopped abruptly after prolonged use.
- Diuretics (“Water Pills”)
Diuretics are commonly prescribed for high blood pressure, heart failure and fluid retention.
They help the kidneys remove sodium and water.
They’re valuable medicines, but excessive fluid loss or changes in electrolytes such as sodium and potassium can cause problems in some patients.
That’s why doctors may periodically monitor kidney function and electrolyte levels depending on the medication and medical condition.
Don’t compensate by taking potassium supplements unless your healthcare professional recommends them—some medications can actually cause potassium to become too high rather than too low.
- Certain Blood Pressure Medications
Blood-pressure medicines are extremely important because untreated hypertension itself can damage the heart, brain, kidneys and blood vessels.
However, like all medications, they can have side effects.
For example, certain medicines can cause dizziness or low blood pressure, while calcium-channel blockers such as amlodipine may cause ankle swelling in some patients.
ACE inhibitors and ARBs can affect kidney function and potassium levels, which is why blood testing may sometimes be recommended.
These potential effects are not a reason to stop hypertension treatment.
For most patients who need these medicines, controlling high blood pressure provides major health benefits.
Older Adults Should Be Particularly Careful
Medication effects can change with age.
Kidney and liver function may change, and many older adults take several prescription and OTC products simultaneously.
This increases the possibility of drug interactions and duplicate ingredients.
NSAIDs are a particularly important example: FDA labeling identifies older age as one factor that increases the risk of gastrointestinal bleeding.
A periodic medication review with a doctor or pharmacist can therefore be valuable.
Watch for Duplicate Ingredients
This is one of the easiest medication mistakes to make.
You might take a painkiller and then a cold or flu medicine containing the same active ingredient.
FDA specifically warns consumers to check OTC labels because taking multiple medicines containing the same ingredient can unintentionally double the dose.
Don’t just read the product name.
Look for the Active Ingredient section.
Your Kidneys Are Especially Important
Kidney function affects how the body handles many medicines.
NSAIDs such as ibuprofen and naproxen deserve particular caution.
Long-term NSAID use can cause kidney injury, and the risk can become greater in people who are dehydrated or already have reduced kidney function.
People with chronic kidney disease should therefore check with a healthcare professional before routinely using OTC pain medicines.
Never Stop an Important Prescription Because of an Online List
This is the most important message in the article.
Seeing your medication mentioned here does not mean it’s damaging your body or that you should stop taking it.
The actual risk depends on your dose, how long you’ve taken the medicine, your age, kidney and liver function, other health conditions and the other medications you use.
Abruptly stopping some prescription drugs can itself be dangerous.
Instead, ask your doctor or pharmacist:
Do I still need this medicine? Is my dose appropriate? Are there important interactions? Do I need any blood tests or monitoring?
The Bottom Line
Every medication involves a balance between benefits and potential risks.
Common medicines such as NSAIDs, acetaminophen, PPIs, decongestants, antihistamines, corticosteroids and cardiovascular medications aren’t automatically dangerous.
The real problems often arise from excessive doses, unnecessary long-term use, drug interactions, duplicate ingredients or use in people with particular risk factors.
Use medicines exactly as directed, keep your healthcare providers informed about everything you take—including OTC drugs and supplements—and periodically review long-term medications with your doctor or pharmacist.
Medical disclaimer: This article is for general educational purposes only and does not replace individualized medical advice, diagnosis or treatment.
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