The Dangers of Choosing Combination Products Over Single Active Ingredient Products

Christine Marie ManaloDebbie ChenMegan Sailors

Why people choose combination over-the-counter (OTC) products?

OTC combination products examplesDangers of choosing combination

products Side effects, adverse drug events

Solutions, prevention Labels, smart panels, phone

applications, internet

Many OTC combination products contain the same active ingredients Consumers end up ingesting

unnecessary active ingredients that can lead to more side effects, adverse drug events, and ultimately, an increase in the cost of healthcare.

Not reading or not understanding the Drug Facts panel, and thus unaware that there are multiple active ingredients

Cost: save money by purchasing one product with multiple ingredients so they can use it repeatedly for various symptoms

Convenience

Products containing acetaminophen Actifed® Plus (as a combination product containing

Acetaminophen, Pseudoephedrine, Triprolidine) Alka-Seltzer® Plus Cold & Sinus (as a combination product

containing Acetaminophen, Phenylephrine) Anacin® (as a combination product containing Acetaminophen,

Aspirin, Caffeine) Backprin® (as a combination product containing Acetaminophen,

Caffeine, Magnesium Salicylate) Codimal® (as a combination product containing Acetaminophen,

Chlorpheniramine, Pseudoephedrine) Comtrex® Cold and Cough (as a combination product containing

Acetaminophen, Dextromethorphan, Phenylephrine) Contac Sinus® (as a combination product containing

Acetaminophen, Pseudoephedrine) Coricidin® (as a combination product containing Acetaminophen,

Chlorpheniramine) Dayquil® (as a combination product containing Acetaminophen,

Dextromethorphan, Pseudoephedrine) Dimetapp® Cold And Fever (as a combination product containing

Acetaminophen, Brompheniramine, Pseudoephedrine) Dristan® Cold Non-Drowsy (as a combination product containing

Acetaminophen, Pseudoephedrine) Drixoral® Sinus (as a combination product containing

Acetaminophen, Dexbrompheniramine, Pseudoephedrine Extended Release Tablet)

Dryphen® (as a combination product containing Acetaminophen, Chlorpheniramine, Phenylephrine)

Duraflu® (as a combination product containing Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine)

Duratuss® A (as a combination product containing Acetaminophen, Guaifenesin, Phenylephrine)

Emagrin Forte® (as a combination product containing Acetaminophen, Caffeine, Guaifenesin, Phenylephrine)

More products containing acetaminophen Excedrin® (as a combination product containing Acetaminophen, Aspirin, Caffeine) Excedrin® Back & Body (as a combination product containing Acetaminophen, Aspirin) Excedrin® PM (as a combination product containing Acetaminophen, Diphenhydramine) Midol PMS® (as a combination product containing Acetaminophen, Pamabrom, Pyrilamine) NyQuil® Cold/Flu Relief (as a combination product containing Acetaminophen,

Dextromethorphan, Doxylamine) Sinus Aid® (as a combination product containing Acetaminophen, Pseudoephedrine) Sinutab® (as a combination product containing Acetaminophen, Pseudoephedrine) Sudafed® PE Cold & Cough (as a combination product containing Acetaminophen,

Dextromethorphan, Guaifenesin, Phenylephrine) Sudafed® PE Sinus Headache(as a combination product containing Acetaminophen,

Phenylephrine) Supac® (as a combination product containing Acetaminophen, Aspirin, Caffeine) Suphedrin Sinus® (as a combination product containing Acetaminophen, Pseudoephedrine) Tavist® Allergy/Sinus/Headache (as a combination product containing Acetaminophen,

Clemastine, Pseudoephedrine) Tavist® Sinus (as a combination product containing Acetaminophen, Pseudoephedrine) Theraflu® Sore Throat (as a combination product containing Acetaminophen,

Chlorpheniramine, Pseudoephedrine) Tricom® (as a combination product containing Acetaminophen, Chlorpheniramine,

Pseudoephedrine) Tylenol® Cold (as a combination product containing Acetaminophen, Dextromethorphan,

Pseudoephedrine) Unisom® With Pain Relief (as a combination product containing Acetaminophen,

Diphenhydramine) Vicks 44® Cold, Flu and Cough (as a combination product containing Acetaminophen,

Chlorpheniramine, Dextromethorphan, Pseudoephedrine)

Products containing ibuprofen Advil® Allergy Sinus (as a combination

product containing Chlorpheniramine, Ibuprofen, Pseudoephedrine)

Advil® Cold and Sinus (as a combination product containing Ibuprofen, Pseudoephedrine)

Advil® PM (as a combination product containing Diphenhydramine, Ibuprofen)

Dayquil® Pressure and Pain (as a combination product containing Ibuprofen, Pseudoephedrine)

Dimetapp® Sinus (as a combination product containing Ibuprofen, Pseudoephedrine)

Dristan® Sinus (as a combination product containing Ibuprofen, Pseudoephedrine)

Motrin® PM (as a combination product containing Diphenhydramine, Ibuprofen)

Products containing aspirin Alka-Seltzer® (as a combination product containing Aspirin, Citric Acid, Sodium

Bicarbonate) Alka-Seltzer® Extra Strength (as a combination product containing Aspirin, Citric Acid,

Sodium Bicarbonate) Alka-Seltzer® Morning Relief (as a combination product containing Aspirin, Caffeine) Alka-Seltzer® Plus Flu (as a combination product containing Aspirin, Chlorpheniramine,

Dextromethorphan) Alka-Seltzer® PM (as a combination product containing Aspirin, Diphenhydramine) Anacin® (as a combination product containing Aspirin, Caffeine) Anacin® Advanced Headache Formula (as a combination product containing

Acetaminophen, Aspirin, Caffeine) Aspircaf® (as a combination product containing Aspirin, Caffeine) Bayer® Aspirin Plus Calcium (as a combination product containing Aspirin, Calcium

Carbonate) Bayer® Aspirin PM (as a combination product containing Aspirin, Diphenhydramine)

Bayer® Back and Body Pain (as a combination product containing Aspirin, Caffeine)

BC Headache (as a combination product containing Aspirin, Caffeine, Salicylamide)

BC Powder (as a combination product containing Aspirin, Caffeine, Salicylamide)

Emagrin® (as a combination product containing Aspirin, Caffeine, Salicylamide)

Excedrin® (as a combination product containing Acetaminophen, Aspirin, Caffeine)

Excedrin® Back & Body (as a combination product containing Acetaminophen, Aspirin)

Goody's® Body Pain (as a combination product containing Acetaminophen, Aspirin)

Levacet® (as a combination product containing Acetaminophen, Aspirin, Caffeine, Salicylamide)

…selecting products without

adequate information can lead to

serious adverse drug

events!

Prevention: Reading labels

Technology: Phone apps, Smart panels Medilyzer

Web sources Familydrugguide.com

Always consult the pharmacist

Reading labels Look at drug information box in back,

not just listed symptoms on the front This will list active drug ingredients as

well as their indications Follow directions for use If unsure, ask the pharmacist!

Website: http://www.medilyzer.com/index.html

Smart Phone on the go▪ iPhone, Android and BlackBerry (coming soon)

Smart Panel in the pharmacy Website at home

Powerful OTC drug information tool Dosage Instructions Drug Interaction Checker OTC Side Effect information

How Do You Use the Medilyzer iPhone Application? Scan Barcode or type in A picture of the medication

will appear Touch the picture of the medication Active

ingredients, warning, dosage information & comparable generic products will appear

Compare multiple medications, touch “Check Interaction” located on the main screen▪ Green check = OKAY to take medications at the same time▪ Red stop sign = DO NOT take the medications and the same

time and consult the pharmacist

1. Scan Barcode or type in A picture of the medication will appear

1. Touch the picture of the medication Active ingredients, warning, dosage information & comparable generic products will appear

1. Compare multiple medications, touch “Check Interaction” located on the main screen▪ Green check = OKAY to

take medications at the same time

▪ Red stop sign = DO NOT take the medications and the same time and consult the pharmacist

A Comprehensive, Interactive, Multi-lingual Database of Medications

Analyzes prescription and OTC medication information and interprets it for the consumer

Dosages, warnings, side effects, and interactions are personalized for each individual based on existing health conditions entered by the consumer.

Fast and Easy to Use Works quickly and accurately to ensure customer

satisfaction while minimizing health risks Medication comparisons happen in mere seconds giving

consumers need-to-know information on the go. Lowers Costs

Scan any brand medication and find the equivalent generic product that the store carries

Multi-Lingual Use the system in any language.

MedlinePlus: Drugs, Herbs and Supplements http://www.nlm.nih.gov/medlineplus/druginform

ation.html

Mayo Clinic: Health Information http://www.mayoclinic.com/health/drug-informa

tion/DrugHerbIndex Family Drug Guide

http://www.familydrugguide.com/family/ub

More is MoreThe MORE active ingredients

contained in a product, the MORE chances there are for unwanted side effects

TAKE THE LEAST NUMBER OF ACTIVE INGREDIENTS FOR SYMPTOMS