Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are some of the most commonly used medications, with more than 30 billion doses taken annually in the US alone. Unfortunately, NSAIDs aren&rsquo;t just widely used: they&rsquo;re also widely abused, with nearly one out of seven users going over the daily limit, according to a January 2018 study from the Boston University School of Medicine.

That may not seem like a big deal, but NSAIDs can have serious side effects&mdash;even when taken as prescribed, says <a href="https://www.sharecare.com/doctor/dr-charan-k-cheema">Charan K. Cheema, DO</a>, a family medicine physician with <a href="https://www.sharecare.com/group/saint-joseph-mercy-health-system">Saint Joseph Mercy Health System</a> in Saline, Michigan. And because side effects are dose-related, overdoing it makes them even more likely, leading to bigger problems than the aches, pain and fever you originally took the meds for.

Who overdoses and why 
The recommended daily limit of NSAIDs varies from drug to drug. For ibuprofen, the most popular NSAID, it&rsquo;s 1200 mg for over-the-counter (OTC) drugs and 3200 mg for prescription meds, divided into three or four doses over a 24-hour period. Study participants, who kept a daily diary of their NSAID use for one week, exceeded the limit in several ways:

<ul>
	<li>They took too much of a single NSAID at one time. This was more likely when people used meds calling for a one-pill dose versus the more common two-pill dose.</li>
	<li>They took two different NSAIDs at the same time.</li>
	<li>They failed to wait long enough before taking another dose.</li>
</ul>

Most participants in the study only took OTC meds. But those using prescription NSAIDs complied significantly better with the maximum dosage&mdash;only 2 percent exceeded the daily limit. This highlights the concern about the lack of medical oversight with OTC meds. &ldquo;People often think that these drugs are safe, even at higher doses, because they&rsquo;re available over the counter,&rdquo; says Cheema.

A poor understanding of dosing recommendations was common among study participants who took too much medicine, as were the attitudes that they could choose what dose to take and that it wasn&rsquo;t necessary to start with a low dose to see if it would do the trick. People who exceeded the limit also were more likely to have ongoing pain and poor physical function.

How too many NSAIDs can affect you 
NSAIDs can be hard on the stomach, causing minor troubles, such as indigestion and stomach ache, or more serious problems like irritation of the stomach lining, ulcers and bleeding in the stomach or bowel. Gastrointestinal (GI) issues are more likely if you&rsquo;re older because your stomach lining weakens with age, but even younger people who are predisposed to it can experience irritation with these types of medications, says Dr. Cheema.

Except for aspirin, which is a type of NSAID, these drugs are also linked to a greater risk for heart attacks and strokes. In fact, one 2017 systematic review and meta-analysis found that taking any dose of NSAIDs for one week, one month or more than a month was associated with a 20 to 50 percent increased risk of heart attack compared with not using these drugs&mdash;though the risk was greatest with higher doses and during the first month of use.

&ldquo;You really have to be careful when prescribing these types of medications to people who&rsquo;ve had a heart attack or are at increased risk of heart disease,&rdquo; Cheema cautions. In these cases, she says <a href="https://www.sharecare.com/health/acetaminophen/what-is-acetaminophen">acetaminophen</a>, which works differently than NSAIDs and doesn&rsquo;t increase the risk of heart attacks, may be a safer option.

<a href="https://www.sharecare.com/health/kidney-disease/article/high-blood-pressure-diabetes-watch-out">Kidneys</a> may be affected, as well. &ldquo;Over time, NSAIDs can reduce blood flow to the kidneys,&rdquo; says Cheema. For people with normal kidneys, taking too many NSAIDs for too long can result in chronic interstitial nephritis, a disease contributing to renal failure. Those with kidney function problems should use lower doses or shouldn&#39;t take NSAIDs at all.

Using NSAIDs safely 
To avoid side effects, take the lowest effective dose for the shortest amount of time. &ldquo;The longer you&rsquo;re on them, the higher the risks,&rdquo; says Cheema. While there&rsquo;s no dose that completely avoids all these risks, Cheema advises using NSAIDs no more than two to three times a week.

If you need to take these drugs for long periods, talk to your doctor for advice about how to reduce the risk of side effects. For instance, Cheema sometimes switches things up by having patients substitute a dose of acetaminophen instead of taking ibuprofen or naproxen (another NSAID) every time.

Another option: topical anti-inflammatories, which work well for localized pain near the surface of the skin, like joint pain from arthritis. Compared to pills, only a little of the drug from these creams, gels, liquids and patches makes it into your bloodstream; also, topicals don&#39;t cause GI stress, and may be a safer bet when it comes to heart health. In an October 2017 study published in the Journal of the American Heart Association, people who used topical NSAIDs&mdash;even those who already had heart disease&mdash;had fewer heart attacks and strokes than those who took oral NSAIDs.

Alternatives to NSAIDs 
When it comes to easing pain, medication isn&#39;t the only game in town.

<ul>
	<li>Heat, which relaxes muscles and boosts blood flow, and ice, which reduces swelling, can help. So can wearing a brace or elastic bandage to support the area that&rsquo;s hurting.</li>
	<li>Exercise and physical therapy may improve strength, function and range of motion to reduce pain, and boost energy and mood, as well.</li>
	<li>The <a href="https://www.sharecare.com/health/pain-management/slideshow/natural-ways-manage-pain">mindful breathing</a> done during meditation and yoga are also proven to help alleviate pain.</li>
</ul>

Other potentially effective non-drug therapies include <a href="https://www.sharecare.com/health/acupuncture/how-does-acupuncture-treat-pain">acupuncture</a> and <a href="https://www.sharecare.com/health/mind-body-therapies/how-biofeedback-therapy-works">biofeedback</a>; speak to your doctor if you&#39;re interested in these options for chronic pain.

Medically reviewed in March 2018.

How Much is Too Much Ibuprofen?

Has your doctor ever handed you a prescription that you&rsquo;ve been completely unable to read? But when you hand the mystery message over to the pharmacist, she says, &ldquo;No problem. You can pick it up in an hour.&rdquo; How can she possibly know what the doctor ordered, you wonder?

Well, fortunately, most of the time pharmacists get it right. But even when totally legible printed prescriptions are used, mistakes happen&mdash;51 million a year out of 3 billion medications dispensed, says&nbsp;Pharmacy Times. And while that&rsquo;s a small percentage, it&rsquo;s a huge number.

So, when you get a prescription, ask the doctor or his staff member what it says, and then write the info down on a separate piece of paper. This way, you can double check what you know to be correct with what the pharmacist says.&nbsp;<a href="https://www.sharecare.com/health/preventing-medical-errors/medication-error-pharmacy">But don&rsquo;t stop there</a>.

According to one Canadian study, it seems a lot of mistakes get made once the right med with the right dose comes home with you. Labels on medication bottles can be hard to read, so instead of taking one pill every four hours for three days, you may take three pills every four days&mdash;<a href="https://www.sharecare.com/health/health-care-basics/article/pill-refill-anxiety-medication-mixups">or some other mix-up</a>&mdash;and either fail to get the treatment you need or overdose yourself.

To fix this, check that you can easily read and understand the label BEFORE you leave the pharmacy. If you can&rsquo;t, ask for a do-over with clearer, cleaner, bigger type.

Medically reviewed in July 2019.

Your Prescription—Right From the Start

You know bisphenol A (BPA) is nasty stuff. Unfortunately, the bad news about this toxin just keeps on coming. A pair of just-released studies links BPA with heart disease, obesity, and diabetes risk.

BPA is an organic compound that&#39;s used in plastics, such as water bottles, the lining of canned goods, and thermal receipts. Problem is, BPA mimics estrogen in your body and is thought to disrupt hormone function. BPA is linked to a host of potential health problems, from fertility trouble to cancer to developmental delays in kids. <a href="https://www.sharecare.com/health/breast-cancer/how-toxins-contribute-breast-cancer" target="_blank">Learn more about the link between breast cancer, BPA, and other toxins</a>.

Reasons to seek BPA-free products 
A new study from Britain links high urinary concentrations of BPA in healthy men and women to a higher risk of heart disease 10 years later. In another new study, Chinese researchers linked high concentrations of BPA to obesity -- especially belly fat -- and insulin resistance (a forerunner of diabetes) in middle-aged and elderly people. American researchers have found a similar connection between BPA and type 2 diabetes. <a href="https://www.sharecare.com/health/diabetes-complications/prevent-diabetes-high-blood-pressure" target="_blank">Discover ways to help prevent diabetes</a>.

With that kind of news, you certainly don&#39;t want a side order of BPA every time you eat or drink. Simple changes can limit your exposure to BPA and possibly prevent diabetes, heart disease, obesity, and other health-related problems.

<ul>
	<li>Opt for fresh food. One study found that a diet of organic fresh food can reduce urinary levels of BPA and DEHP (a type of phthalate chemical that&#39;s also a hormone disruptor) by more than 50% in just 3 days.</li>
	<li>Look for BPA-free containers. When you do buy packaged foods, choose those in glass jars, aseptic packaging, and BPA-free cans.</li>
	<li>Store food in glass, ceramic, or stainless-steel containers. You can find plastic containers that are free of BPA, but some researchers have found traces of BPA in those, too.</li>
	<li>Shop for dry goods at the bulk bins. Pick up flour, rice, beans, dried fruit, cereal, and pasta at the bulk bins at health-food stores. Sure, you&#39;ll put bulk-bin finds into plastic bags, but you can transfer them to BPA-free containers as soon as you get home.</li>
	<li>Avoid microwaving food in plastic containers. The heat causes BPA and other chemicals to leach into food. Similarly, don&#39;t put plastic containers in the dishwasher.</li>
	<li>Don&#39;t handle thermal receipts. These are those carbonless receipts you collect everywhere you go, from the grocery store to the gas station to the ATM. Yep, they have BPA. Refuse receipts if you have the option. If you don&#39;t, wash your hands after handling them. BPA in thermal receipts can be absorbed through your skin, as well as ingested with food.</li>
</ul>

Medically reviewed in April 2018.

3 Reasons to Worry About Toxic BPA

From lowering cancer risk to boosting your beauty regimen, aspirin&rsquo;s a versatile little pill&mdash;but it&#39;s important to know the potential side effects.

Surprising Reasons to Take Aspirin (And When to Skip It)

If you&rsquo;ve got a fever and you&rsquo;re coughing, congested or battling a sore throat, chances are you&rsquo;re also missing work, losing sleep&mdash;and running out of patience. It&rsquo;s natural to want to feel better as quickly as possible. Many people with flu-like symptoms think antibiotics are a quick-fix for their misery. But in most cases, antibiotics are not the answer.

Antibiotics are powerful drugs, but they aren&rsquo;t a cure-all. They specifically target bacteria, killing these microscopic organisms or preventing them from reproducing. But most chest colds and other illnesses are not caused by bacteria.

&ldquo;The vast majority of respiratory illnesses are viral,&rdquo; explains <a href="https://www.sharecare.com/doctor/dr-r-r-brown">Rush Brown, MD</a>, a primary care physician affiliated with <a href="https://www.sharecare.com/group/memorial-health">Memorial Health</a> in Savannah, Georgia. &ldquo;Antibiotics will not do anything to a virus. They will not help at all.&rdquo;

Bacteria vs. virus: What&rsquo;s the difference? 
Bacteria are ubiquitous. These one-celled microscopic organisms can be found just about everywhere in the environment&mdash;even in the human body. Different types of bacteria live on your skin, inside your mouth and along your digestive tract.

Many of these microbes actually help you stay healthy. Only certain species of bacteria, including some that are normally found on the body, have the potential to make people sick, including Streptococcus, Staphylococcus and E. coli. These and other types of bacteria are responsible for some common illnesses, like strep throat, bacterial pneumonia and urinary tract infections (UTIs). The immune system can usually fight harmful bacteria on its own. More serious infections, however, are treated with antibiotics.

Antibiotics often work quickly. Even though these drugs may need to be taken for a week or more, people usually start feeling better and are no longer considered to be contagious after about 24 hours. Although antibiotics are highly effective against bacteria, they are useless against viruses&mdash;the culprits responsible for the common cold, the flu and other viral illnesses that cause similar symptoms.

Unlike bacteria, viruses need a living host to replicate. These tiny germs consist of genetic material wrapped in protein. Antibiotics won&rsquo;t clear a viral infection, help you feel better or prevent you from spreading the illness to others.

In fact, there is no specific treatment for most viral illnesses. If taken right away, some anti-viral medications can reduce the severity and duration of the flu, according to Dr. Brown. But in most cases, people with a cold or other virus must rely on rest, fluids and other supportive care until they recover on their own in about one to two weeks.

&ldquo;The reality of the matter is we cannot make them well overnight,&rdquo; he says. &ldquo;It just takes time.&rdquo;

The risks of antibiotic misuse 
Since the symptoms of flu-like viruses are similar to the warning signs of a bacterial infection, it&rsquo;s often tough to tell the difference. Feeling uncertain or frustrated, some people urge their doctor to prescribe them an antibiotic without knowing whether or not they really need it.

&ldquo;For many years, unfortunately, my colleagues handed them out to make patients happier, maybe before we had as much data and before we were tracking these things as well as we do now,&rdquo; Brown says. &ldquo;We&#39;re certainly trying to reeducate everyone.&rdquo;

Every year in the United States, about 30 percent of antibiotics&mdash;some 47 million prescriptions&mdash;are still prescribed unnecessarily. This is not only unwarranted but also risky for two reasons:

1. The number of drug-resistant germs is increasing as the arsenal of effective antibiotics is dwindling. Before penicillin was discovered in 1928, people more often died of bacterial infections, such as pneumonia and tuberculosis, than from heart disease, cancer and other non-contagious diseases. In the following decades, as more life-saving antibiotics were developed, the average life expectancy of Americans jumped from about 50 years of age to nearly 80.

Every time antibiotics are used, however, bacteria have a chance to adapt and become resistant to them. Overusing or misusing antibiotics (not taking them as prescribed, skipping doses or not completing the entire course of treatment) allows more bacteria to develop resistance, making them stronger and more difficult to kill.

&ldquo;The more you use an antibiotic, the less effective it may become in the future,&rdquo; Brown explains. &ldquo;That certainly holds true for individuals, but also for the community.&rdquo;

With few new antibiotics under development, scientists are concerned that the rise of antibiotic-resistant bacteria will undo progress that has been made against bacterial infections over the past 70 years. Eventually, the increased risk for tough-to-treat infections may complicate common injuries and routine surgeries, like joint replacements.

Each year in the United States, some two million people develop infections that are caused by drug-resistant bacteria. These so-called superbugs claim at least 23,000 lives, the U.S. Centers for Disease Control and Prevention reports. That number is on track to reach 30,000 by 2050, according to a November 2018 report from the Organization for Economic Cooperation and Development (OECD). If left unchecked, it&rsquo;s also estimated that drug-resistant infections could drain $100 trillion from the world economy over the next 32 years.

2. Like all medications, antibiotics may cause allergic reactions or other unwanted side effects. Taking these drugs unnecessarily exposes you to these risks without offering a potential benefit. Side effects from antibiotics may include:

<ul>
	<li>Rash</li>
	<li>Dizziness</li>
	<li>Nausea</li>
	<li>Diarrhea</li>
	<li>Secondary yeast or bacterial infections</li>
	<li>Irregular heartbeat</li>
	<li>Tendonitis, or increased risk for tendon injuries</li>
</ul>

Things you can do 
If you&rsquo;re suffering from a range of symptoms, including a runny nose, cough, low-grade fever, sore throat and other flu-like symptoms, you may have a virus. If so, antibiotics won&rsquo;t help, but there are some things you can do to ease your discomfort, including:

<ul>
	<li>Rest</li>
	<li>Drink plenty of fluids</li>
	<li>Gargle with saltwater for temporary relief of a sore throat</li>
	<li>Ask your doctor about over-the-counter pain and fever reducers, such as acetaminophen or ibuprofen</li>
	<li>Use a cool mist vaporizer or humidifier to reduce congestion</li>
</ul>

You can also try over-the-counter cough remedies or saline nasal sprays to get temporary symptom relief. These should be taken only as directed. Some of these products contain more than one active ingredient. Read all labels to ensure you&rsquo;re not taking too much of any one medication.

Viruses usually clear up in a week or two. If your symptoms persist for more than 10 days without improvement, you could have a bacterial infection or another health issue that may need treatment and you should see your doctor.

Some other warning signs and symptoms that should be evaluated by a doctor:

<ul>
	<li>You have a persistent high fever and chills.</li>
	<li>Your fever or other symptoms gradually worsen over time, or improve initially but then get worse.</li>
	<li>You feel short of breath.</li>
	<li>Your sore throat develops very suddenly, and you have tiny red spots on the roof of your mouth.</li>
</ul>

Your doctor can perform a physical exam and tests to determine if you have a bacterial infection or another health issue that requires treatment. Sometimes a blood or urine test may also be needed to confirm or rule out a diagnosis.

&ldquo;I would say a temperature above 100.5 [Fahrenheit] for more than 48 hours that&rsquo;s just not getting better should certainly prompt somebody to get checked out,&rdquo; advises Brown. &ldquo;Let somebody look at you so that we can try and figure out if there&#39;s something else going on or something we need to treat.&rdquo;

Seek immediate medical attention if you&rsquo;re having trouble breathing, are in severe pain or if you&rsquo;re confused or disoriented. These may be symptoms of a life-threatening infection or other medical emergency.

Do I Need an Antibiotic?

Retired NFL defensive lineman Shaun Smith says for nine years he fired up &ldquo;two blunts before every game.&rdquo; He appears with other retired players on a Bleacher Report YouTube video about marijuana use in the NFL that&rsquo;s been viewed 2,773,000 times. And those guys say 80 percent of players and staff smoke marijuana recreationally, if not right before taking the field. Their motive?

&ldquo;We&rsquo;re all big guys and our bodies hurt,&rdquo; says Smith. And they use it as an alternative to opioid pain meds. Bo Sciafe, former tight end for the Titans and the Bengals, says he developed &ldquo;an injury-plagued journey&rdquo; during his career and had been prescribed pain pills&mdash;he then found himself in a dark place. &ldquo;So it was easy for me to receive the benefits of marijuana as a viable option.&rdquo; These days he uses topicals to ease pain and arthritis.

But does smoking marijuana really ease pain and treat chronic diseases? And does cannabidiol or CBD, an active ingredient in marijuana (without the psychoactive effect of THC&mdash;the other much-touted ingredient), really work topically to ease pain? Well, the players would say yes. But the science isn&rsquo;t so clear. So, let&rsquo;s review the reliable findings, good and bad, and offer our suggestions.

A word to the wise 
If it&rsquo;s legal where you live and <a href="https://www.sharecare.com/health/pharmaceuticals/article/what-need-to-know-about-medical-marijuana">marijuana for easing pain</a> (as pill, edible, smokable, or topical) is prescribed by a licensed doc, you want to be sure it&rsquo;s going to be effective. Remember, smoking anything has serious health repercussions, and masking pain instead of alleviating it only prolongs or worsens your discomfort.

What studies suggest 
Pro: A new study published in Neurology has found that THC in marijuana eases neuropathic pain, a complex, chronic condition caused by changes in nerve

function or structure. Diabetes causes about 30 percent of neuropathy cases, but there are hundreds of diseases associated with neuropathic pain. FYI: THC binds to your body&rsquo;s natural endocannabinoid system, which plays a part in regulating everything from digestion to temperature.

Pro: A textbook called Contemporary Health Issues on Marijuana published by Oxford Clinical Psychology lays it out pretty clearly: &ldquo;Medical marijuana in the United States has bypassed the standard process of scientific investigation.&rdquo; But they also say, &ldquo;We conclude that some benefits of marijuana&rsquo;s core elements&mdash;tetrahydrocannabinol and cannabidiol&mdash;are supported by a handful of controlled clinical trials for a very limited number of health problems.&rdquo; Those health problems include two types of <a href="https://www.sharecare.com/health/pharmaceuticals/article/marijuana-extract-treat-anxiety-epilepsy">epileptic syndromes</a>, for which the cannabis-based drug Epidiolex was approved by the FDA in June of 2018.

Pro: The CBD potions available are derived from the hemp plant and CBD does not cause a &ldquo;high.&rdquo; Some studies show it helps reduce intraocular pressure in glaucoma. Others support its use in controlling Parkinson&rsquo;s disease symptoms and easing PTSD-related nightmares.

Con: In July of 2018, The Lancet Public Health published &ldquo;Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study.&rdquo; Their conclusion after tracking more than 1,500 people: &ldquo;We found no evidence of a temporal relationship between <a href="https://www.sharecare.com/health/pharmaceuticals/article/marijuana-curb-opioid-addiction">cannabis use and pain</a> severity or pain interference, and no evidence that cannabis use reduced prescribed opioid use or increased rates of opioid discontinuation.&rdquo;

Con: When it comes to using CBD either orally or topically, the preparations on the market seem pretty unreliable. A 2017 study in JAMA found that almost 43 percent of CBD products contained too little CBD; around 26 percent contained too much, and 20 percent contained the get-you-high chemical THC.

Our suggestion: If you have chronic pain, see a physical therapist and orthopedic doctor for joint and muscle pain. Explore use of ice baths, saunas/whirlpools and massage. Opt for anti-inflammatory food choices (ditch red meats, go for veggies and whole grains) and try stress management using deep breathing or meditation. Acupuncture may also help, as can cognitive behavioral therapy, which can change your response to pain.

Marijuana for Pain: Hype or Hope?

When it comes to a lingering case of the sniffles, your first instinct may still be to run to the family doctor for an antibiotic to knock them out.

The truth is, though, antibiotics aren&rsquo;t a one-size-fits-all solution when you aren&rsquo;t feeling well. And when you take them for the wrong reason, they can actually do more harm than good.

What Happens When I Take an Antibiotic I Don&rsquo;t Need? 
A doctor prescribes an antibiotic when bacteria, rather than a virus, causes the illness in question. This means if you&rsquo;ve got a cold, the flu, or even something like mono, an antibiotic isn&rsquo;t going to make you feel better.

They could also bring on some not-so-pleasant side effects, like an allergic reaction or upset stomach. Overuse and misuse of antibiotics also contribute to <a href="https://www.sharecare.com/health/superbugs/article/have-antibiotics-reached-their-expiration-date" style="line-height: 1.6em;">antibiotic resistance</a>, which is what happens when the bacteria adapt and make the medication ineffective. This means longer, more severe infections.

When Are Antibiotics the Right Choice? 
There are times when an antibiotic is still the best bet for getting you back on your feet, though, and if you have symptoms of these six illnesses, it could be time to head to your doctor for a prescription.

Bacterial sinus infection - may set in after a cold, but also can be hard to distinguish from a cold

<ul>
	<li>Symptoms: Cloudy or discolored nasal drainage is the big clue, along with headaches, facial tenderness, congestion, bad breath, fever and fatigue. Symptoms that last more than 10 days, or get better then worse again, suggest a bacterial infection.</li>
</ul>

Whooping cough - a serious bacterial respiratory infection that mainly affects infants younger than six months old, kids who haven&rsquo;t been immunized and older children and adults whose immunity is wearing off&nbsp;

<ul>
	<li>Symptoms: Early symptoms include runny nose, mild cough, low-grade fever and sneezing. After one to two weeks, severe coughing fits often appear. They can last over a minute, followed by a &ldquo;whooping&rdquo; sound, vomiting and exhaustion.&nbsp;&nbsp;</li>
</ul>

Strep throat -&nbsp;a contagious sore throat infection caused by Streptococcus bacteria, more common in children than adults

<ul>
	<li>Symptoms: A severe sore throat may be accompanied by a fever of 101&deg;F or above, swollen tonsils (sometimes with white patches), red spots on the roof of the mouth, headache, nausea, vomiting, swollen lymph nodes and a rash.</li>
</ul>

Bacterial ear infection - occurs when germs cause fluid buildup in the middle ear; it can also cause the tubes in the ear to become blocked or swollen

<ul>
	<li>Symptoms: Most ear infections, viral and bacterial, share common symptoms such as fever, headaches, ear pain, pressure in the ear, drainage, reduced hearing and dizziness.&nbsp;</li>
</ul>

Urinary tract infection (UTI) - an infection of the urinary tract&mdash;including the urethra, bladder and kidneys&mdash;most commonly caused by bacteria; affects more women than men.

<ul>
	<li>Symptoms: Symptoms of a UTI vary by age, but most commonly include an intense need to use the restroom, burning or pain during urination and cloudy or dark urine. In older adults, symptoms can be vague and include weakness, fatigue, muscle aches and abdominal pain.&nbsp;</li>
</ul>

Bacterial pneumonia - A serious bacterial infection in the lungs; often a complication of the flu

<ul>
	<li>Symptoms: Bacterial pneumonia often causes very high fever, sweating, increased heart rate and rapid breathing, along with a cough, shortness of breath, sharp chest pain, headache, loss of appetite and, in older adults, confusion.</li>
</ul>

Medically reviewed in March 2018.

6 Ailments That Call for an Antibiotic

In Mel Brooks&rsquo; Young Frankenstein, when Igor (Marty Feldman) steals a brain for Dr. Frankenstein (Gene Wilder), there&rsquo;s a mix-up and the doc gets a brain from someone named Abbey. Abbey Normal. When Dr. Frankenstein realizes he&rsquo;s placed an abnormal brain into his seven-foot tall creation, the mix-up sets up one of the funniest films of all time.

Mixing up brains may make for hilarious comedy, but when it comes to your meds, don&rsquo;t make mistakes that can mix up your brain <a href="https://www.sharecare.com/health/anxiety/article/anti-anxiety-meds-kill-thousands-every-year">or worse</a>. &nbsp;

A study found that people are making more mistakes with their meds than they used to and they&rsquo;re paying a price. Cases of reported medication errors more than doubled from 3,065 in 2000 to 6,855 in 2012. Over 400 people died from those mistakes. The most common medicinal mix-ups that caused serious health problems were with cardiovascular drugs and painkillers such as aspirin and acetaminophen. Most common mistakes: Taking the wrong dose; the wrong drug; or a double dose.

Getting your meds in order 
Eighty-seven percent of Americans 65 or older average four different meds daily! To make sure you <a href="https://www.sharecare.com/health/health-care-basics/how-decrease-chance-medication-errors">get your dosing right</a>, try:

<ul>
	<li>Reading dosage instructions on Rx bottles carefully.</li>
	<li>Making sure each medication is labeled if you move your meds from an Rx bottle to a pillbox.</li>
</ul>

If you need help organizing your medications, ask your doc, neighbor or family member for help.&nbsp;

How to Avoid Mixing Up Your Daily Medications 

The U.S. Food and Drug Administration (FDA) is now requiring stronger warnings on the labels and medication guides for a class of commonly prescribed antibiotics called fluoroquinolones, including Cipro (ciprofloxacin) and Levaquin (levofloxacin).

They&rsquo;ve concluded that for patients with sinusitis, bronchitis or less severe urinary tract infections (UTIs), the risk of serious side effects associated with these drugs generally outweighs their benefits&mdash;especially if other treatments are available.

Why the new warnings? 
After conducting a safety review, the FDA found that this class of antibiotics could cause disabling and potentially permanent side effects involving the tendons, muscles, joints and nervous system.

And it&rsquo;s not the first time questions have been raised about fluoroquinolones&rsquo; safety.

Back in 2008, the FDA linked these antibiotics to tendon rupture and tendinitis in some patients. And in 2013, the FDA issued a follow-up, warning against the drugs&rsquo; potential to cause permanent nerve damage, or <a href="https://www.sharecare.com/health/pain-conditions/what-is-peripheral-neuropathy" style="line-height: 1.6em;">peripheral neuropathy</a>.&nbsp;

Studies have also linked fluoroquinolones to potentially fatal aortic tears and <a href="https://www.sharecare.com/health/aneurysms/is-an-aortic-aneurysm-how-soon-do-i-need-surgery" style="line-height: 1.6em;">aortic aneurysm</a>.

Doctors prescribe these antibiotics to over 26 million Americans each year.

What if I&rsquo;m currently taking these drugs? 
&ldquo;It&#39;s important for patients to be aware of side effects and symptoms, and report any to their doctors,&rdquo; says <a href="https://www.sharecare.com/user/dr-darria-longgillespie">Darria Long Gillespie, MD, MBA, FACEP</a>, emergency room physician and senior vice president of clinical strategy at Sharecare. &ldquo;But I also don&rsquo;t want people to stop taking these medications without telling anyone.&rdquo;

That&rsquo;s because while there are serious side effects associated with these antibiotics, taking an incomplete course of any antibiotic &ldquo;is the perfect set-up for an antibiotic-resistant infection,&rdquo; she says.

Talking to your doctor 
If you are taking this type of antibiotic and begin to experience muscle, joint or nerve pain, confusion or cloudy thinking, hallucinations, tingling, prickling or a pins-and-needles feeling in your hands and feet, it&rsquo;s important to talk to your doctor right away, even if you&rsquo;ve stopped taking the medication.

If your doctor does prescribe a fluoroquinolone antibiotic for sinusitis, bronchitis or a UTI, ask about alternative treatment options, and be open about your concerns.

&ldquo;The main lesson here,&rdquo; says Dr. Long Gillespie, &ldquo;is that every medication has side effects, and that includes our most common antibiotics. Antibiotics are wonderful, life-saving medications, but they do not prevent infections and they don&rsquo;t treat viral infections. It&rsquo;s crucial that we only prescribe them when needed.&rdquo;

Medically reviewed in March 2018.

FDA Issues Stronger Warning for Common Antibiotics

When Rosemary Butler belted out the chorus on Jackson Brown&rsquo;s version of&nbsp;Stay (Just a Little Bit Longer)&nbsp;more than four decades ago, a lot of 50- to 60-year-olds apparently decided to take that advice. There are now over 72,000 centenarians in the US!

Advances in chronic disease treatment and prevention are extending your lifespan&mdash;and increasing the number of medications you take. About 75 percent of you, age 65 and up, take drugs for at least two chronic disorders, and almost one-third of you take five or more medications. You also take 35 percent of all over-the-counter (OTC) drugs. No wonder drug interactions are an increasing problem.

One study found combining prescription meds for high blood pressure (HBP) and osteoarthritis is the most common cause of a risky drug interaction. If you add a cox-2 inhibitor for pain on top of a beta blocker for HBP, the cox-2 inhibitor blocks the beta blocker; your blood pressure stays too high. Other combos of prescription and/or OTC meds cause just as much trouble.

To minimize&nbsp;<a href="https://www.sharecare.com/health/health-care-basics/what-is-a-drug-interaction">drug interactions</a>:

<ul>
	<li>Write down each prescription, non-prescription med, and supplement you take.</li>
	<li>Schedule time with your pharmacist to review your list, checking for drug interactions; take notes.</li>
	<li>Take your list and notes to your primary care physician. Create a wellness plan that includes stress management, walking and avoiding the Five Food Felons. This will reduce your need for chronic disease meds. Medicare and most insurance companies cover this visit annually without any co-pay.</li>
</ul>

Here are Dr. Mike&rsquo;s Five Food Felons:

<ol>
	<li>Trans fats&nbsp;raise lousy LDL cholesterol and triglyceride levels, lower your healthy HDL cholesterol level and fuel disease-triggering inflammation.</li>
	<li>Saturated fat&nbsp;in red meats, poultry skin, full-fat dairy products, palm oil and coconut oil fuels cancer risk, coronary artery disease, dementia, obesity and diabetes.</li>
	<li>Added sugars and&hellip;</li>
	<li>Sugar syrups&nbsp;both cause the proteins in your body to be less functional and age your immune system, cardiovascular system and joints. Plus, they disrupt your metabolism and contribute to almost every lifestyle-related malady, including some cancers.</li>
	<li>Refined and processed grains&nbsp;don&rsquo;t contain the fiber or nutrients (contained in 100 percent whole grains) that you need to keep the bacteria in your gut happy, glucose levels regulated, immune system strong and digestion running smoothly.</li>
</ol>

<a href="https://www.sharecare.com/health/healthy-eating-guidelines/foods-avoid-to-stay-healthy" target="_blank">Related: What foods should I avoid to stay healthy?</a>

Medically reviewed in January 2020.

Resolving Prescription Conflicts

For the eleventh year in a row, law enforcement agencies are teaming up with the United States Drug Enforcement Administration (DEA) for National Prescription Drug Take Back Day. On Saturday, October 23, around 5,000 locations across the country will be accepting prescription drugs for disposal. Collection sites will be open from 10 a.m. local time.

Nationwide, 839,543 pounds&mdash;more than 420 tons&mdash;of expired, unused, or unwanted prescription drugs were gathered during the last collection, held in April 2021. Since the first collection in 2010, the DEA has collected 14,524,391 pounds&mdash;7,262 tons&mdash;of prescription drugs.

A 2017 survey found that roughly 6 million Americans abused controlled prescription medication, with a majority of pills obtained from family members and friends. These drugs often come from home medicine cabinets. Disposing of drugs at events like the National Prescription Drug Take Back Day is a good way to keep prescription opioids and other medications out of the wrong hands and to help prevent drug addiction, overdose, and accidental poisoning. Disposal is always free of charge and anonymous.

You can visit the DEA&rsquo;s website to <a href="https://takebackday.dea.gov/" style="color:#0563c1; text-decoration:underline" target="_blank">find a drop-off location near you</a>, learn more about this year&#39;s event, and get information about treatment for substance abuse. Google has also launched their own <a href="https://recovertogether.withgoogle.com/prevention/" style="color:#0563c1; text-decoration:underline" target="_blank">locator tool</a> to make finding your nearest collection site simple.

If you can&#39;t participate in this year&#39;s take back, there are other ways to safely remove medications from your home.

<ul>
	<li>Hand off unwanted medication at a DEA-authorized <a href="https://apps2.deadiversion.usdoj.gov/pubdispsearch/spring/main;jsessionid=rxqv6oz8if0BowbSpLvpupNVoNS4o8Z0N9cg3d-p.web2?execution=e1s1" style="color:#0563c1; text-decoration:underline" target="_blank">controlled substance public disposal location</a>. Authorized collection sites may include pharmacies, hospitals, and law enforcement buildings.</li>
	<li>In a sealed bag, mix pills with dirt, used coffee grounds, or kitty litter. Toss out with your household trash.</li>
	<li>Certain medications can be flushed down the toilet, but it&rsquo;s best to check the <a href="https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-fdas-flush-list-certain-medicines#FlushList" style="color:#0563c1; text-decoration:underline" target="_blank">U.S. Food and Drug Administration&rsquo;s</a> list of approved medications before heading to the bathroom.</li>
</ul>

There&rsquo;s never a bad time to get rid of unwanted medication. <a href="https://takebackday.dea.gov/" style="color:#0563c1; text-decoration:underline" target="_blank">National Prescription Drug Take Back Day</a> occurs twice a year, usually in April and October.

Sources:

U.S. Drug Enforcement Administration. &ldquo;Take Back Day.&rdquo; 2021. Accessed October 21, 2021. 
U.S. Food &amp; Drug Administration. &ldquo;Disposal of Unused Medicines: What You Should Know.&rdquo; October 1, 2020. Accessed October 21, 2021.

Trash Your Old Pills on National Prescription Drug Take Back Day

When it comes to taking medicine, a surprising number of people aren&#39;t doing it right. In one recent study, 70% of parents gave little kids the wrong dose of liquid medicine. Other research shows that two-thirds of adults don&rsquo;t finish their <a href="https://www.sharecare.com/question/guidelines-proper-disposal-medications">prescription drugs</a>, and plenty skip refills of important meds for ongoing conditions including heart disease and diabetes. That can be as dangerous as forgetting to put your foot on the brake pedal at intersections. Here&#39;s how to get the right stuff at any age:

<ul>
	<li>For kids: Measure liquid meds with an oral medication syringe. To use: Suck up the right dose, then gently squirt small amounts between your child&#39;s gum and cheek so he or she can swallow comfortably.</li>
	<li>For teens: Talk about OTCs. Most teens didn&#39;t know the basics about drugstore safety. Read medication labels and dosage directions with your teens, and discuss the dangers of taking too much: specifically, <a href="https://www.sharecare.com/question/what-are-symtoms-liver-damage">liver damage</a> from too much acetaminophen and gastrointestinal bleeding from too much ibuprofen or aspirin.</li>
	<li>Adults: Refill by mail. Mail-order pharmacies are so convenient that at least one study found that using them led to fewer gaps in prescription drug usage.</li>
	<li>Seniors: Ask your doctor to simplify your prescriptions. It&#39;s tough remembering when to take everything. See if your doc will help you get on a regimen where you take most of your medications at the same time of day, rather than scattered throughout the day.</li>
</ul>

Medically reviewed in July 2019.

Tips for Making Your Medications Safer

From vitamin store oils to online foot creams, cannabidiol (CBD) can be found just about everywhere these days, in a stunning array of products&mdash;and millions of people are getting in on the trend. Based on a January 2019 survey, Consumer Reports estimated that about 64 million Americans tried CBD during the two years prior, often to treat health conditions like insomnia, anxiety or pain.

The problem is, while people take CBD for a multitude of medical issues, there is currently little scientific evidence it actually helps. In some cases, it may even pose safety risks. That&rsquo;s why healthcare providers (HCP) must be careful about the information they relay to patients&mdash;and patients should let their HCPs know if they&rsquo;re taking CBD.

&ldquo;Patients are nervous sometimes to tell their physicians that they&#39;re using these products, so I encourage them to have that open dialogue with me and I thank them for sharing,&rdquo; says Tulisa LaRocca, MD, an internist affiliated with <a href="https://www.sharecare.com/group/jfk-medical-center">JFK Medical Center</a> in Atlantis, Florida. &ldquo;I urge patients and other healthcare providers to retain their clinical curiosity about CBD, but also a healthy skepticism.&rdquo;

So, what is CBD, exactly? Do the purported health perks really live up to the hype? And what potential problems with CBD should patients keep in mind?&nbsp;

The basics of CBD 
CBD is a cannabinoid, a chemical compound that comes from the cannabis plant. There are more than 100 known cannabinoids, including CBD and tetrahydrocannabinol (THC), the substance that creates a high when you use marijuana. Unlike THC, CBD has no psychoactive effect, which is part of its appeal.&nbsp;

Certain varieties of the cannabis plant have lower amounts of THC and higher amounts of CBD. These types are commonly known as hemp, and they&rsquo;re often used to make CBD products, including oils, sprays, creams and pills.

Currently, the legal status of these and other CBD products is extremely complicated. Though the 2018 Farm Bill legalized hemp on a federal level, state and local regulations vary widely, meaning what&rsquo;s readily available in Colorado may be unlawful in next-door Nebraska.&nbsp;

The U.S. Food and Drug Administration (FDA) also restricts how CBD can be advertised and sold. It&rsquo;s against the law to market CBD in food or as a supplement, for example, and to peddle it across state lines. Importantly, it&rsquo;s also illegal to push a CBD product as a prevention, treatment or cure for any disease without FDA approval.&nbsp;

That said, the general enforcement of CBD rules is somewhat lax, and the substance remains widely accessible in much of the U.S., especially once online retailers are taken into account. In many states, there are even brick-and-mortar stores dedicated entirely to CBD goods. &ldquo;I drive around my area, and I see at least four or five CBD stores on the way to work,&rdquo; says Dr. LaRocca.

Does CBD really have health benefits? 
People take CBD for a wide variety of problems, often without the recommendation of a HCP. &ldquo;A lot of our patients are using CBD on their own without consulting physicians,&rdquo; says LaRocca. &ldquo;The biggest use I hear about is for <a href="https://www.sharecare.com/health/pain-management/slideshow/natural-ways-manage-pain">chronic pain</a>. The second most common would be for anxiety, and the third most common reported to me is for insomnia.&rdquo;&nbsp;

Some research hints that CBD has potential for treating these, and perhaps other, health problems. For example, a Neuropsychopharmacology review published online in 2017 found overwhelming evidence that cannabinoids helped block inflammation and pain in rodents. Other small human studies have found that CBD may curb the urge to use heroin, suggesting it could help treat opioid abuse.&nbsp;

In addition to promising research, there&rsquo;s also widespread anecdotal support for CBD. No matter the illness, many people report that taking CBD simply helps them feel better. This may be true for some, and it may hint at a possible placebo effect for others&mdash;the idea that if people believe something works, it just might help.&nbsp;

That said, much more CBD research is needed, and there&rsquo;s currently little concrete scientific proof that it&rsquo;s an effective therapy for most conditions. In fact, the FDA has approved just one medication containing CBD for the treatment of disease: Epidiolex, for people with Dravet syndrome or Lennox-Gastaut syndrome. &ldquo;They&#39;re rare childhood seizure disorders where children can have multiple seizures in a day,&rdquo; says LaRocca. &ldquo;[Epidiolex] has reduced the frequency of seizures.&rdquo;&nbsp;

On occasion, a company will market CBD specifically as a cure for serious chronic health problems, including illnesses like cancer and <a href="https://www.sharecare.com/health/alzheimers-disease/article/what-need-know-about-alzheimers-disease">Alzheimer&rsquo;s disease</a>. But patients must understand that it will not prevent, treat or cure these conditions.&nbsp;

&ldquo;If a patient tells me that they&#39;ve been on the website or spoke to a company that touts CBD as being a cure for any disease&mdash;cancer, neurodegenerative, whatever&mdash;I tell them to beware,&rdquo; says LaRocca. Companies making these claims put patient lives at risk, since sick people may use CBD instead of seeking proven medical care.&nbsp;

Other possible downsides of CBD 
In general, CBD is considered safe to use in the short-term for most people, and there&rsquo;s little evidence you can abuse or become dependent on it. However, there are risks of side effects, including nausea, fatigue, irritability, low blood pressure, sleepiness, dry mouth and lightheadedness.&nbsp;

CBD may also interact negatively with other medications, supplements and even foods; fattier meals and snacks can increase its absorption and effects. What&rsquo;s more, not much is known about how CBD affects certain populations, including pregnant women, children and older adults. The FDA strongly advises pregnant and nursing women to avoid CBD.

That&rsquo;s not all. Due in large part to its relative newness, many experts have unresolved questions and concerns about the compound, including its:

<ul>
	<li>Long-term safety: CBD&rsquo;s effects over time remain unclear. For instance, there are some indications it can lead to liver injury in certain people.&nbsp;</li>
	<li>Lack of dosing guidelines: There&rsquo;s little professional medical guidance regarding how much CBD to take for any given condition, and how the amount might vary depending on the form of CBD. &ldquo;One dose is not a one-dose-fits-all,&rdquo; says LaRocca. &ldquo;It&#39;s very different dosages for different conditions and for each individual.&rdquo;</li>
	<li>Labeling inaccuracies: Since the FDA doesn&rsquo;t generally police the purity and safety of CBD products, labels aren&rsquo;t guaranteed to be accurate. There may be unlisted additional ingredients, including THC, or the listed amount of CBD may be incorrect. &ldquo;There have been a lot of companies that will sell CBD, and then when the patients have had it analyzed by a third party, there&#39;s very little CBD in there,&rdquo; says LaRocca.</li>
</ul>

Despite these risks, many people decide to go ahead with CBD anyway. In these cases, LaRocca advises patients to exercise caution and take a conservative approach. When her patients use CBD, she recommends starting with a low dose, slowly working up to a dose that&rsquo;s effective, and monitoring progress.&nbsp;

&ldquo;If you&#39;re taking it for pain, see how you feel with your pain,&rdquo; she says. &ldquo;Keep a log and document how you feel. If you&#39;re using it for <a href="https://www.sharecare.com/health/sleep-health/slideshow/simple-habits-sleep-soundly">sleep</a>, document how many hours you&#39;re sleeping. If you&#39;re using it for anxiety, document how you&#39;re feeling with your anxiety.&rdquo;

To avoid issues with labeling errors, she also recommends asking product manufacturers to provide a third-party evaluation of CBD content. &ldquo;A reputable company should have no problem showing you that,&rdquo; she explains.

Ultimately, CBD requires plenty of additional research before we more fully understand its capabilities and drawbacks. For these reasons, it&rsquo;s always best to speak with an HCP before trying a CBD product. Until then, as LaRocca says, be curious, be skeptical&mdash;and go to your provider with questions.&nbsp;

Medically reviewed in October 2019.

Sources: 
Gill, Lisa. &ldquo;CBD Goes Mainstream.&rdquo; Consumer Reports. April 2019. 
UCLA Health. &ldquo;Cannabis and its Compounds.&rdquo; 
Harvard Health Publishing&rdquo; &ldquo;Cannabidiol (CBD) &mdash; what we know and what we don&rsquo;t.&rdquo; 
National Cancer Institute. &ldquo;Cannabis and Cannabinoids (PDQ&reg;)&ndash;Patient Version.&rdquo; 
Medline Plus. &ldquo;Cannabidiol (CBD).&rdquo; 
Oregon State University Extension Service. &ldquo;What is Industrial Hemp?&rdquo; 
U.S Food and Drug Administration (FDA). &ldquo;Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD),&rdquo; &ldquo;What You Need to Know (And What We&rsquo;re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD,&rdquo; &ldquo;FDA Regulation of Cannabidiol (CBD) Products,&rdquo; &ldquo;Statement from FDA Commissioner Scott Gottlieb, M.D., on signing of the Agriculture Improvement Act and the agency&rsquo;s regulation of products containing cannabis and cannabis-derived compounds,&rdquo; &ldquo;FDA is Committed to Sound, Science-based Policy on CBD,&rdquo; &ldquo;What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding,&rdquo; &ldquo;Warning Letters and Test Results for Cannabidiol-Related Products.&rdquo; 
VanDolah, Harrison J. et al. Clinicians&rsquo; Guide to Cannabidiol and Hemp Oils. Mayo Clinic Proceedings. Volume 94, Issue 9, 1840 &ndash; 1851. 
Donvito G, Nass SR. et al. The Endogenous Cannabinoid System: A Budding Source of Targets for Treating Inflammatory and Neuropathic Pain. Neuropsychopharmacology. 2018 Jan;43(1):52-79. 
UpToDate.com. &ldquo;Seizures and epilepsy in children: Refractory seizures and prognosis.&rdquo; 
Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708&ndash;1709.

What Is CBD and Why Are so Many People Using It?

The teaser for the 2018 film Vitamania, a documentary about the history of supplements, recounts a disastrous 1913 Antarctic trek. The last two remaining explorers, Mawson and Mertz, had to slaughter their Huskies for food. Later, they became progressively ill, with drying and fissuring of the skin and, for Mertz, madness and death. There&rsquo;s speculation that eating the dogs&rsquo; liver, packed with vitamin A, gave the mis-adventurers a condition called hypervitaminosis A.

These days, hypervitaminosis A mostly happens when someone takes too much <a href="https://www.sharecare.com/health/vitamins-supplements/slideshow/supplements-you-probably-dont-need#slide-5">vitamin A</a> for too long. But that&rsquo;s just one of the <a href="https://www.sharecare.com/health/dietary-supplements/article/things-you-need-to-know-about-supplements">hazards of taking supplements</a>. For example, according to the NIH, &ldquo;products labeled as kava have been linked to the development of . . . acute liver injury which can be severe and even fatal.&rdquo;

Supplements aren&rsquo;t regulated by the FDA&mdash;they&rsquo;re only able to issue alerts and recalls after dangerous products appear on the market&mdash;but the agency recently announced it would explore improving communication about harmful ingredients and reform regulatory guidelines that ensure product safety. The question: How good a job will they do?

For now, look for a seal from U.S. Pharmacopia, NSF International or ConsumerLab.com certifying a supplement isn&rsquo;t contaminated and the contents are verified. And rely on Dr. Mike&rsquo;s Fab8+, including probiotics, vitamin D, omega-3 and 7, and coenzyme Q10. More than four human studies have shown the benefits of taking them regularly. And discuss all supplements with your doctor so you don&rsquo;t have negative interactions with other supplements or meds you&rsquo;re taking.

Medically reviewed in January 2020.

Drug Information