[aarongolliver]

For this reason I try my hardest to buy single-active-ingredient versions of everything. I can keep a list of what pill combos combine into nyquil/mucinex/whatever, and can avoid doubling up on anything unintentionally.

[function_seven]

They way OTC medications are packaged and marketed drives me bonkers. I take a sleeping pill every once in a while. I was at the store once comparing two boxes of pills. One was marked "Sleep Aid", and was $8 or so. The allergy medication nearby was the same count, same dosage, and only $5.

They were both diphenhydramine HCL, 25mg. Both tablets. The only differences were the labels, the pill colors (blue for ZZZZ, pink for allergy), and the price.

And the other benefit to stocking single-drug medications is more flexibility. I imagine some hapless guy whose has pain in the morning, but sees only "Advil PM" in the medicine cabinet.

If I need Advil PM, I'll take a regular ibuprofen and a regular diphenhydramine.

[treeman79]

Was in Er for an optical migraine, they gave me a dose Of diphenhydramine.

It took everything I had to not start literally climbing up the walls. My anxiety and energy level skyrocketed.

One of kids is the same way on Benadryl.

Apparently 5% have such a reaction.

I got tired of explaining the reaction to doctors and nurses, (got called a liar several times). Although I had one nurse almost in tears as she had same reaction, but no one would believe her.

So on forms I put I’m allergic to allergy medication.

[nitrogen]

Could the dissolution rates of the tablets be different?

[diydsp]

Ugh yup. Extra hard trying to explain this to a demented family member who just wanted to sleep... diphenhydramine worsens alzeimer's. :(

[johnisgood]

Keep in mind that taking higher doses of DPH has the opposite effects, i.e. you will definitely NOT sleep from it. See "anticholinergic toxicity". When I was younger I thought taking more of it is going to help me sleep better, but I ended up with auditory hallucinations, tachycardia, and the like. I was hospitalized for it, albeit left untreated, or rather, treated as a junkie and they threw me into a detox room, but that is a different issue.

[johnisgood]

I could not edit my comment, so here it is: I forgot to include a relevant symptom I had, which is delirium. I was in a delirious state for many hours, and it left me in a disassociated state for some time afterwards.

Just to add, most nootropics are cholinergics in some way or another. Take a look at choline supplements, or racetams (from Wikipedia: "Racetams are understood to work by activating glutamate receptors that are colocalized with cholinergic receptors, thus increasing the frequency of activation of the latter."). They are supposed to help people with Alzheimer's disease, improve their memory and whatnot. There are many studies around to support this. There is also Huperzine A that has been investigated as a possible treatment for Alzheimer's disease and there was a meta-analysis that found it efficacious in improving cognitive function (see https://en.wikipedia.org/wiki/Huperzine_A for more).

But yeah, anticholinergics are known to be bad for people with Alzheimer's disease, and some cholinergics are known to be effective in improving cognition of those who have it. Of course there are other medications that are supposed to be avoided, here is more about it for the curious (it mentions DPH, too): https://www.mind.uci.edu/medications-and-patients-with-alzhe...

[jiggawatts]

It drove me crazy that in Japan OTC painkillers had a minimum of 4 active ingredients and up to 6 in one case. I could not find any that did not contain caffeine, for example.

The pharmacist explained that caffeine reduces headaches. Well that's great, but I didn't have a headache, I had muscle aches, and I was trying to sleep. He looked at me like I was crazy.

[3np]

My understanding is that this is also to prevent abuse / recreational use. For example OTC cough pills containing dihydrocodeine (an opiate), but with enough caffeine and others to make recreational doses of the opiate unpleasant even for those with high caffeine tolerance. Or DXM, which is only found with enough guanfecine (IIRC) to make you feel like crap if you take too much. Kind of like how industrial ethanol is mixed with things that would make you vomit.

Or so my pet monkey told me.

[taneq]

This is something that really irks me. The reason you always get paracetamol packaged with codeine is to prevent abuse of the codeine. They'd literally rather you destroy your liver and die than risk getting addicted to codeine.

[kayodelycaon]

Wonderful. Caffeine (and many stimulants) either give me panic attacks or trigger manic episodes.

A cup of green tea is enough to ruin my day and possibly the next week.

[dragonwriter]

> The pharmacist explained that caffeine reduces headaches.

Also, IIRC, caffeine specifically has been identified to help with migraines, not headaches more generally.

[karlerss]

My headaches (and I guess many others) are often caused by caffeine withdrawal. Taking caffeine without a painkiller usually solves the problem.

[jiggawatts]

One meta-theory I had is that the caffeine has been determined to help with headaches only because studies done on it are for people who are ill and need pain management, and ill people tend to change their coffee habits.

When I'm healthy and working, I regularly drink about three espresso shots a day. If I'm sick, that plummets to zero while I'm lying in bed and feeling miserable. Invariably, I'll get a killer headache, which the paracetamol alone doesn't fix. I know this, and either I just ignore the headache or make myself some instant coffee at home.

But a badly run scientific study would not control for this quantifiable effect: Sick people get headaches, and dosing them with caffeine reduces the headaches! Ergo... caffeine reduces headaches.

However, I very much doubt that caffeine has a headache reducing effect in sick people that aren't also having caffeine withdrawal.

Imagine a world where most office workers would regularly partake in, say, Opiates to "take the edge off" their stressful jobs. In that world, researchers would confidently conclude the OTC pain relief medication should include Naloxone!

This isn't even that outlandish a scenario. There are countries where people living at high altitude habitually chew Coca leaves to counteract altitude sickness. Should OTC pain killers in those countries include Propranolol? Is it right to force tourists wanting ordinary Paracetamol to also take drugs for acute Cocaine withdrawal just because most locals feel better if they get it?

It's absurd to mix drugs like this, if you think about it a little...

[thinkingemote]

> caffeine

I had a chat with my chemist about why a small bit of caffeine was in the more expensive brands of acetaminophen / paracetamol. I asked if it was used as a kind of pick me up to feel more awake.

He said that the dose of caffeine was very very small and not for that, but it actually helps the paracetamol work better or faster.

[jjeaff]

Ya, and it's way cheaper that way. Especially if you buy the basics in bulk at a big box store.

Acetomeniphin Ibuprofen Benadryl Pseudoephedrine

Covers almost all of the many combinations for sale at the drug store.

[contingencies]

Not as many as glycerine!

[coldtea]

>For this reason I try my hardest to buy single-active-ingredient versions of everything.

Yes, but according to the post, the single-active-ingredient version of acetaminophen might make you less cautious and more risky, and lead you to buy multiple-action drugs!

:-)