Taking medicines without medical advice? 10 common drugs you should not misuse

Medicines are meant to treat illness, relieve symptoms and improve quality of life. But when they are taken without proper advice, used for too long or taken in higher doses than recommended, they can cause serious problems.

In Nigeria, it is not uncommon for people to keep medicines at home and use them whenever a familiar symptom returns. A person may take an antibiotic for a fever, continue a painkiller for weeks because the pain has not gone away, or use a steroid cream repeatedly because it worked on a previous skin problem.

The fact that a medicine is commonly used does not mean it is harmless.

Some medicines can damage the liver or kidneys when misused. Others can cause stomach bleeding, nerve problems, serious infections or dependence. Antibiotics can also contribute to antimicrobial resistance when they are taken unnecessarily.

In this article, Tribune Online explores 10 common medicines that should not be taken casually or used beyond recommended instructions.

Paracetamol

Paracetamol is one of the most widely used medicines for pain and fever. It is generally safe when taken at the recommended dose, but taking too much can cause severe liver damage and, in serious cases, liver failure or death.

One problem is that people may unknowingly take paracetamol from more than one medicine. Some cough, cold and flu preparations also contain paracetamol, so taking them together with additional paracetamol tablets can result in an overdose.

People should therefore check the active ingredients of medicines before combining them. A person who thinks they have taken more paracetamol than recommended should seek medical help promptly, even if they feel well. Symptoms of overdose may not appear immediately.

Diclofenac

Diclofenac is a non-steroidal anti-inflammatory drug commonly used for pain and inflammation.

It can be effective, but taking high doses or using it for a prolonged period can increase the risk of serious side effects, including stomach ulcers and bleeding. NSAIDs can also cause kidney problems in some people.

People with kidney disease, stomach ulcers, certain heart conditions or other risk factors may need to avoid diclofenac or use it only under medical supervision. It is also not advisable to combine diclofenac with other NSAIDs such as ibuprofen or naproxen unless specifically advised by a healthcare professional.

Using more painkillers because the original dose is no longer relieving the pain may simply mask an underlying condition while increasing the risk of harm.

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Ibuprofen

Ibuprofen is another popular painkiller used for headaches, toothache, body pains and inflammation. Although it is available without prescription in many places, it can cause problems when taken inappropriately. High doses or prolonged use can increase the risk of stomach ulcers or bleeding  and kidney problems.

The risk may be greater in people who already have kidney disease, stomach problems or certain other medical conditions. Taking ibuprofen together with another NSAID can also increase the risk of side effects. People should therefore check with a pharmacist or doctor before combining pain medicines.

Omeprazole

Omeprazole reduces stomach acid and is commonly used for heartburn, acid reflux and some stomach conditions. Because it is effective, some people continue taking it for months or years without reviewing whether they still need it. Long-term proton pump inhibitor use has been associated with low magnesium levels in some patients. Severe low magnesium can cause muscle spasms, seizures and abnormal heart rhythms.

Long-term use has also been linked in some studies and regulatory reviews with bone fracture risk, although the risk appears to be much less of a concern when over-the-counter treatment is used as directed for short periods. People who have been taking omeprazole for a long time should discuss continued use with a healthcare professional rather than stopping or continuing it indefinitely on their own.

Metronidazole

Metronidazole is used to treat certain bacterial and parasitic infections. It is not a general-purpose medicine for every stomach upset, diarrhoea or infection. One reason it should not be taken casually is that prolonged use has been associated with peripheral neuropathy, which can cause numbness, tingling, burning sensations or weakness.

Unnecessary antibiotic use can also contribute to antimicrobial resistance, making some infections harder to treat in the future. People should not keep leftover metronidazole and use it whenever they develop diarrhoea or abdominal discomfort. The cause of such symptoms needs to be established before treatment is chosen.

Ciprofloxacin

Ciprofloxacin belongs to a group of antibiotics called fluoroquinolones. These medicines can cause serious adverse effects, including tendinitis  and tendon rupture. They have also been associated with peripheral neuropathy, which may cause pain, burning, tingling, numbness or weakness. In some cases, these effects can be long-lasting or irreversible.

The risk of tendon problems is particularly important in older people and in people taking corticosteroids, among other risk groups. Ciprofloxacin should therefore not be treated as an ordinary medicine for every infection. Antibiotics should be selected according to the suspected or confirmed infection and professional medical advice.

Betamethasone

Betamethasone is a corticosteroid used in different forms to control inflammation and certain skin conditions. The problem begins when people use steroid medicines without knowing what is causing their symptoms. A steroid may reduce redness, itching or swelling while allowing an underlying infection to continue.

Repeated or prolonged use can also cause other steroid-related problems, depending on the strength, formulation, amount used and part of the body treated.This is particularly important with steroid creams. 

A person may see an itchy skin rash improve temporarily and assume the condition has been cured, when the steroid has only suppressed the inflammation. Steroids should therefore be used for the condition they are intended to treat and for the duration recommended by a healthcare professional.

Clonazepam

Clonazepam belongs to a group of medicines called benzodiazepines. It may be prescribed for conditions including certain seizure disorders, panic disorder and muscle spasms.

It can cause drowsiness and, when used for longer periods, the body can become dependent on it. 

People who have taken clonazepam for more than a few weeks may need a gradual reduction in dose rather than stopping suddenly. So longer use of clonazepam is capable of causing addiction. 

Stopping it abruptly after prolonged use can cause withdrawal symptoms. Clonazepam can also interact with other medicines that cause drowsiness, including some strong painkillers. Alcohol can further increase its sedative effects. It should never be borrowed from another person or used simply because someone feels anxious or is having difficulty sleeping.

Amoxicillin

Amoxicillin is a commonly prescribed antibiotic and is useful for certain bacterial infections.

However, it does not treat viral illnesses such as most common colds and many cases of flu. Taking it whenever someone has a fever, cough or sore throat is therefore not a safe approach.

Unnecessary antibiotic use exposes the person to possible side effects without providing a benefit. It also contributes to antimicrobial resistance, which occurs when bacteria become less responsive to medicines used against them.

Another problem is keeping unfinished antibiotics and using them later for a different illness. The correct antibiotic, dose and duration depend on the infection and the individual patient.

Steroid tablets 

Prednisolone and similar corticosteroids can be very useful in treating inflammation, allergic reactions and several other medical conditions.

But they are powerful medicines and should not be taken casually.

Prolonged or repeated steroid use can affect the body’s normal immune and hormonal functions. It can also make a person more vulnerable to infections and cause other complications depending on the dose and duration of treatment.

Another important issue is stopping suddenly after prolonged treatment. Some people need their dose reduced gradually under medical supervision rather than stopping abruptly.

Steroids should therefore be taken only for an appropriate medical reason and according to the prescribed instructions.