Choosing Nonprescription Medicines

Most people with diabetes go to the pharmacy more often than they see their doctor, diabetes educator or other health care professionals. In addition to prescription medications, the pharmacy has a wide variety of over-the-counter products. It's important for you to know how the different products relate to your diabetes management. Some of the products may cause problems. Remember to ask your pharmacist any questions you have about products.

Cough, Cold, Allergy and Flu

Avoid taking medication you don't need. Choose a product with ingredients that treat your specific symptom(s).
Decongestant, expectorant and cough-suppressant products are available to treat your multi-symptom cold.
Decongestants keep you from coughing as they reduce congestion and the swelling of your nose tissue. Because this type of cough syrup contains epinephrine medications, it can raise your blood glucose. Only use this type if your doctor recommends it.
Cough expectorants break up mucous and respiratory secretions in your chest.
Cough suppressants keep you from coughing.
Look for sugar-free cough and cold syrups and lozenges sweetened with acesulfame potassium, saccharin or aspartame.
Avoid products that list dextrose, fructose, high-fructose corn syrup, lactose, sorbitol, mannitol and honey.
Look for products that do not contain alcohol. Alcohol can lower blood glucose. The amount of alcohol will vary among cough, cold, allergy and flu products.

Pain Relievers

Aspirin^® relieves mild to moderate pain and fever. Contact your physician if any of the following side effects develop during treatment: bleeding or irritation of stomach, nausea, vomiting, pain, any loss of hearing, including ringing or buzzing in the ears, skin rashes, hives or itching, breathing difficulties. Consult your physician or pharmacist prior to taking this medication if you: have a predisposition to asthma, stomach problems, peptic ulcer, severe liver disease, gout, severe anemia or allergy to salicylates, have a history of blood coagulation defects, are receiving anticoagulant drugs, are scheduled for surgery within seven days, are taking anti-inflammatory drugs, anticonvulsants, anti-diabetic or gout medicine or other medications containing salicylates or acetaminophen. Consult a physician before taking when pregnant or nursing.
Acetaminophen is for the treatment of mild to moderate pain and fever. Acetaminophen seldom causes stomach problems but can harm the liver and kidneys if taken in amounts larger than what is suggested on the label. Do not take this product if allergic to acetaminophen. If rash or itching occur, talk to a doctor. As with any other pain medicine, talk to a doctor before use: with other products containing acetaminophen, salicylates or any other pain or fever medicine, in persons with serious kidney or liver disease, if you are pregnant or nursing a baby. Chronic heavy alcohol users may be at increased risk of liver damage when taking more than the recommended dose of acetaminophen.
Ibuprofen helps relieve mild to moderate pain and fever. Do not take ibuprofen if taking acetylsalicylic acid (ASA) or if allergic to products containing ASA, ibuprofen, other anti-inflammatory drugs, or any of ibuprofen's ingredients. Consult your physician before taking ibuprofen if you have peptic ulcers, high blood pressure, heart, kidney or liver disease, any other serious disease, or are taking any other drug. Do not take ibuprofen if you are pregnant or nursing a baby, unless directed by a physician. If abdominal pain, heartburn, nausea or vomiting, bloating, diarrhea or constipation, ringing or buzzing in the ears, nervousness, sleeplessness, dizziness, any change in vision, fluid retention, itching, skin rashes or any other side effect or unexplained symptom develops while taking Ibuprofen discontinue use immediately and contact a physician.
Topical pain relievers (liquids) are applied to the skin to help relieve muscle and joint pain. They may cause a rash, stinging, itching, burning or skin irritation, making symptoms from nerve damage worse if this continues discontinue use.Do not use salicylate containing products if allergic to salicylate products or taking anticoagulent medication.

Vitamin and Mineral Supplements

If you are unable to eat a healthy balanced diet, a multi-vitamin and mineral supplement may be beneficial.

Constipation and Diarrhea

Do not use laxatives in the presence of abdominal pain, nausea, fever or vomiting. Laxatives should not be taken within two hours of another medicine because the desired effect of the other medicines may be reduced.

Bulk laxatives expand, take up water and use bulk to stimulate the intestine. These products can take from 12 to 72 hours to work. Bulking products should be taken with at least 250 mL (1 cup) of fluid. Sugar-free versions are available but most contain other carbohydrate sweeteners.
Stimulant laxatives are products that work in six to 12 hours (rectal stimulant laxatives work in a 1/4 to one hour). Overusing stimulant laxatives and most other oral laxatives can cause dependence for bowel function. Laxatives are not to be taken for more than one week unless directed by a doctor.
Saline laxatives increase water in the intestine to promote a bowel movement and should be used under the direction of your doctor, if you have kidney problems or are on tetracycline or a sodium-restricted diet.
Laxatives containing docusate are stool softeners.
Docusate is used for relief of occasional constipation and may not work until after three days of once-a-day treatment. Drink increased fluids with use.
If used too often, mineral oil laxatives like other laxatives, may cause dependence for bowel function.
Products that contain bismuth subsalicylate should not be taken with other salicylates such as acetysalicylic acid (ASA), medication for thinning of blood, diabetes, gout or arthritis except on the advice of a doctor.

Indigestion, Heartburn and Gas

Antacids reduce stomach acidity. They do not lower the amount of acid made by the stomach. Antacids help relieve heartburn, indigestion and sour stomach. Products containing magnesium or aluminum should not be used by individuals with kidney disease except on the advice of a doctor. Antacids may interact with certain prescription drugs. Check with your pharmacist about taking antacids with your prescription drugs. Do not take within two hours of another medicine — the effectiveness of the other medicines may be altered. The sodium content varies among antacids. Check the label for sodium content if you are pregnant or on a sodium-restricted diet. Do not use for more than two weeks unless directed by a doctor.
Some products contain charcoal for relief of gas. Charcoal can interfere with absorption of some medications if they are taken within two hours of each other.
Avoid gas-forming foods such as cabbage, Brussels sprouts, broccoli, cauliflower and dried beans while taking medications for gas.

Skin and Foot Care

Most lotions contain ingredients called emollients that make a layer of oil to trap moisture to the surface of the skin.
Urea and alpha hydroxy acids can help dry skin. Urea helps the skin absorb and keep moisture. The alpha hydroxy acids exfoliate dry rough skin cells, exposing new skin cells. You may want to try Dermal Therapy™ lotions, which contain urea and alpha hydroxy acids and are available in body, face, finger, heel and hand, elbow and knee formulas. It's suggested you use them twice a day on moist skin.
Topical corticosteroids contain hydrocortisone and are used for relief of skin irritations and rashes. The hydrocortisone content varies from 0.5% to 1% and usually has no effect on blood glucose levels. They should be applied according to product directions. Call your doctor if burning, swelling or redness develops.
Corn and callus removal products are not recommended for people with diabetes due to increased risk of developing infection. A pumice stone can be used to smooth corns and calluses. Soaking your feet dries the skin and is not recommended. Go to your doctor if you have painful calluses or corns.

Dental Products

Some mouthwash products can help reduce gingivitis (minor inflammation of the gums caused by plaque above the gumline) or plaque.

Hypoglycemia and Other Diabetes Products

Glucose tablet products are available for treatment of low blood glucose. They come in a variety of flavours. Small travel sizes are available to carry with you. Tablets available in Canada contain either three or five grams of glucose. When treating low blood glucose, you need either five three-gram tablets or three five-gram tablets.
Glucose gel products contain liquid glucose. Gel products are good for use when the low blood glucose causes chewing problems but you can still swallow. The carbohydrate content of gels varies from 10 to 24 grams per tube.
If you take insulin, you may want to have a glucagon kit available in case you have severe low blood glucose and become unconscious. Glucagon is given by injection, and family members should be taught how to use it. Glucagon makes the liver produce glucose to raise your blood glucose. A prescription is needed.
Using skin products that contain alcohol can dry and toughen your skin, and are not recommended for cleaning the fingers before blood glucose testing. Instead, wash your hands with warm soapy water.
Urine ketones should be tested in people with type 1 diabetes when the blood glucose is over 13.3 mmol/L and for people with type 2 diabetes when sick. Test strips are available for testing ketone levels in urine.