Avoid serious harm from over-the-counter medicines at home✳
Fever reducers, painkillers, cold remedies, stomach meds, and anti-diarrheal drugs — many of these can be bought without a prescription at any pharmacy. Just because they’re available without a doctor’s order doesn’t mean they can be taken carelessly. This section won’t list which medicine fits each condition; instead, it highlights a few simple actions that can prevent serious consequences. All figures here are based on mortality rates, covering outcomes such as liver failure, stomach bleeding, and newborn kidney failure. Most benefits boil down to “preventing at least one serious incident.” Since studies rarely quantify exactly how much risk drops after taking these steps, the benefit level is judged by how severe those possible outcomes would be — each entry explains the reasoning behind its rating. For topics already covered elsewhere, we simply point the way. If someone accidentally swallows medicine or cleaning products, see section 13, item 20 (accidental ingestion). For chronic-disease medicines taken as prescribed for the full course, see section 16, item 1 (finish the prescribed course). For buying prescription drugs online only after a prescription review, see section 28, item 6 (get weight-loss drugs with a hospital prescription). The beneficiaries of this section’s items are you and your family — the top two tiers.
The English edition builds on dlgrv’s independent translation. New or revised passages absent there were machine-translated on this site and have not been professionally reviewed. Check the author’s Chinese original for the latest text. Published translation snapshot: dlgrv/HowToLiveBetter · 5a3133f
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01Evidence B
Before taking two cold or pain relievers at the same time, check their ingredient lists — only one of them should contain acetaminophen.
Acetaminophen is present in many cold medicines. Taking two such products means you’re consuming double the dose, which can damage the liver. In the U.S., nearly 30% of patients suffering from acute liver failure due to acetaminophen never receive a liver transplant in time. Domestic instructions recommend a maximum daily intake of 2 grams, and alcohol should be avoided while taking this drug.
Cost
No cost at all. It only takes a minute or two to glance at…
Benefit
Over six years, 22 U.S. hospitals tracked 662 cases of acute liver failure. Of these, 275 (42%) were caused by…
02Evidence B
Do not give children aspirin, nimesulide, or metamizole for fever; cold medicines containing metamizole should also be avoided in minors.
For reducing a child’s fever, none of these three drugs should be used. Aspirin is linked to Reye’s syndrome, a condition that damages the brain and liver; in U.S. statistics, around 30% of affected children died, though cases dropped by over 90% after warnings were issued. Nimesulide is prohibited for children under 12, while metamizole is banned for anyone under 18.
Cost
No cost involved. Simply check the generic name and ingred…
Benefit
Reye’s syndrome can lead to brain disease and fatty liver degeneration, typically occurring after influenza or…
03Evidence A
People over 60, with a history of stomach bleeding, taking anticoagulants or steroids should consult a doctor before using painkillers like ibuprofen
Painkillers such as ibuprofen, naproxen, and aspirin can harm the stomach. In large-scale trials, individuals taking ibuprofen faced roughly four times the risk of stomach bleeding or perforation compared to those not taking it. This risk is even higher for older adults, those with prior stomach bleeding, individuals on anticoagulants or steroids, and regular drinkers.
Cost
No cost involved. Simply ask a doctor or pharmacist.
Benefit
These medications are classified as nonsteroidal anti-inflammatory drugs (NSAIDs);
04Evidence B
For children under 2 with colds, don’t give them over-the-counter multi-ingredient cold and cough medicines on your own
China’s National Medical Products Administration requires 14 types of over-the-counter multi-ingredient cold medicines for children to carry a warning label stating they are not recommended for parents to give to kids under 2 years old, and should only be used under the guidance of a doctor or pharmacist. Clinical trials conducted on children show that cough medicines and antihistamines have no better effect than placebo.
Cost
There is no cost at all;
Benefit
In its Announcement No. 57 of 2021, the National Medical Products Administration updated the instructions for…
05Evidence B
Pregnancy after 20 weeks: avoid taking ibuprofen and similar painkillers on your own
After 20 weeks of pregnancy, most of the amniotic fluid is produced by the fetus’s kidneys. Taking ibuprofen or similar medications at this stage may harm the fetal kidneys and reduce the amount of amniotic fluid. Some reports received by U.S. authorities describe cases where newborns died after such exposure. Low-dose aspirin prescribed by doctors is not included in this warning.
Cost
No cost involved.
Benefit
In October 2020, the U.S. Food and Drug Administration (FDA) issued a safety warning. Use of nonsteroidal anti…
06Evidence B
Buying omeprazole over the counter for heartburn and acid reflux — use it for no more than 7 days; see a doctor immediately if you have trouble swallowing, vomit blood, or pass black stools
Since 2022, omeprazole enteric-coated tablets have been available over the counter without a prescription. However, the package instructions clearly state that you should only take it for up to 7 days, and avoid using it again within two months. If you experience trouble swallowing, pain in the throat, vomit blood, or pass black stools, do not take it on your own — these are potential signs of serious medical conditions. This medication can also mask symptoms of stomach cancer, potentially delaying an accurate diagnosis.
Cost
No cost involved — just follow the dosage instructions on…
Benefit
In its Announcement No. 68 of 2022, the National Medical Products Administration reclassified omeprazole enter…
07Evidence A
Don’t ask doctors for antibiotics for the common cold
Taking antibiotics for a cold doesn’t speed up recovery compared to not taking them at all. For adults, the risk of side effects is more than twice as high when using antibiotics. For cases where nasal discharge with pus lasts less than 10 days, there is no clear benefit to taking antibiotics either.
Cost
It costs nothing and can even save you money on medicine.
Benefit
A Cochrane systematic review pooled data from 6 randomized trials involving 1,147 participants. When comparing…
08Evidence A
For diarrhea, start by drinking oral rehydration solution; do not give anti-diarrheal drugs to children under 5
The most important thing during diarrhea is rehydration, not stopping the diarrhea itself. Mix the solution exactly as directed on the package and drink it — never substitute it with sugary juices or soft drinks, as the excess sugar can actually worsen dehydration. Never give anti-diarrheal medications such as loperamide to kids under 5 years old; in severe cases these drugs can cause life-threatening intestinal blockages.
Cost
A box of oral rehydration solution costs just a few dollar…
Benefit
WHO’s guidelines on diarrhea treatment state clearly that anti-diarrheal and anti-vomiting drugs provide no re…
09Evidence B
Don’t take painkillers for more than 15 days a month; limit combination painkillers to 10 days. Otherwise, headaches may actually be caused by the medication itself.
If you suffer from frequent headaches and take painkillers every day, you might end up with even more frequent headaches. The International Classification of Headache classifies this condition as medication-overuse headache. For regular non-opioid painkillers like acetaminophen, aspirin and ibuprofen, taking them for 15 days or more per month for 3 consecutive months meets the criteria. For combination painkillers — which contain two or more pain-relieving ingredients or extra additives like caffeine (for example, acetaminophen with codeine) — the limit is 10 days per month over the same period. Even if you rotate between different non-opioid painkillers, the total number of days you take them still counts toward this limit. Epidemiological studies from multiple countries confirm that over half of people who experience headaches for 15 days or more each month fall into this category. Most patients see their symptoms improve after cutting back on excess medication, and other preventive headache treatments also become more effective.
Cost
No direct cost. You’ll just need to keep track of how many…
Benefit
The third edition of the International Classification of Headache published by the International Headache Soci…
