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Self-medication:can we really heal ourselves?

Self-medication:can we really heal ourselves? Many of us have this instinct to pull out an old box of medicine from the cupboard and pretend to be a doctor when we start to feel sick. A practice that has its limits.

Taking medication without going through the doctor's box is becoming more and more common, especially among young people. 54% of women aged 25 to 34 regularly resort to self-medication, compared to only 38% of those aged 50-64*. At a time when doctors are overwhelmed and when public authorities are trying to drastically reduce medical expenses, becoming an actor in your health is - after all - a logical approach.

And with the proliferation of medical deserts, asking for an appointment with your GP for each sore throat or back would be absurd. Unless you are a hypochondriac, many small everyday ailments can therefore be resolved with the pharmacist. But be careful:to avoid mistakes, you must adopt a minimum of precautions.

Above all, do not mix

Over-the-counter medications, that is, medications that can be purchased without a prescription, are frequently considered harmless. However, it is not. They contain active ingredients that guarantee their effectiveness. These are therefore not trivial and can generate side effects. “Paracetamol-based analgesics are often wrongly trivialized, observes Professor Jean-Paul Giroud, pharmacologist and author of Self-medication, the expert guide (ed. La Martinière).

Many different drugs contain it, marketed under different names, which can cause problems with overdose in case of accumulation." So do not take a painkiller and a cold remedy on your own, for example, without asking your pharmacist for advice. Similarly, combining a tranquilizer with an anti-allergic can be dangerous, especially if you take the wheel, because their sedative effect adds up.

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Conversely, a self-medication drug can cancel the effect of another drug (a digestive bandage and an antibiotic for example). At the pharmacy, it is therefore always better to list the medications you are taking before buying over-the-counter tablets lightly.

Beyond one or two symptoms, distrust!

A runny nose or a simple headache can sometimes be managed alone, especially if the cause is obvious:a cold snap, lack of sleep or excessive alcohol consumption the night before. "But if the headache is accompanied by acute diarrhea, you should consult, advises Professor Giroud. Likewise, if vomiting or stiff neck are associated".

In theory, self-medication is only for healthy adults. In case of chronic illness (diabetes, kidney or liver disorders, chronic inflammatory bowel disease, etc.), it is best not to take initiatives so as not to swallow contraindicated remedies. "Self-medication is also to be avoided in pregnant or breastfeeding women, as well as in infants", insists Professor Jean-Paul Giroud.

Read the notice carefully

Sold without a prescription , analgesics block the nerve impulses causing our pain to reduce or eliminate them. They are divided into two categories:those based on paracetamol (Doliprane®, Dafalgan®, Efferalgan®...) and non-steroidal anti-inflammatory drugs (NSAIDs) what are ibuprofen (Advil®, Nurofen®...) and aspirin.

To avoid misunderstandings, always read the instructions , which few people actually do. "The dosage of the drug must be strictly observed", specifies Professor Giroud.

If the paracetamol constitutes a lesser danger, certain precautions are necessary all the same:it is not taken for more than five days in a row, and especially not combined with alcohol (not to be used after a "hangover" therefore) . Overdoses of paracetamol can lead to severe liver failure. In France, it is even the leading cause of liver transplantation. Similarly, we respect a dosage of 4 grams maximum per day and a delay of 4 hours between each dose for adults (up to 6 hours for children).

Regarding ibuprofen, no more than 200 mg or 400 mg every 4 to 6 hours in adults (60 mg per kilogram per day in children), depending on the intensity of the pain. For the aspirin , the dosage is 500 mg or 1 g (i.e. 1 or 2 tablets at 500 mg or 1 tablet at 1000 mg) per intake, to be repeated if necessary after a minimum period of 4 hours, without exceeding the dose of 3 g of aspirin per day (i.e. 6 tablets of 500 mg or 3 tablets of 1000 mg per day).

Beware of non-steroidal anti-inflammatory drugs

Before taking any NSAID, it is important to seek medical advice if you suffer from serious heart, liver, kidney disease or high blood pressure. In pregnant women, it is formally contraindicated from the beginning of the 6th month of pregnancy. Similarly, it is excluded in the event of a history of stomach or duodenal ulcer, gastrointestinal bleeding, allergy and/or asthma related to taking ibuprofen or other anti-inflammatory drugs. inflammatory.

In a press release published on April 18, 2019, the National Agency for Health Products and Medicines (ANSM) warns of the dangers of ibuprofen (Advil, Nurofen, Upfen...) and ketoprofen (Profenid, Toprec, Ketum...) taken in self-medication. These non-steroidal anti-inflammatory drugs , used in case of fever or pain, can promote serious infectious complications (skin, pleuro-pulmonary, neurological or ENT infections) leading to hospitalizations, sequelae or even death.

The health authority explains that "these infectious complications (mainly due to Streptococcus or Pneumococcus) were observed after very short durations of treatment (2 to 3 days), including when taking NSAIDs was combined with antibiotic therapy. They occurred when ibuprofen or ketoprofen were prescribed or taken as self-medication for fever but also in many other circumstances such as benign inflammatory skin lesions (local reaction, insect bite, etc.), respiratory manifestations (cough, lung infection,…) or ENT (dysphagia, angina, otitis,…).

"She also recalls that non-steroidal anti-inflammatory drugs "are already known to be the cause of serious bacterial skin complications (necrotizing fasciitis) when used in chickenpox and should be avoided in this case. "

If you have misplaced the instructions for your medicines, you can find them on the website www.base-donnees-publique.medicaments.gouv.fr.

Finally, a symptom that worsens or does not go away despite the pharmacist's treatment should lead to a consultation.

* OpinionWay survey for Medaviz June 2018

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