Winter colds and flu often lead people to reach for over-the-counter pain relief, so UT Southwestern Medical Center physicians say it’s important to follow maximum dosage warnings, adding up both over-the-counter and prescription medications.

There is no safe drug, only a safe dose,” says Dr. Carl Noe, who leads UT Southwestern’s Eugene McDermott Center for Pain Management. “Exceeding the recommended dose of over-the-counter pain relievers is dangerous and can cause liver failure with acetaminophen, or kidney failure and internal bleeding with anti-inflammatories.”

Exceeding recommended dosages can happen accidentally by failing to add up different medicines you are taking, or by failing to account for medicines already in your system. For example, many people take a daily, low-dose aspirin as a preventive measure to reduce the chance of heart attack. That needs to be part of the total dosage of aspirin when they take a cold medicine.

Additional suggestions:

• Mention over-the-counter medicines as well as prescriptions when you talk to your doctor.
• Use your pharmacist as a resource to help you decipher what’s in your prescription. medicines and what over-the-counter medications could cause problems with that.
• Alcohol can increase the toxicity of acetaminophen, so avoid the combination.
• Don’t mix over-the-counter cold medicines. Stick with one to avoid confusion about dosage.