OTC pain relievers and pregnancy – National Consumers League

If you are pregnant or breast-feeding, ask your doctor or nurse before taking any medication (OTC or prescription). It is especially important not to use aspirin, ibuprofen, or naproxen sodium during the last three months of pregnancy unless directed to do so by a doctor, because these medicines may cause problems in the unborn child, or complications during delivery.


Acetaminophen has not been shown to cause birth defects or other problems in laboratory studies. However, to be on the safe side, talk to your doctor before taking any OTC medications during pregnancy.


Laboratory studies have found that aspirin can cause birth defects in animals. Do not take aspirin during the last three months of pregnancy unless your doctor has ordered it. Some reports have suggested that too much aspirin use late in pregnancy may cause a decrease in the newborn’s weight and possible death of the fetus or newborn infant. However, the mothers in these reports had been taking much larger amounts of aspirin than are usually recommended.

Studies of mothers taking aspirin in the doses that are usually recommended did not show these unwanted effects, but there is a chance that regular use of aspirin late in pregnancy may cause unwanted effects on the heart or blood flow of the fetus and newborn infant. Use of aspirin during the last two weeks of pregnancy may cause bleeding problems in the fetus before or during delivery, or in the newborn infant. Also, too much use of aspirin during the last three months of pregnancy may increase the length of pregnancy, prolong labor, cause other problems during delivery, or cause severe bleeding in the mother before, during, or after delivery.

Ibuprofen and Naproxen Sodium

FDA-approved labeling for both ibuprofen products and naproxen sodium products contain the same warning, which states that women should not take these medications during the last three months of pregnancy (unless directed to do so by a doctor), because they may cause problems in the unborn child or complications during delivery.

Answers to your questions about OTC painkillers – National Consumers League

Every day millions of consumers turn to over-the-counter (OTC) pain medications for temporary relief of pain from headaches, colds, muscular ache, and arthritis, and to reduce fever. While these medications are largely safe when taken according to label directions, there are risks when taking any drug. Just because a medication is available on the shelf of your local grocery or discount store does not make it any safer than a drug that has been prescribed by your doctor.

Are all OTC pain medications the same?

No. Many different types of pain medications, or analgesics, are available without a prescription. Two common types of OTC analgesics are non-steroidal anti-inflammatory drugs or NSAIDs, and acetaminophen.

  • NSAIDs, or anti-inflammatories, reduce inflammation caused by injury or rheumatoid arthritis. People use them to stop the pain caused by muscular aches, arthritis, headaches, menstrual cramps, and other minor aches and pains. Anti-inflammatories available over-the-counter, or without a prescription, include aspirin (Bayer, Bufferin), ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). These products work by blocking the production of the enzyme COX. There are two forms of the COX enzyme: COX-1 protects the stomach and kidneys, and COX-2 is responsible for inflammation. NSAIDs block the production of both COX enzymes. The stomach irritation and ulcers that can occur with the use of these anti-inflammatories are the result of blocking the production of the stomach-protecting enzyme.
  • Acetaminophen (Tylenol) is used to relieve pain and reduce fever. Because it works mostly on the central nervous system and is not an anti-inflammatory, it does not reduce the swelling or stiffness caused by an injury or rheumatoid arthritis. Acetaminophen is generally less irritating to the stomach than other OTC pain relievers, but may cause liver problems when taken with alcohol or when fasting.

How do I know which OTC pain medication is right for me?

The right painkiller depends on what type of pain you want to relieve and your personal risk factors.

  • If you suffer from arthritis or athletic injuries, anti-inflammatories can reduce the inflammation, but regular use may cause stomach problems or ulcers. Those especially at risk include people over 65 years old, those with a history of ulcers, and those taking steroids or blood thinners.
  • For reduction of fever and relief of pain, acetaminophen, while generally easier on the stomach than other OTC pain medications, has its own risks. Daily use for a long period of time (over a year) may increase the chances of kidney damage. And taking acetaminophen when fasting or with alcohol, even moderate amounts, may cause serious liver problems.
  • If you have a history of kidney, liver or stomach problems (including ulcers), or are allergic to certain pain medications, you should always consult your doctor before taking any type of pain medication. If you take an OTC pain medication for an extended period of time (more than 10 days), you should discuss with your doctor how to best manage your pain.
  • If you are pregnant or nursing, talk to a health professional before using any OTC pain reliever. It is especially important not to take an NSAID during the last three months of pregnancy because it may cause problems for the unborn child.

I heard that NSAIDs relieve arthritis pain. Is it safe for me to take a nonprescription NSAID every day?

Over 14 million arthritis suffers take high doses of aspirin and other NSAIDs, or anti-inflammatories, to ease their symptoms. But continuous use of these drugs can increase the risk of stomach problems. Recent medical studies show that use of OTC NSAIDs increases the risk of stomach bleeding by as much as two to three times. Stomach bleeding caused by NSAIDs is now recognized as the most common serious drug reaction and accounts for as many as 16,500 deaths and over 107,000 hospitalizations per year in the United States. Most of those experiencing NSAID-related stomach problems have no warning signs. There are certain risk factors (for example, age or medical history) that increase the chances of having stomach problems while taking anti-inflammatories.

Acetaminophen can also relieve the pain of arthritis, but not the underlying swelling and inflammation. Continuous, or chronic, use of acetaminophen can also have serious side effects. If you suffer from arthritis pain you should consult a health professional about the most effective and safe way to manage your pain.

If I want more pain relief, can’t I just increase the dose?

More is not necessarily better when taking an OTC pain medication, and it can be dangerous. Read the label carefully and always take the recommended dose, or follow your doctor’s instructions. A third of all consumers take more than the recommended dose of an OTC drug thinking it will increase the drug’s effectiveness. But studies have linked overuse of anti-inflammatories and acetaminophen with kidney and liver problems.

I have a cold and a headache. Can I take two different OTC pain medications at the same time to relieve my pain?

You should be very careful when combining OTC painkillers. Many popular pain medications for headaches and colds combine pain-relieving products. Read the labels of these combination products carefully to make sure you are not taking more than the recommended amount or combining medications unknowingly. For example, one adult dose of Nyquil contains a cough suppressant, an antihistamine, and 1,000 mg. of acetaminophen. If you take the recommended adult dose of Nyquil along with two extra-strength Tylenol, you will have doubled your acetaminophen dose and taken half the recommended daily amount at one time. And the combination of some OTC pain relievers with different active ingredients can create harmful interactions.

Combining anti-inflammatories with antacids or an acid blocker such as Pepcid AC or Tagamet to stop the stomach irritation of anti-inflammatories may actually increase the risk of ulcers. By stopping heartburn symptoms, a warning sign for treatment, the acid blockers may result in late detection, larger ulcers, and even hospitalization.

What about interactions between pain relievers and other substances?

Alcohol — Since alcohol irritates the stomach lining, drinking it while taking anti-inflammatories or acetaminophen can be disastrous. If you drink three or more glasses of alcohol a day you should talk to your doctor or pharmacist before taking an OTC pain medication.

Dietary supplements — You should always know which dietary supplements you are taking, including vitamins, minerals and herbals, since some may interact with OTC pain relievers and cause side effects. For example, Ginkgo, a supplement that thins the blood, may cause excessive bleeding when combined with aspirin.


Understand your OTC Drug Facts labels – National Consumers League

You’re taking more responsibility for your own healthcare, medicating yourself for minor ailments like colds, headaches, and stomach aches. But do you know enough about the medicines you take to make informed healthcare decisions for you and your family? Looking at your medication labels carefully – and understanding what they say – will help you use them wisely and avoid problems.

Labels: take them seriously

OTCs are available without a prescription, but they’re still medications. Take them seriously and read the labels each time you take the medication.

It’s a good habit to get into. Your life is hectic. Do you really remember the last time you read the label on your headache medication? Was it before you started taking that new daily prescription, or after? Checking the label each time you use the medication will help to ensure that you won’t have a problem.
Sometimes labels change, so check each time you buy a new OTC. You may inadvertently pick up a bottle of an OTC you’ve taken before, but not notice that the per-pill dosage is higher.

Drug Facts labels

FDA approved a regulation in 1999 requiring that all OTC drug labels contain certain information such as ingredients and doses and warnings in a standardized format. This covers 100,000+ nonprescription products, including sunscreens. In the same way that “Nutrition Facts” helped consumers understand the fat content of foods, FDA hope its “Drug Facts” label will help consumers choose and use OTCs. Here are the sections that appear in the Drug Facts label and how to understand what they mean:

Active ingredients
Active ingredients are the specific chemical ingredients that make a drug work. This section also shows the amount of active ingredient in each dose.

Explains the class of drug. For example, you might see the word antihistamine under “purpose” on a label for an allergy medication.

What you should use the drug for. Make sure you find a medication that relieves only the symptoms you need it to. Ask your healthcare provider or pharmacist for help in choosing the right medications for your symptoms. 


Do not use…
Lists when the product should not be used under any circumstances

Ask a Doctor before use if you have…
Some labels have warnings for people with chronic health problems such as high blood pressure, heart disease, glaucoma, asthma, or diabetes. People older than 65 or younger than two may not be able to take some OTCs. This section explains who should consult a health care provider before taking the medications.

Ask a Doctor or pharmacist before use if you are…
Sometimes the food you eat, other medicines you take, or tobacco can interact with medications. On this portion of the label, companies will list foods or beverages to avoid while taking the medication. Talk to your healthcare provider or pharmacist about all the medications you take, both prescription and over-the-counter. Don’t forget to mention any dietary supplements too; interact with medications.

When using this product…
For most people OTCs are safe, effective, and without complications. But some people do experience side effects. The most common side effects are listed on the label. If you have a side effect to an OTC, re-read the label. Most side effects are minor nuisances, but should be discussed with your doctor. If the side effect is severe or continues, you should stop taking the medication and call your healthcare professional.
This part of the label will also describe substances or activities to avoid while taking the medication.

Two warnings commonly found on OTCs are:

  1. Do not drink alcoholic beverages while taking this medicine. People also ignore or forget this common warning when taking OTCs, but mixing alcohol and medications can cause serious problems. For example, combining alcohol and certain OTC medications for colds, coughs, and allergies can cause excessive sleepiness, mental confusion, or breathing difficulty. Sometimes the combination makes the medicine less effective.
  2. Do not drive or operate heavy machinery. Many people ignore this warning on some OTC medications. Driving after taking some nonprescription medicines such as cold, cough, and allergy or sleep aids can cause impaired judgment and reaction time. Use the medications only as recommended. Remember that medications may affect people differently. It may take 2 or 3 doses before you know how a medication will affect you.

Stop use and ask a doctor if…
When side effects are severe or continue, you should stop taking the medication and call your healthcare professional. This section will explain the serious side effects that warrant an immediate call to your doctor.

Pregnancy/breastfeeding warning
If you are pregnant or breastfeeding, you should always consult a doctor before taking any medication.

Keep out of reach of children
This warning explains what to do incase of an overdose. 


This is where you?ll find out how much of the medication to take, when, how and how often. Do not use medications longer than the time listed on the label. The label will tell you when to consult your healthcare provider if you have not had relief from your symptoms. Persistent symptoms may signal a serious problem that requires attention and treatment by your health care provider.Inactive ingredients

Other Information

This area will include information, as necessary, on how to store the medication.

Inactive ingredients

This is the list of ingredients that are only used as additives for color, flavor, binding, or bulk.

Do you have questions about your over-the-counter medications?

Companies may list a phone number for any questions you may have about the medication.

Ask your health-care provider and/or pharmacist the following:

  • Are there any over-the-counter medicines or dietary supplements I should avoid when taking this prescription medication?
  • Is it okay to take _____ over-the-counter medication with my prescriptions?
  • Do my OTCs or dietary supplements interact with any food or beverages?

Understanding your phone bill – National Consumers League

Life’s a lot more complicated than it used to be – and so is your phone bill!

With more competition for telephone service and new services being developed every day, you have more choices for your communications needs than ever before. But understanding your options – and your phone bill – has become much harder.

Many phone companies are redesigning their bills to make them easier to understand. However, the charges may still be confusing unless you know some basics about how telephone billing works.

Looking at your phone bill carefully – and understanding what it says – will help you use phone services wisely and avoid fraud.

Basic services

  • Your local phone bill includes a basic monthly charge for the dial tone that enables you to make and receive calls, maintain the connection between your home and the telephone company’s central office, be listed in the telephone book, get a copy of the directory, and make a limited number of calls for directory assistance.

Local calling charges

  • You may have a “flat rate” local telephone plan in which your monthly service charge includes the ability to make an unlimited number of calls to other phones located near you. The size of the local calling area varies from company to company.
  • If you have “measured service,” you are limited to the number of calls that your monthly package allows; if you make more calls, you pay an additional charge for each one.
  • You may only have one choice for local services now, but as time goes on there will be more competition. The pricing plans and service options offered by each company may vary.

Local toll

  • Sometimes called “short distance calls,” local toll calls are made to places that are not close enough to be in your local calling area but not far enough away to be handled as long distance calls.
  • As competition for phone services increases, more consumers can choose whether to have local toll calls completed by their local telephone companies or other companies.
  • The area that each company serves for local toll calling and the prices they charge may vary.

Long distance

  • There are many ways that you can make long distance calls. Most consumers have a regular, or “presubscribed” long distance carrier. When you dial “1” plus the area code and the phone number, the access code for the presubscribed carrier is automatically entered and the call is billed at the rates that company charges.
  • In most parts of the country there is competition for long distance service. Calling plans can vary widely, not only in rates but in the geographic areas they cover, and companies may offer more than one plan to choose from. There may be a monthly fee in addition to the charge for each long distance call and there may be a minimum monthly charge.
  • You can also make long distance calls using a “dial-around service.” You manually enter another company’s access code (such as 10-10-XXX), then “1”, the area code, and the phone number. That company will then bill for the call based on its own rates. Look at ads for dial-around services carefully – the prices they quote may only apply if you talk for a certain number of minutes, or the rates may vary depending on time of day or where you are calling, and there may also be a monthly fee added.
  • Calling cards, which are like charge cards for telephone calls, are available from many companies. You can use them from your home phone, a pay phone, a phone in a hotel room, or somewhere else. The charges might be billed through your local phone company or directly by the calling card company. Depending on your calling card company, the cost of some calls could include a surcharge in addition to the per-minute rate. There may also be a monthly fee. Be aware that some phone companies may not accept calls made with cards issued by other companies.
  • Collect calls are charged to the bill of the person whose number is being called. They can be made through a local or long distance operator or through services offered by other companies. The rates vary according to which company provides the service. For instance, if you call collect through an operator at a pay phone, the cost is set by the company that provides service to the phone you’re using. If you make a collect call from the same phone through another company’s 800 number collect call service, the call is billed at that company’s rates.

Pay-per-call services

  • These are information and entertainment services provided through 900 numbers, some 800 numbers, and certain international phone numbers.
  • The rates can vary from as little as a few cents to several dollars per minute. Some pay-per-call services are billed at a flat rate for each call.
  • Charges for pay-per-call services provided through 900 and 800 numbers are set by the service providers, not the telephone companies. They will appear on a separate page in your phone bill.

Miscellaneous services

  • Miscellaneous services can include caller ID, call waiting, voice mail, paging, and even Internet and other non-telephone services. They may be provided by your local phone company or other companies.
  • Depending on what company provides them, charges for miscellaneous services may appear on the phone bill under your local company’s services or on a separate page.
  • Before you pay your bill, read it carefully and make sure that you are only being charged for services you have authorized.

Fees, surcharges, and taxes

  • In addition to the charges you pay for the services you use, you’ll find various fees, surcharges, and taxes on your bill. Taxes go straight to the government. Some fees and surcharges billed by telephone companies cover the costs of carrying out government-mandated programs, others are intended to recover portions of their operating expenses. Companies may use different terms to describe these charges.

Directory assistance

  • Your monthly local service charge may include a certain number of “free” calls for directory assistance. If you make more local directory assistance calls than are included in your monthly package, there is an additional charge for each call.
  • You may also be charged by your long distance company for any long distance directory assistance calls you have made using their operators.
  • Many local and long distance companies have begun to provide nationwide directory assistance services, with rates that vary from company to company. You may be allowed to request more than one listing in each call to directory assistance. Know what each company charges for directory assistance before placing the call. And if the directory assistance operator offers to complete the call for you, be aware that there may be an additional charge for this service.

Lifeline surcharge

  • Some states collect a lifeline surcharge to assist low-income consumers. As of July 1, 2000, low-income consumers who subscribe to Lifeline service will not be billed for the subscriber line charge or the universal service fee.

Local number portability charge

  • Local telephone companies have created a system that allows consumers to keep the same phone number when they change local service providers. This fee, charged to all customers, covers the cost of this technology. The amount of this fee may vary based on where you live.

State subscriber line charge

  • Some states allow local phone companies to assess this fee to recover the cost of providing lines for services within the state, like intrastate long distance and local service.

Subscriber line charge, or end-user common line charge

  • This is a fee that the Federal Communications Commission allows local phone companies to charge to recover a portion of the costs of completing long distance calls on their local networks.


  • There is a federal excise tax assessed on telephone service.
  • You may also be charged state and municipal taxes depending on where you live.

Telecommunications relay service

  • Some people who have hearing or speech disabilities use a special type of text telephone, called a TTY, to place calls.
  • This fee, which is charged to all customers, covers the cost of providing a “translation” service for calls between TTYs users and people using traditional voice telephone. It also helps to subsidize the cost of specialized telecommunications equipment for people with specific disabilities.

Universal service fees, universal connectivity charge, telephone assistance plan, or universal service fund

  • Long distance companies, and most local providers, charge this fee as part of a federal program to subsidize local telephone service for low-income consumers or those who live in areas where the cost of providing telecommunications services is exceptionally high.
  • It also covers discounted communications services for schools, libraries, and rural health care facilities.

911 surcharge

  • This is collected on behalf of state or local governments to cover the cost of providing 911 access to emergency services.

Live well with asthma: Peak flow meters – National Consumers League

Even when you feel like you are breathing well, a peak flow meter can alert you to changes in your lung function. You may see a drop in peak flow numbers even before you have asthma symptoms (like coughing or wheezing). This device can help you manage your asthma and may reduce the number and severity of asthma flare-ups.

Keeping a peak flow chart can be very helpful to you, and to your health care provider. You can use it to track your lung function and provide important information on how you are responding to treatment at home so your doctor or nurse can help you with the best treatment plan.

Use and Care of Your Peak Flow Meter

  • Understand how to properly use your peak flow meter.
  • Follow the cleaning instructions. This will help keep the readings accurate.
  • Follow your health care provider’s recommendation on how often you should use your peak flow meter and at what time of day.

How to Graph Your Score

Ask your health care provider to help you determine your personal best peak flow score.

Your personal best peak flow score may change over time. It changes for children as they grow. Discuss this with your care provider at least once a year.

When you know this personal best score, you can graph your peak flow scores into zones:

  • green (best)
  • yellow (caution)
  • red (medical alert)

Using these colors helps you visually track scores that are in your own personalized zones. One easy way to do this is to use highlighters to color in the green, yellow, and red zones on your chart.

Green Zone: This is a score that is 80 percent to 100 percent of the personal best score. This is your goal for optimum management of your asthma.

Yellow Zone: This is a score that is 50 percent to 80 percent of the personal best score. This is your caution zone. Review your daily treatment plan for proper treatment in this zone, which may include a call to your health care provider or increased medication use or dose. If your prescribed treatment is not working, or you find yourself often falling within this zone, you may need to revise your daily treatment plan with your health care provider.

Red Zone: This is a score that is below 50 percent of your personal best score. Consider this your “danger” zone. Contact your health care provider for instruction when you get a reading in this zone.

Work with your health care provider to find your personal best peak flow score and set the color zones. Be sure to get written instructions on what to do when you record readings in each of these zones.

Let’s say your personal best peak flow score, as determined by your health care provider, was 625. Here is how the color zones could look:

Green Zone: Between 80 and 100% of personal best score. Determine 80% of your score to get the “floor” for the green zone. (625 x .80 = 500; green zone ranges from 500 to 625)

Yellow Zone: Between 50 and 80% of personal best score. Determine 50% of your score to get the “floor” for the yellow zone. (625 x .50 = 312; yellow zone from 312 to 500)

Red Zone: Below 50% of Personal Best (chart red zone below 312)

No matter what your peak flow meter number is, get help if you experience asthma symptoms that you and your health care provider have identified in your plan as being serious (such as severe wheezing or chest tightness).

Parenting a child with asthma is no picnic – National Consumers League

Watching your child have an asthma attack, or even just symptoms, can be frightening. Keep your kids safe by planning ahead.

For parents of young babies with asthma 

Talk to your doctor to make a daily treatment plan. At the first sign of symptoms (wheezing, coughing, or rapid breathing) respond right away. See a doctor regularly to check on your baby’s asthma, even if the baby is not having symptoms.

Babies can go from having just a few asthma symptoms to a severe attack very quickly! Listen to your baby when he or she is breathing normally so you will be able to spot signs that something is wrong. Your baby needs emergency help if: 

  • Breathing rate increases to more than 40 breaths per minute while sleeping. To find breaths per minute, use a watch or timer to count the number of breaths your
    child takes in 15 seconds, and multiply that number by 4.
  • Suckling or feeding stops altogether.
  • Ribs or stomach move in and out deeply and rapidly
    when breathing.
  • Chest expands but does not deflate when exhaling.
    This is not normal breathing.
  • Face changes color from normal to pale or red in the face, or his or her fingernails turn blue.
  • Cry becomes softer and shorter.
  • Nostrils open wider.

DO NOT do these things if your baby is experiencing asthma symptoms:

  • Do not have your baby breathe warm, moist air (like the mist from a hot shower or vaporizer). These things may contain mold that you may not be able to see, and this could make your baby’s breathing worse.
  • Do not have your baby breathe into a brown paper
     held tightly over the nose and mouth, as people often do for hyperventilation.
  • Do not give your baby over-the-counter medicines.
    Use the asthma medicines that your doctor has prescribed.
  • Do not give your baby a lot of liquid to drink. Normal amounts are okay. 

For parents of school-aged children with asthma

Asthma is the biggest reason children miss school days in the United States, causing more than 14 million missed school days a year! Because children spend so much time at school, teachers and other staff need to understand asthma, how to manage symptoms, and how to do their part to create a healthy breathing environment.

You can help your child stay healthy (and in school!) by welcoming teachers and staff into your child’s asthma management team. Talking regularly with people in your child’s school can help you manage your child’s asthma and enable the school provide a healthy environment. Be sure that the people charged with caring for your children during the day know what they can do to manage your child’s asthma.

By working together, you can keep your child’s asthma under control.

What You Can Do:

Here are some things you can do:

  1. Develop an asthma action plan for school – Work with your child’s health care provider to develop a plan with step-by-step instructions for how to avoid – and if necessary treat – an asthma flare up at school. The plan should include a list of your child’s asthma triggers, medications and emergency contacts. Make multiple copies of the plan and give them to all adults who interact with your child at school, such as teachers, principals, classroom aides, playground monitors and the school nurse.
  2. Make sure your child can take asthma medications at school. Talk with the school about how and when your child can take medications. A school nurse can hold medications (including a fast-acting inhaler or bronchodilator) for your child. Or, if your health care provider agrees, and your child is comfortable, ask that he or she be able to carry and use a fast-acting inhaler at school without asking permission. If your child is embarrassed about taking medications, try to arrange for a private area or time that will not attract attention. Confirm that asthma medications can be and are taken on field trips.
  3. Help your child fully and safely participate in physical activity at school. If exercise is an asthma trigger for your child, confirm that your child can use medications before, during and after physical activity. If necessary, ask the school for permission to modify the physical activity (such as walking quickly instead of running). Kid’s need exercise, so be sure to encourage your child’s participation; but be realistic about what he or she can handle, and keep needed medication available just in case.
  4. Monitor the school environment. Look at your child’s school for asthma triggers, such as strong smelling cleaning supplies. If triggers cannot be reduced, ask about switching your child to another classroom where there is less exposure to the triggers. Look for:
    • Air quality and ventilation

Are the school grounds free of tobacco smoke at all times? Are art and chemistry classrooms well ventilated so chemical vapors don’t spread?

    • Cleanliness

Are the classes dusted and cleaned regularly? Is dust-free chalk used? Are unscented cleaning chemicals used when possible?

    • Classroom pets

Pets with fur or feathers can trigger asthma. Even if the pet is not kept in your child’s classroom, air circulation systems can spread animal dander to other parts of the school.

    • Moisture

Moisture can lead to mold which can trigger asthma. Are windows free of condensation? Are classroom sinks and bathrooms free of leaks?

What Your Child’s School Can Do:

If you have questions about how the school supports children with asthma, talk to school personnel about your concerns.

For more information on what schools can do to manage asthma, visit the National Asthma Education and Prevention Program, National Heart Lung and Blood Institute.

Adapted from the Guidelines for the Diagnosis and Management of Asthma, National Asthma Education and Prevention Program of the National Heart, Lung and Blood Institute, 1997 and from guidelines from the School Asthma Education Subcommittee, National Asthma Education and Prevention Program, National Heart Lung and Blood Institute.

Live well with asthma: Know your triggers – National Consumers League

May is Asthma Awareness Month! Did you know that many asthma patients have found that making just one lifestyle change helps improve their symptoms. Know your triggers and avoid them.

Things that bring on asthma or make it worse are called your triggers. It is important for you to know your own asthma triggers. They are different for everyone.

Here’s a list of some of the most common allergens (which cause an allergic reaction), irritants (which irritate your body), and other things that can bring on asthma symptoms. Your personal list may include some of these or even additional ones that you and your health care provider have identified.


  • Dander (from the skin, hair, or feathers of animals)
  • Dust mites (insects too small to see found in house dust)
  • Cockroaches
  • Pollen from trees, grass, and flowers
  • Mold, both indoor and outdoor


  • Tobacco smoke
  • Air pollution
  • Cold or dry air
  • Sudden changes in the weather
  • Strong odors (paint, chemicals, solvents)
  • Scented products (perfume, lotions, candles)
  • Strong emotional expression (including crying or laughing hard) and stress


  • Common colds and other viral infections of the ear, nose and throat
  • Other infections, such as upper respiratory infections
  • Medicines, such as aspirin or beta-blockers
  • Sulfites in food or beverages (dried fruit, wine)
  • Diseases that cause heartburn can worsen asthma symptoms, especially at night.

Control and avoid your triggers

Using your asthma medicine regularly and the right way is a must for managing your asthma. It’s just as important to know what your triggers are and avoid them. Many people with asthma find that even making just one lifestyle change, like not hanging out with people who smoke or getting rid of family pets, has improved their asthma.

The following steps may help you reduce or get rid of the most common allergens and irritants that trigger asthma flare-ups.

Keep your home dust-free.

  • In at least the bedroom, get rid of heavy drapes, upholstered furniture, wool rugs, rug pads, stuffed animals and anything with feathers.
  • Use an airtight, allergy-proof plastic cover on all mattresses and pillows.
  • Use cotton or synthetic blankets, not quilts or comforters.
  • Use foam or Dacron (polyester fiber) pillows, not pillows filled with feathers.
  • Wash all bedding in hot water (150 degrees) every week.
  • Avoid using ceiling fans, and if you do use them, make sure you clean off dust from the hard-to-reach top side.
  • Cover air vents with glass fiber or cheesecloth filters.
  • Consider using a HEPA filter to control airborne allergens.

Keep your home bug-free.

  • Control cockroaches with insect sprays and roach traps, as cockroach allergens are a very common asthma and allergy trigger. Remember to wear a mask while spraying chemicals to avoid breathing in irritating fumes.

Keep your home pet-free (if you can).

  • Sometimes emotional attachments make it difficult to get rid of a family pet. If they have to live inside your house, keep them out of the bedroom where asthmatic family members sleep.
  • Choose a pet without fur or feathers (such as fish).

Keep your home mold-free.

  • Get rid of molds that are often found in basements, bathrooms, attics, closets, and water-damaged areas of the house.  If you find any, after removing it, make it less likely that it will return by taking out carpeting, wallpaper, or paneling in these areas.  Don’t use vaporizers or humidifiers in places that contain (or used to contain) mold.

Keep your home breathe-friendly.

  • Keep indoor humidity low(less than 50 percent), since dust mites and mold increase in high humidity.
  • Don’t smoke! And don’t let others smoke in your house.
  • Avoid using strong scentsand sprays, such as deodorizers, strong smelling cleaning products, and scented candles.
  • Don’t use the self-cleaning feature on your oven.
  • During pollen season, keep windows closed in the car and home to avoid exposure (especially on windy days).
  • Stay indoors when pollen counts are highest – during the middle of the day and afternoon.
  • Watch the weather report and listen for air quality news. Avoid being outside on days when pollution or ozone counts are high.

Outside Your Home

  • Remove wet leaves, cut grass or garden debris.
  • Use non-organic material for mulching and other landscaping.
  • Remove mold from roof shingles or siding.
  • Take your plants outside.
  • Wear a scarf over your mouth and nose in the winter.


Women’s health: Understanding hormone risk – National Consumers League

Hormone health – whether related to health promotion, disease prevention, or optimal nutrition – is a critical issue for women and the health care providers who treat them. Issues such as hormone therapy, breast cancer prevention and treatment, and soy consumption are challenging health topics made more complicated by the ever-growing, and sometimes conflicting, information available to the public.  In this confusing environment, how do women and their health care providers access reliable information to make wise choices?

This question and others were explored at the National Consumers League’s Women’s Health Forum: Navigating Health Information, held on January 18, 2007 in Washington D.C., at the National Press Club. 

The forum provided attendees with background on these topics and explored how women and their health care providers must sift through vast amounts of often conflicting resources in order to find credible and reliable information. The American Nurses Association co-provided the forum and offered up to six hours of continuing education credit for nurses who attended. In addition to nurses, audience participants included other health care providers, consumer advocates, researchers, policy makers, and representatives from government and industry.

Tips for Identifying Reliable Resources

At the Women’s Health Forum, speakers and participants discussed the challenge of finding dependable information about the confusing and often controversial issues within women’s health. How’s a consumer to know whether what he or she is reading is trustworthy? The forum produced the following tips for judging the quality of health information:

1) When the resource includes information focusing on research for a specific medical treatment, consider the following:

  • What is the observed relative risk/benefit of the treatment, as well as the absolute risk/benefit? (See box below on the difference between absolute and relative risk) Are the findings statistically significant? Is this true for all populations or sub-groups evaluated?
  • Do the treatment studies have disease outcome results, or just surrogate markers?
  • If there is no evidence of harm or benefit available for the treatment, consider whether this is because the research findings are contradictory or not performed/available to the public; and
  • Is there a placebo effect – meaning that the patient’s symptoms are altered in some way (i.e., alleviated or exacerbated) by an otherwise inert treatment, due to the individual expecting or believing that it will work.

2) Always consider the source of information (does it appear in a peer-reviewed journal, or is it a sponsored white paper that has not undergone external scientific review?), the completeness of the research, and the financial ties of the source. Keep in mind that results from industry-sponsored studies are sometimes more favorable to that industry’s products than those conducted by independent third parties.

3) When reviewing health information, consider it in the context of your immediate concern (e.g., any symptoms you are trying to relieve or health conditions you want to treat now) AND your longer-term concerns (e.g., conditions or future health problems you are trying to avoid). Looking at the information in terms of both current and future health implications should help you make more informed and complete decisions.

Understanding risk

There are two main ways to talk about risk – relative risk and absolute risk.

Absolute risk refers to a person’s risk (or chance) of developing a disease over a certain time period.

Relative risk compares the risk of getting a disease in two different groups of people – such as a group taking medicine A compared to a group taking medicine B.

Although reports on new treatments often highlight the relative risk reduction of a treatment, the absolute risk gives a better sense of your individual risk. Both absolute and relative risk are important to consider, but relative risk can be misleading.

For Example:

Say 2 in 10,000 women risk developing cataracts by the time they are 70 years old. Research shows that a new treatment reduces the relative risk by 50%, meaning that a woman’s risk is reduced by half. In this example, the absolute risk of developing a cataract now falls from 2 in 10,000 women (.02%), to 1 in 10,000 women (.01%). A woman’s relative risk may be reduced by 50% with treatment, but a .02% absolute risk without treatment is still a pretty small risk.

This difference is particularly important for patients to consider when they look at the risks of particular treatments as well as benefits. If you have a very low absolute risk for a disease even before treatment, then the side effects associated with that treatment may not be worth the relative benefit you might get from taking it.