Have you ever stopped to think about the risks that might come with the medications you take or give to your children? In the United States, TV commercials for medications always mention potential side effects, some of which can be quite serious. Meanwhile, in Latin America, this information often remains a mystery to most people.
This difference isn’t trivial, it can significantly impact your health and your family’s well-being. That’s why in this article, we’ll explain why this disparity exists, how it can lead to an endless cycle of medications, and what you can do to make more informed decisions. If you want to safeguard your health and your loved ones, keep reading!
Why Does the U.S. Disclose Side Effects?
If you’ve ever watched a drug commercial on TV in the United States, you’ve likely noticed something that seems contradictory: while the ad shows happy families, people jogging in a park or enjoying a sunny day, a voiceover quickly lists potential side effects at the end.
For instance, an ad for an antidepressant might warn, “Side effects may include nausea, insomnia, weight gain or suicidal thoughts.” Similarly, a pain reliever ad might caution, “May cause stomach pain, internal bleeding or liver damage.” Why include such serious risks in an advertisement?
The answer lies in U.S. regulations. The FDA (Food and Drug Administration) tightly oversees the advertising of both prescription and over the-counter drugs. Since 1997, the U.S. has allowed direct-to-consumer (DTC) advertising of prescription medications, a practice also permitted in New Zealand but rare elsewhere.
The FDA requires these ads to clearly and understandably present both the benefits and the most significant risks. This serves two purposes: it protects consumers by ensuring they’re informed, and it shields pharmaceutical companies from potential lawsuits.
In the U.S. if a patient experiences a severe side effect and wasn’t properly warned, they can sue the pharmaceutical company for millions of dollars due to lack of transparency. Lawsuits are common and costly in this country, for example, in 2012, the pharmaceutical giant GlaxoSmithKline paid $3 billion to settle lawsuits related to misleading promotion of drugs like Paxil and Avandia, partly for downplaying their risks and failing to disclose them adequately (1).
That’s why, even though the cheerful imagery in these ads might seem ironic, companies are legally obligated to include those warnings to avoid legal trouble.
A Culture of Transparency in the U.S.
In the United States, transparency around medications goes beyond TV commercials, there are accessible resources like MedlinePlus (https://medlineplus.gov/), a platform created by the U.S. National Library of Medicine, where you can look up any medication and find detailed information about its uses, dosage and potential side effects.
For example, if you search for ibuprofen, you’ll learn that it can cause stomach issues, kidney damage or even increase the risk of heart attacks with long-term use. This tool is designed to empower patients, enabling them to make informed decisions.
Moreover in the U.S., doctors and pharmacists are required to provide detailed information about prescribed medications. The inserts that come with medications typically include comprehensive lists of side effects, interactions and warnings.
This reflects a culture where patients tend to be more proactive in seeking information, partly because the healthcare system is private and expensive, motivating people to educate themselves to avoid medical errors or unnecessary costs.
The Situation in Latin America: Less Information, More Risks
In Latin America, the situation is starkly different, and this can put you at risk without you even realizing it. Direct-to-consumer advertising of prescription drugs is either banned or heavily regulated in most countries in the region.
For instance, ads for over-the-counter drugs (OTC) like ibuprofen or acetaminophen rarely mention serious side effects, creating a false sense of safety, you might assume a medication is completely safe because the ad didn’t warn you otherwise.
Additionally, there’s a significant lack of education and access to reliable information. Unlike the U.S. where platforms like MedlinePlus are widely available, Latin America lacks similar government-provided public databases.
Medication inserts are often written in technical language that’s hard for most people to understand, meaning you’re entirely reliant on what your doctor or pharmacist tells you, and they often don’t have the inclination to explain the risks in detail.
Self-Medication: A Dangerous and Common Habit
Just like in the U.S., self-medication is a serious issue in Latin America, while it might seem like a quick fix, it carries significant risks, Ibuprofen and acetaminophen are among the most commonly used drugs without medical supervision, driven by several factors that highlight the challenges of the region’s healthcare systems and economic realities.
- Limited access to doctors, especially in rural areas: In many rural communities across Latin America, access to doctors is scarce, clinics or hospitals can be hours away, making it difficult for people to seek professional care. As a result, many turn to medications they already have at home or buy from the nearest pharmacy without consulting a doctor.
- Long wait times in public healthcare systems: Public healthcare systems in Latin America, such as Mexico’s IMSS (Mexican Social Security Institute), often provide free care but are overwhelmed, wait times for appointments can stretch into weeks, and many people feel they can’t wait that long to address a simple pain or cold, so they opt to self-medicate instead.
- Economic constraints and the cost of consultations: While some pharmacies in the region offer affordable consultations with doctors (sometimes as low as $3.50 USD), many families face financial hardships that force them to prioritize essentials like food or transportation over healthcare costs. For them, paying for a consultation and then the prescribed medication can feel like a luxury, instead, they often choose to buy only the medication they think they need (like ibuprofen for pain) without considering the risks or whether it’s the right treatment.
- Ease of purchasing medications without a prescription: In many Latin American countries, it’s easy to buy medications at pharmacies without a prescription, even for drugs that technically require one, this lack of strict regulation allows people to purchase painkillers or antibiotics without consulting a doctor. While this might seem convenient, it increases the risk of misuse, such as taking the wrong dose or using a medication that isn’t appropriate for their condition.
This habit of self-medication can be dangerous, for example, frequent use of ibuprofen can lead to nervousness, itching, excessive tiredness, constipation and it may also increase the risk of heart attacks or strokes (2). Yet, many people are unaware of these risks because no one warns them.
The Case of Montelukast: A Troubling Example
One of the most concerning examples is Montelukast, a medication commonly prescribed to treat asthma and allergies, especially in children. Often, doctors prescribe it at the first sign of a runny nose, diagnosing “allergies” without thorough testing, but what many parents don’t know is that Montelukast can have serious side effects.
In 2020, the FDA issued a black box warning (the most serious type) for Montelukast, highlighting risks of neuropsychiatric effects such as anxiety, depression, nightmares and even suicidal thoughts (3). Based on this evaluation, the FDA determined that “the risks of Montelukast may outweigh the benefits in some patients, particularly when the symptoms of the disease are mild and can be adequately treated with alternative therapies.”
Picture this scenario: a mother gives Montelukast to her daughter because the doctor said her runny nose was due to allergies, suddenly, the girl starts having nightmares or seems more anxious, but the mother doesn’t even consider that the medication might be the cause, because no one warned her about these risks and she assumes it’s completely safe since the doctor prescribed it.
In Latin America, this information rarely reaches parents, many pediatricians continue prescribing Montelukast without mentioning these potential side effects, and parents administer it, trusting the doctor implicitly. This is especially worrisome because a simple cold might not justify using a medication with such serious risks.
An Endless Cycle: Medications That Create More Problems
The issue doesn’t stop with side effects, sometimes, a medication solves one problem but creates another, leading to a never-ending cycle of more medications, a phenomenon known as a “prescribing cascade.” For example, if you take ibuprofen for pain or inflammation, you might develop stomach pain as a side effect, then, you’re prescribed or self-prescribe a stomach protector, which in turn might cause dizziness, and so on.
In the case of Montelukast, if a child develops anxiety as a side effect, the doctor might prescribe another medication to treat it, without anyone stopping to consider whether the first medication was truly necessary.
In Latin America, this cycle is worsened by the lack of awareness about risks, it happens in the U.S. too, but patients here at least have greater access to information to question or break the cycle. Both regions however, this focus on treating symptoms rather than addressing the root cause perpetuates a dependency on medications.
Critics like Dr. Peter Gøtzsche, in his book Deadly Medicines and Organised Crime, argue that the pharmaceutical industry has a financial interest in keeping patients as “lifelong customers” by promoting drugs that treat symptoms rather than cure diseases, so if you’re interested in diving deeper into this topic, it’s a must-read—well-documented and packed with valuable insights.
Lawsuits in the U.S. vs. Unawareness in Latin America
In the U.S., transparency has led to a rise in lawsuits over permanent damage caused by medications, for example, patients who suffered severe side effects like liver damage from painkillers or heart problems from certain antidepressants, have won millions of dollars in lawsuits against pharmaceutical companies. This has forced companies to be more cautious and transparent, but it also reflects a system where patients are more aware of their rights.
In Latin America however, the situation is quite different, often, parents notice unusual behaviors in their children, such as anxiety or nightmares, but it doesn’t cross their minds that a medication like Montelukast could be the cause. Instead, they attribute it to other factors, like school stress or family issues, and the problem persists unresolved.
This lack of information leaves families vulnerable, without the tools to protect themselves.
Why Knowing These Risks Matters
Understanding the risks of the medications you or your children take allows you to make informed decisions, for instance, if you know that Montelukast can cause anxiety or suicidal thoughts, you can weigh whether the benefits of using it for a simple runny nose or allergy outweigh those risks, perhaps a cold doesn’t justify exposing your child to such side effects.
The same applies to ibuprofen, if you take it frequently for every minor ache, whether mild or severe without knowing it can cause stomach or kidney damage over time, you might be creating a bigger problem without realizing it.
Being informed lets you decide whether it’s worth using a medication or if it’s better to address the root cause of the issue like stress, dehydration, poor posture or dietary imbalances that might be putting pressure on your body, and tackle it with lifestyle changes that can resolve the problem for good.
How Can You Learn More?
Fortunately, there are accessible resources you can use to educate yourself, one excellent option is MedlinePlus (https://medlineplus.gov/), a platform created by the U.S. National Library of Medicine. Here you can look up any medication like Montelukast, ibuprofen or others—and find detailed information about its uses, dosage and potential side effects.
For example, you’ll find that Montelukast “may cause serious or life-threatening mental health changes” (4), or that drugs like naproxen can lead to ringing in the ears, headaches, flu-like symptoms, hearing problems and even increase your risk of heart attacks (5).
This website is free and user-friendly, providing the information you often don’t get from your doctor or pharmacist.
Additionally, we recommend talking to your doctor and asking specific questions: What are the possible side effects of this medication? Is it really necessary for this issue? Are there safer or more natural alternatives? Don’t be afraid to ask, your health and your family’s well-being are on the line.
A Call to Action: Educate Yourself and Protect Your Health
The contrast between the U.S. and Latin America in how medication information is handled highlights an urgent need: governments in Latin America must invest in educational campaigns and create accessible platforms where people can learn about the risks of medications.
In the meantime, you can take charge, read labels, seek out reliable information and avoid self-medicating without understanding the consequences. A little effort today can prevent serious problems tomorrow.
Here at Blissenza, we’re committed to your well-being. We’ll continue sharing consistent, detailed information about medications, their risks and healthier alternatives to help you make informed decisions. Follow us on social media for high-quality insights on this and other vital health topics.