Key Takeaways

The Food and Drug Administration (FDA) is warning consumers that some arthritis and pain management products contain hidden ingredients that could be dangerous.

Through extensive testing over 10 years, the FDA found that some arthritis and pain management products contain active drug ingredients and components commonly found in prescription drugs, which could come with significant health risks for people who use these products.

“These products may cause potentially serious side effects and may interact with medications or dietary supplements a consumer is taking,” the agency said in astatement. “It is clear from the results of our decade of testing that retailers and distributors, including online marketplaces, do not effectively prevent these types of potentially harmful products from being sold to consumers.”

Here are some of the potentially dangerous products that are marketed to consumers online and in stores that could have these hidden ingredients, and what to do if you’re taking any of them.

The Most Common OTC Drugs in the U.S.

Which Products Are Dangerous?

According to the FDA, there are at least 22 OTC arthritis and pain management products that have potentially harmful hidden ingredients.

The products listed below are only a portion of the potentially dangerous products that are marketed to consumers online and in stores.Even if a product is not on the list, the FDA emphasized that you should still use caution before using any OTC arthritis and pain management products.

The products listed below are only a portion of the potentially dangerous products that are marketed to consumers online and in stores.

Even if a product is not on the list, the FDA emphasized that you should still use caution before using any OTC arthritis and pain management products.

Many of these products have been advertised and sold in some retail stores and on various websites, including Etsy, Amazon, Walmart, eBay, and Botanical-be.

What ‘Hidden’ Ingredients Could Be in These Products?

A hidden ingredient is anything contained in an over-the-counter (OTC) product that is not disclosed or listed on the label.

Candy Tsourounis, PharmD, a clinical pharmacist and professor of Clinical Pharmacy in the Department of Clinical Pharmacy at the University of California San Francisco, told Verywell that ingredients in OTC products can be active (e.g., a medicine like ibuprofen) or inactive (e.g., fillers, flavorings, coatings, or preservatives.

Tsourounis said that many OTC arthritis and pain management products contain ingredients that belong to three different drug class categories: NSAIDs, steroids, and muscle relaxers.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medications commonly used to reduce inflammation and treat conditions such as arthritis, headaches, and muscle injuries.

A few hidden NSAIDs that have been found in OTC arthritis and pain management products include ibuprofen, diclofenac, piroxicam, indomethacin, meloxicam, ketorolac, phenylbutazone, and naproxen.

Tsourounis said that products that have NSAIDs like diclofenac in them can lead to an increased risk of cardiovascular events, such as heart attack and stroke, as well as a higher risk for gastrointestinal damage, including bleeding, ulceration, and holes in the stomach and intestines.

The FDA warned that hidden ingredients like NSAIDs could also interact with other medications and raise the risk for adverse events, especially for people who take more than one NSAID-containing product.

Can You Take Advil for Arthritis?

Corticosteroids (Steroids)

Corticosteroids (steroids) are a type of anti-inflammatory drug that’s used to treat inflammatory conditions like asthma, atomic eczema, and multiple sclerosis (MS).Dexamethasone and prednisone-21-acetate are steroids that have been found in several arthritis and pain management products, as they may help with painful and inflamed joints, muscles, and tendons.

Tsourounis said that corticosteroids like dexamethasone or prednisone can affect a person’s ability to fight off infections, as well as cause high blood sugar levels, muscle injuries, and psychiatric symptoms.

When corticosteroids are taken for a long time and/or at high doses, they can suppress the adrenal glands and lead to symptoms of extreme fatigue, muscle weakness, weight loss, abdominal pain, and loss of appetite.

Muscle Relaxants

Muscle relaxants are prescription medications that can help treat muscle-related symptoms, such as muscular pain or spasms, as well as injuries that cause symptoms like lower back pain.Muscle relaxants that have been found in arthritis and pain management products include methocarbamol and chlorzoxazone.

Tsourounis said that muscle relaxants can cause side effects like sedation, dizziness, and low blood pressure. They can also affect a person’s mental and physical abilities to do certain tasks, like driving or operating machinery at work.

Taking Muscle Relaxers for Arthritis

What to Do If You Use One of These Products

You should not buy any products that the FDA has listed, but what if you’re already using them? If you are currently taking one of the listed arthritis or pain management products, Tsourounis said to stop immediately and contact your provider.

“Some hidden ingredients can be very dangerous—especially for someone that is allergic to the hidden ingredient or if someone has compromised kidney or liver function, or if the hidden ingredient is found in significant amounts that interacts with other medications the patient is taking,” she said.

Your healthcare provider or pharmacist can talk to you about safer options for managing your symptoms. In some cases, they may want to do some testing, like seeing how your kidneys are working, to figure out what the safest and most effective treatment will be for you going forward.

Jack Kann, RPh, BS, Director of Pharmacy at South Shore University Hospital, told Verywell that you should also report any side effects or complications you may have experienced while using the listed products.

You or your provider can report adverse events or side effects to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program. The report can be found online atMedWatch Online Voluntary Reporting Form. You can also download, print, and fill out theform, then submit it via fax to 1-800-FDA-0178.

Treatment Options for Arthritis

How Do I Know If an OTC Product Is Safe?

“Consumers should be very cautious when taking OTC products,” said Kann. “Labels should be checked, and it is always important to discuss taking these medications with their healthcare providers.

Kann added that while many of these products are “marketed in non-traditional stores,” it is always better to purchase health agents in pharmacies.”

When you’re buying OTC products, Tsourounis recommends that you:

What This Means For You

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Tainted arthritis/pain products.American Academy of Orthopedic Surgeons.What are NSAIDs?.Arthritis Foundation.Corticosteroids.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of adrenal insufficiency and Addison’s disease.Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ.2021;374:n1446. doi:10.1136/bmj.n1446

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Tainted arthritis/pain products.American Academy of Orthopedic Surgeons.What are NSAIDs?.Arthritis Foundation.Corticosteroids.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of adrenal insufficiency and Addison’s disease.Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ.2021;374:n1446. doi:10.1136/bmj.n1446

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Food and Drug Administration.Tainted arthritis/pain products.American Academy of Orthopedic Surgeons.What are NSAIDs?.Arthritis Foundation.Corticosteroids.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of adrenal insufficiency and Addison’s disease.Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ.2021;374:n1446. doi:10.1136/bmj.n1446

Food and Drug Administration.Tainted arthritis/pain products.

American Academy of Orthopedic Surgeons.What are NSAIDs?.

Arthritis Foundation.Corticosteroids.

National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of adrenal insufficiency and Addison’s disease.

Cashin AG, Folly T, Bagg MK, et al.Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.BMJ.2021;374:n1446. doi:10.1136/bmj.n1446

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