Over The Counter Drugs

Over-the-counter (OTC) drugs are those drugs that are safe and effective for use by the general public without a doctor’s prescription.

  • It is also called prescription decontrolled drugs.
  • These drugs are non-prescription or over-the-counter drugs.
  • These have little significant pharmacological activity and therefore the physician need not be very much concerned about their use by the patients themselves.
  • It is used primarily for symptomatic relief and not as a substitute for prescription drugs.


  • Comparatively cheaper
  • The chemist himself may prescribe OTC
  • Consumers are able to:
  1. Self diagnose
  2. Self-treat
  3. Self manage
  • OTC is considered a time-saving medication. Some patients do not want to spend much time at a physician’s clinic.
  • Lesser number of side effects compared to prescription medications.

Drugs Used by Indians

Over-the-counter drug products account for 55 percent of drugs used by Indians, whereas Prescription Drugs account for 45 percent

Types of OTC Medications

  • Analgesics
  • Antibiotics
  • Cough Suppressants
  • Anti Acne Drugs
  • NSAIDs
  • Antiseptics
  • Decongestants
  • Antacids
  • Antifungals
  • Anti Histamines
  • Smoking Cessation Drugs

Rules For the Proper Use of OTC Drugs

  • Always know what you are taking.
  • Know the effects.
  • Read and heed the warnings and cautions.
  • Don’t use anything for more than 1 to 2 weeks.
  • Be particularly cautious if also taking prescription drugs.
  • If you have questions, ask a pharmacist.
  • If you don’t need it, don’t use it!

Special Patient Groups

Many patient groups may be particularly susceptible to adverse events that are caused by OTC products.

They include:

  • Children
  • Women who are pregnant or breastfeeding
  • Geriatric patients
  • People taking prescription drugs & people having health problems

OTC Medications Are Safe but Not Risk-Free

As with all medications, there can be risks with use.

The risks of OTC use include:

  • Delay in seeking medical advice for a serious illness.
  • Risk of drug-drug/herbal/dietary supplement interactions.
  • Risk of adverse events.
  • Potential for dependence, misuse, and abuse.

Misuse And Abuse of OTC Drugs

  • Physical dependence
  • Psychological dependence
  • Nonprescription products that can be severely habit-forming: decongestants, laxatives, antihistamines, sleep aids, antacids, and ephedrine.
  • Only 16% reads the entire product label.
  • If they read them they do not follow the directions on the label.

Abuse is most common in adolescents aged 10-17 years. Adolescents are 18% times more likely to die from an OTC overdose than from an illicit drug-dose overdose.

Rational Use Of OTC Drugs

Rational use of medicines refers to the correct, proper, and appropriate use of medicines. Rational use requires that patients receive the appropriate medicine, in the proper dose, for an adequate period of time, and at the lowest cost.


Pain relief medicines (also known as “analgesics” and “painkillers”) are regulated by the Food and Drug Administration (FDA). Some analgesics, including opioid analgesics, act on the body’s peripheral and central nervous systems to block or decrease sensitivity to pain. Others act by inhibiting the formation of certain chemicals in the body. These relieve the minor aches and pains associated with conditions such as headaches, fever, colds, flu, arthritis, toothaches, and menstrual cramps.

There are basically two types of OTC pain relievers:

  1. Acetaminophen
  2. Non-steroidal anti-inflammatory drugs (NSAIDs).

Acetaminophen is an active ingredient found in more than 600 OTC and prescription medicines, including pain relievers, cough suppressants, and cold medications. NSAIDs are common medications used to relieve fever and minor aches and pains. They include aspirin, naproxen, and ibuprofen, as well as many medicines taken for colds, sinus pressure, and allergies. They act by inhibiting an enzyme that helps make a specific chemical.

Use as Directed

Pain medications are safe and effective when used as directed. However, misuse of these products can be extremely harmful and even deadly.

  • Consumers who take pain relief medications must follow their healthcare professional’s instructions carefully. If a measuring tool is provided with your medicine, use it as directed.
  • Do not change the dose of your pain relief medication without talking to your doctor first.
  • Also, pain medications should never be shared with anyone else. Only your healthcare professional can decide if a prescription pain medication is safe for someone.

Special Patient Groups

Talk with your doctor before taking any NSAID if you:

  • Are over age 60
  • Are pregnant or nursing
  • Have three or more drinks of alcohol every day
  • Have bleeding problems
  • Have liver or kidney disease
  • Have heart disease
  • Take a medicine to thin the blood, such as warfarin (Coumadin)
  • Take a medicine for high blood pressure
  • Children and teenagers who are recovering from a viral infection such as the flu or chickenpox should not take aspirin. It has been linked to Reye’s syndrome, a serious but rare condition that can result in brain, kidney, and liver damage.
  • Naproxen sodium is not recommended for children under 2.
  • Ibuprofen is considered safe for children 6 months and older in the right dose.

OTC Counseling Questions

Counseling patients about self-care and nonprescription drugs is not the same and cannot follow the same procedure as prescription drugs. That is why OTC counseling requires much more exploratory open or close-ended questions on the part of the pharmacist which are especially useful to clarify information gathered about the patient’s condition. It allows for gathering the most abundant amount of information.

These questions usually start with who, what, how, why or where. For example:

  • “Which of the prescription medications do you take on a regular basis?”
  • “Which of the nonprescription and herbal medications do you use?”
  • “What types of conditions do you routinely see your doctor for?”

Some other questions are also possible:

  • “Have you ever experienced any side effects after taking the Over-the-counter Drugs ?”
  • “Have you taken this OTC medication before?”

Patient Counseling

Step 1:

Every pharmacist should begin the OTC counseling session by introducing himself/herself by name which identifies him/her as the pharmacist. He/she should try to relax the patient by beginning the session with a friendly smile and a handshake. The pharmacist should also explain that he/she can provide assistance with Over-the-counter drugs product selection and explain how to use such medication.

Step 2:

In order to elicit key information the pharmacist should first and foremost try to obtain relevant information about the patient’s demographic (e.g. sex, age, pregnancy, nursing, weight, allergies, social history, etc), disease (e.g. history of present illness, current symptoms, course of illness, past history, other underlying medical conditions) and drug (e.g. current medication, medication taking history, OTC history etc.) Moreover, by using suitable verbal and written communication techniques, the pharmacist should inform, educate, and counsel patients about the following:

  • Drug name (generic and/or brand name)
  • The route, dosage form, dosage, and administration schedule;

Special directions for preparation and administration as well as precautions to be taken during the process;

  • Techniques for self-monitoring of drug therapy;
  • Storage;
  • Potential drug-drug or drug-food interactions or other therapeutic contraindications; and
  • Accordingly other Information “peculiar to the specific patient or drug etc.

In addition, it is of vital importance to demonstrate to patients- how to use medications in various forms such as inhalers, patches, drops, ointments, lozenges, gargles, etc. Ask them to demonstrate making sure that patients understand which route of administration should be used thus ensuring that patients have all the necessary instructions in writing and that they understand how to schedule their medications in accordance with meals and other medications.

Make sure you also check our other amazing Article on: Medication History
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