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Sunday, March 1, 2015
When pharmacists talk to consumers about a possible side effect from one of their medications, they normally ask a number of questions about the medical history and any other medications the person may be taking, including those purchased over-the-counter (OTC). A frequent response when asked about OTC preparations is, "Oh, that wouldn't cause any problem. It's not the same as a 'drug.' I wouldn't be able to just buy something that might hurt me."
Unfortunately, these attitudes are all too common. They form the basis of a number of dangerous misconceptions about OTC medications held by consumers, including the following:
Dangerous Misconceptions About Over-the-Counter Drugs
EACH OF THE ABOVE STATEMENTS IS FALSE. If you found yourself agreeing with any of them, read on.
Many of the OTC drugs, also called nonprescription drugs, found in pharmacies today started out as prescription drugs. For the FDA to change a prescription drug to an OTC, it must have a generally good safety profile and be used for a condition or symptoms that can be readily "self-diagnosed." Usually the dose is smaller, but OTCs work the same way in the body and have the potential to cause similar side effects as their prescription versions, especially if not used as directed on the product label. A drug's availability over-the-counter makes it more convenient for the consumer, but it also makes the consumer responsible for its proper use.
Part of that responsibility is reading the entire label on an OTC product.
Reading the label has often been a difficult task. The print was too small, the words were too big, and it was hard to compare one product to another because the information was usually not in the same place from label to label. However, in 1999 the Food and Drug Administration's division of OTC drug products released new guidelines to help address these problems. Their goal was a simple, standard label format with large print and easy to understand language. Ingredients, uses, warnings and directions would be easy to find on any product. Companies were given five years to make these label changes. Even with the new, easier-to-read labels, consumers should never hesitate to talk to their doctor or pharmacist when choosing an OTC medication.
Think about the following when reading OTC labels:
For example, Anacin™ contains aspirin as the pain reliever while Anacin Free™ contains acetaminophen; Tylenol™ contains acetaminophen while Tylenol PM™ contains acetaminophen and diphenhydramine, an antihistamine that causes drowsiness. You can end up with an entirely different product if you are not paying attention.
Active ingredients are those that directly affect the symptoms for which you selected the product. For example, pseudoephedrine acts as a decongestant, and it can be used for a stuffy nose. Acetaminophen acts as a pain reliever and lowers fevers. Its uses include relief from aching and fever due to flu.
Many OTC's contain more than one active ingredient as a convenience for the consumer. This convenience of getting "everything" you need in one product can also lead to unintentional overuse and toxicity.
Since many consumers are not just using one product, those who have not familiarized themselves with the entire list of active ingredients may be getting that same ingredient from multiple products, causing an accidental overdose.
The term "inactive" on an OTC label only means that the ingredients do not have a direct effect on what the product is being marketed for. But they should not be ignored because they may be active in other ways. For instance, alcohol is used in some products to help dissolve the other ingredients. While the product is not being used for its alcohol content, the alcohol may cause an adverse effect in some people in terms of interactions with other medications they may be taking or interactions with medical problems or diseases the person may have. Inactive ingredients such as some dyes may cause allergic reactions in sensitive people.
OTC products play a big role in today's healthcare choices. Consumers are able to self-medicate many problems. However, with the convenience also comes the responsibility to use the drug properly and safely. The valuable information provided on the product label must be read and understood. Even with the new, simplified label wording and format, your pharmacist or physician is there to help clarify the information and answer questions. Do not hesitate to ask for their assistance.
This article is a NetWellness exclusive.
Last Reviewed: May 11, 2007
Gaylene B Tsipis, MS, RPh
Adjunct Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati