Over the Counter Medication :

Overview of OTC Medications (Harris Survey) > 100,000 OTC Products Few unique active ingredients > 700 are former Rx meds

Some Interesting OTC Facts: 3/5 people have used an OTC

medication in the last 6 months This is slightly more than who used

an Rx medication in the last 6 months

Basic Points: Medication v. Drug MOST medications can cause

• Nausea• Vomiting• Diarrhea• Dizziness• Drowsiness

Interesting Facts and OTC Problems: People don’t consider OTC’s real

medicine. People just don’t know what is in

these medications, and many contain the same active ingredients.

Only 34% of consumers could identify the active ingredient in the medicine they were taking.

OTC Medication Use by Category: Most common uses include:

Pain (78%) Cough, cold, flu (52%) Allergy and sinus (45%) Heartburn, stomach (37%) Constipation, diarrhea (21%) Skin problems (10%)

For Example: Pain

Most common ingredients:• Acetaminophen (Tylenol aka, APAP)• Aspirin (Many)• Ibuprofen (Motrin IB, Advil)• Naproxen (Aleve) and ketoprofen (Orudis)• Caffeine• Buffers, coatings, long acting, strongest

pain reliever you can buy without a prescription….

OTC Medication Use:

Some specific recommendations and considerations

Pain Acetaminophen (apap)

• first line treatment in those < 18• Generally causes few problems• Is very safe to use

Aspirin• should be avoided in the under 18 age

group • Reye’s syndrome• Other problems usually associated with

stomach distress (NVD)

Pain Ibuprofen

• Fine to use in the <18 age group• Works about as well as apap • Caution if kids are dehydrated• Sometimes used in combo with APAP• Dizziness, plus stomach problems

CAUTION• Aspirin / ibuprofen allergies a concern, in some cases

you are seeing students after their first dose of a medication!

• Hives, shortness of breath, facial swelling, difficulty breathing or swallowing, itching, feeling funny

• Seek medical assistance immediately

Cough, Cold and Flu, Allergy and Sinus Decongestants (stuffy)

Pseudoephedrine (Sudafed)• PPA removed from the market, others include

phenylepherine, and some nasal sprays (Afrin)• Have been associated with hallucinations,

hypertension, irritability and hyperactivity• Can also cause drowsiness, especially as as the

dose wears off• Products are available for very young children,

but dosing is critical, so use pediatric dosage forms and measure carefully

Cough, Cold and Flu, Allergy and Sinus Antihistamines (runny)

• Claritin, Alavert (loratidine) Diphenhydramine (Benadryl), chlor and brompheniramine (Chlortrimeton, Dimetapp)

• Alone, usually cause drowsiness• In combination, variable effects• NLD – 1:05 AM• Kids need plenty of fluids when taking these,

helps with drowsiness and dry mouth, PLUS MORE

Cough Cough suppressants

DM = dextromethorophan• Drowsiness, dizziness, NV

Codeine• Have to sign for OTC use• Not recommended for infants• Small or young children, can be used with caution

Expectorants• Guiafenesin (basic ingredient in most)• Usually no problem, need to use with water, works

about as well as water in OTC doses.• No, water probably works better…

Combination Products are very popular because they have

many choices• Plain, DM, CF, PE, Orange, Grape

These products may contain• Antihistamines• Decongestants• Cough suppressants• Expectorants

Heartburn, Stomach, Gas Antacids – many, many

• Maalox, Riopan, Gaviscon, and plenty more• Tagament, Zantac, Pepcid, etc.

Gas Simethicone

• Breaks up the gas bubbles so they can be expelled and not cause pain. These products do not reduce the amount of gas!

• Gas X• Mylicon• Many generics available

Constipation and Diarrhea The most amazing products that treat

both! How do they know?

• Equilactin• Balances water in the colon to properly form

stools, adds fiber.

Skin Problems Key here is contagiousness

• Is the problem going to spread?• Bacterial, fungal, yes.• Contact dermatologic problems, usually

not.• OTC Skin products usually present few

problems• Neosporin, Polysporin, Micatin, Lotrimin, Lamasil,

Aveeno, Bacitracin, Ivy Dry, Calamine, Hydrocortisone, etc.

• Local reactions possible, sensitivity

Surprising? 49 percent of consumers get

information from ads 57 percent get their information

from a health professional

Ask Your Pharmacist!

10 Tips on OTC use1. Read the label2. Treat only the symptoms you have3. Know what to avoid while taking OTCs – beware

of interactions4. ASK before you buy5. Use as directed on the label6. Be careful if you take > 1 OTC 7. Don’t mix Rx and OTCs including herbals8. Give your doctor a list of ALL meds9. For kids, use pediatric formulas10. Throw meds away if they are expired

Keep in mind: If patient takes OTC meds, more than

1 medication, Rx and OTC meds, and something seems out of character, it could be the cause of adverse reaction.

These kinds of problems need to be brought to the attention of a health professional.