Over-the-counter medications may be neither safe nor effective if they aren’t used properly.
More than one-third of Americans regularly use nonprescription drugs to treat a number of ailments—pain, fever, cold and allergy symptoms, heartburn, and insomnia, to name a few. The manufacturers of the medications sold on drugstore shelves have demonstrated to the FDA that their products are safe and effective. And using them can spare you the money and time spent making a health care visit and filling a prescription.
But these medications are being used by groups of people who weren’t likely to have been included in the clinical trials that furnished evidence of their safety and efficacy, says Dr. Sonia Hernandez-Diaz, professor of epidemiology at Harvard T.H. Chan School of Public Health. “FDA approval for prescription drugs is based on clinical trials of people who have specific conditions. When the same drugs are released over the counter [OTC], anyone can take them. It’s also harder to trace the side effects because people aren’t being monitored, and it’s more difficult for the FDA to recall a drug once it’s OTC.”
There may be scant evidence of the effects of many of these drugs in women—particularly pregnant women, breastfeeding mothers, and older women—who have been underrepresented in clinical research. However, there is at least one safeguard: nonprescription medications with a high potential for misuse or abuse are available only at the pharmacy counter, often in limited amounts.
To increase the likelihood that the product you choose will be effective and safe, you should ask yourself the following questions before you head for the checkout line.
1. Do you understand your symptoms?
Nonprescription drugs may be a good alternative to prescription medications if you’ve been treated for a specific condition in the past and recognize the symptoms. However, new symptoms, particularly if they are severe, warrant a call to your health care provider.
2. Do you know what the product contains?
Reading the labels is always wise, especially since many versions of a single brand can have different active ingredients. For example, the “nighttime” versions of pain relievers may include diphenhydramine, a sleeping aid.
3. Do you know how to take the drug and how long to take it?
The instructions on the label are a good guide. However, don’t expect the same effects from an OTC drug as you would get from the prescription version, which is likely to be stronger.
4. Have you read the warnings on the package insert?
Carefully go over the warnings and the list of things to avoid while taking the medication. Scan the list of other drugs that may interact with the one you’re about to buy.
Can’t answer the questions?
If you can’t answer all these questions, talk to the pharmacist. He or she can help you determine if the product you’ve chosen is really what you need. The pharmacist can also advise you on the appropriate dose, whether or not the medication will interact with other drugs you take, and how long you should take it. And don’t forget to tell your doctor about the nonprescription medications you’re taking, especially those you take regularly.