Americans love to play doctor and the pharmaceutical industry is only too happy to play along. Drugs that once required a physician’s prescription are now readily available in drugstores, supermarkets and even convenience stores.
Prilosec OTC is just the latest in a long list of medicines that have made the switch. At one time, Advil, Aleve, Benadryl, Claritin, Motrin, Pepcid AC, Sudafed and Zantac-75 couldn’t be purchased without a prescription.
Most people assume that over-the-counter medications are safe. But these powerful medicines don’t lose their ability to heal or to harm just because they jump over the prescription counter.
Far too many people make mistakes using OTC drugs. They take the wrong drug in the wrong dose at the wrong time or mix it with the wrong prescription medicine. According to FDA, there are over 170,000 hospitalizations each year because of nonprescription drug problems.
Part of the trouble is that people don’t always read labels. A recent survey found that only one in five checked for potential side effects.
But even conscientious consumers don’t get all the information they need on a tiny OTC bottle. Ibuprofen, for example, is used by millions to relieve arthritis, headaches and back pain. Like other anti-inflammatory drugs, ibuprofen contributes to many hospitalizations for severe stomach complications, including bleeding ulcers.
Although the ibuprofen label contains several warnings in tiny print, they do not compare to the prescribing information a doctor will find in the Physicians Desk Reference. There are two large pages in very small type listing precautions, interactions and possible adverse reactions.
Nowhere on the OTC label are patients warned to steer clear of such pain relievers if they have kidney problems. But doctors are admonished to prescribe this pain reliever only with the utmost caution for a patient with limited kidney function.
People taking blood pressure pills are not warned that ibuprofen or other anti-inflammatory drugs may reduce the effectiveness of some prescribed medicine. Blood pressure could soar into the danger zone when combined with ibuprofen or naproxen.
Choosing among the 100,000 different brands on drugstore shelves can also be overwhelming. Although there are only about 1000 active ingredients in all those bottles, the long, hard-to-pronounce names confuse most consumers.
Roughly two-thirds of Americans admit they have a hard time selecting the best product. But fewer than half ask the pharmacist for help, even though these health professionals are trained to advise on OTC drug use.
Getting the pharmacist’s input could protect people from inappropriate choices. For example, older people who have memory problems may also have trouble sleeping. But using a “PM” pain reliever with the sedating antihistamine diphenhydramine (Alka-Seltzer PM, Excedrin PM, Tylenol PM) may contribute to confusion or dizziness.
To reduce such errors, read labels, consult pharmacists and ask nurses and physicians about proper use of OTC medications. A campaign, Be MedWise, will remind people to take nonprescription drugs seriously. As Surgeon General Richard Carmona emphasizes, “These are real medicines that must be taken responsibly.”

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