Over-the-Counter Medicines: What's Right for You?

Advice for Americans About Self-Care: Access + Knowledge = Power

American medicine cabinets contain a growing choice of nonprescription, over-the-counter (OTC) medicines to treat an expanding range of ailments. OTC medicines often do more than relieve aches, pains and itches. Some can prevent diseases like tooth decay, cure diseases like athlete's foot and, with a doctor's guidance, help manage recurring conditions like vaginal yeast infection, migraine and minor pain in arthritis.
The U.S. Food and Drug Administration (FDA) determines whether medicines are prescription or nonprescription. The term prescription (Rx) refers to medicines that are safe and effective when used under a doctor's care. Nonprescription or OTC drugs are medicines FDA decides are safe and effective for use without a doctor's prescription.

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FDA also has the authority to decide when a prescription drug is safe enough to be sold directly to consumers over the counter. This regulatory process allowing Americans to take a more active role in their health care is known as Rx-to-OTC switch. As a result of this process, more than 700 products sold over the counter today use ingredients or dosage strengths available only by prescription 30 years ago.
Increased access to OTC medicines is especially important for our maturing population. Two out of three older Americans rate their health as excellent to good, but four out of five report at least one chronic condition.
Fact is, today's OTC medicines offer greater opportunity to treat more of the aches and illnesses most likely to appear in our later years. As we live longer, work longer, and take a more active role in our own health care, the need grows to become better informed about self-care.
The best way to become better informed—for young and old alike—is to read and understand the information on OTC labels. Next to the medicine itself, label comprehension is the most important part of self-care with OTC medicines.
With new opportunities in self-medication come new responsibilities and an increased need for knowledge. FDA and the Consumer Healthcare Products Association (CHPA) have prepared the following information to help Americans take advantage of self-care opportunities. 

OTC Know-How: It's on the Label

You wouldn't ignore your doctor's instructions for using a prescription drug; so don't ignore the label when taking an OTC medicine. Here's what to look for:

• Product name
• "Active ingredients": therapeutic substances in medicine
• "Purpose": product category (such as antihistamine, antacid, or cough suppressant)
• "Uses": symptoms or diseases the product will treat or prevent
• "Warnings": when not to use the product, when to stop taking it, when to see a doctor, and possible side effects
• "Directions": how much to take, how to take it, and how long to take it
• "Other information": such as storage information
• "Inactive ingredients": substances such as binders, colors, or flavoring

You can help yourself read the label too. Always use enough light. It usually takes three times more light to read the same line at age 60 than at age 30. If necessary, use your glasses or contact lenses when reading labels.
Always remember to look for the statement describing the tamper-evident feature(s) before you buy the product and when you use it.
When it comes to medicines, more does not necessarily mean better. You should never misuse OTC medicines by taking them longer or in higher doses than the label recommends. Symptoms that persist are a clear signal it's time to see a doctor.
Be sure to read the label each time you purchase a product. Just because two or more products are from the same brand family doesn't mean they are meant to treat the same conditions or contain the same ingredients.
Remember, if you read the label and still have questions, talk to a doctor, nurse, or pharmacist. 

Drug Interactions: A Word to the Wise

Although mild and relatively uncommon, interactions involving OTC drugs can produce unwanted results or make medicines less effective. It's especially important to know about drug interactions if you're taking Rx and OTC drugs at the same time.
Some drugs can also interact with foods and beverages, as well as with health conditions such as diabetes, kidney disease, and high blood pressure.
Here are a few drug interaction cautions for some common OTC ingredients:

• Avoid alcohol if you are taking antihistamines, cough-cold products with the ingredient dextromethorphan, or drugs that treat sleeplessness.
• Do not use drugs that treat sleeplessness if you are taking prescription sedatives or tranquilizers.
• Check with your doctor before taking products containing aspirin if you're taking a prescription blood thinner or if you have diabetes or gout.
• Do not use laxatives when you have stomach pain, nausea, or vomiting.
• Unless directed by a doctor, do not use a nasal decongestant if you are taking a prescription drug for high blood pressure or depression, or if you have heart or thyroid disease, diabetes, or prostate problems.

This is not a complete list. Read the label! Drug labels change as new information becomes available. That's why it's important to read the label each time you take medicine. 

Time for a Medicine Cabinet Checkup?

• Be sure to look through your medicine supply at least once a year.
• Always store medicines in a cool, dry place or as stated on the label.
• Throw away any medicines that are past the expiration date.
• To make sure no one takes the wrong medicine, keep all medicines in their original containers.    

Pregnancy and Breast-Feeding

Drugs can pass from a pregnant woman to her unborn baby. A safe amount of medicine for the mother may be too much for the unborn baby. If you're pregnant, always talk with your doctor before taking any drugs, Rx or OTC.
Although most drugs pass into breast milk in concentrations too low to have any unwanted effects on the baby, breast-feeding mothers still need to be careful. Always ask your doctor or pharmacist before taking any medicine while breast-feeding. A doctor or pharmacist can tell you how to adjust the timing and dosing of most medicines so the baby is exposed to the lowest amount possible, or whether the drugs should be avoided altogether.  

Kids Aren't Just Small Adults

OTC drugs rarely come in one-size-fits-all. Here are some tips about giving OTC medicines to children:

• Children aren't just small adults, so don't estimate the dose based on their size.
• Read the label. Follow all directions.
• Follow any age limits on the label.
• Some OTC products come in different strengths. Be aware!
• Know the difference between TBSP. (tablespoon) and TSP. (teaspoon). They are very different doses.
• Be careful about converting dose instructions. If the label says two teaspoons, it's best to use a measuring spoon or a dosing cup marked in teaspoons, not a common kitchen spoon.
• Don't play doctor. Don't double the dose just because your child seems sicker than last time.
• Before you give your child two medicines at the same time, talk to your doctor or pharmacist.
• Never let children take medicine by themselves.
• Never call medicine candy to get your kids to take it. If they come across the medicine on their own, they're likely to remember that you called it candy.   

Child-Resistant Packaging

Child-resistant closures are designed for repeated use to make it difficult for children to open. Remember, if you don't re-lock the closure after each use, the child-resistant device can't do its job—keeping children out!
It's best to store all medicines and dietary supplements where children can neither see nor reach them. Containers of pills should not be left on the kitchen counter as a reminder. Purses and briefcases are among the worst places to hide medicines from curious kids. And since children are natural mimics, it's a good idea not to take medicine in front of them. They may be tempted to "play house" with your medicine later on.
If you find some packages too difficult to open—and don't have young children living with you or visiting—you should know the law allows one package size for each OTC medicine to be sold without child-resistant features. If you don't see it on the store shelf, ask.

Protect Yourself Against Tampering

Makers of OTC medicines seal most products in tamper-evident packaging (TEP) to help protect against criminal tampering. TEP works by providing visible evidence if the package has been disturbed. But OTC packaging cannot be 100 percent tamper-proof. Here's how to help protect yourself:

• Be alert to the tamper-evident features on the package before you open it. These features are described on the label.
• Inspect the outer packaging before you buy it. When you get home, inspect the medicine inside.
• Don't buy an OTC product if the packaging is damaged.
• Don't use any medicine that looks discolored or different in any way.
• If anything looks suspicious, be suspicious. Contact the store where you bought the product. Take it back!
• Never take medicines in the dark.