You walk into a pharmacy and there are hundreds of them — over-the-counter medications aimed at treating a variety of issues and illnesses.
These over-the-counter (OTC) products are sold by the millions in the US and used by many Americans to treat health problems in a way that does not require a doctor's prescription.
It is clear that these medications are common, but which are used the most? And are we using them properly?
The American College of Preventive Medicine (ACPM) reported that the most commonly sold OTC oral products in the US during 2009 were cough/cold and allergy remedies. Over 711 million pack units of this type of OTC medication were sold during 2009 in the US.
According to the US National Library of Medicine (NLM), this group of OTC medications includes nasal decongestants, such as pseudoephedrine (brand name Sudafed Congestion), which work to relieve a stuffed-up nose; cough suppressants like dextromethorphan (Delsym), which work to ease coughing; and expectorants, like guaifenesin (Mucinex), which work to loosen up mucus so that it may be coughed up.
Easing the Pain
The second most common OTC products are analgesics, or pain medications. ACPM reported that over 430 million pack units of these medications were sold in the US during 2009.
One common analgesic is acetaminophen (brand name Tylenol), which, according to NLM, works to relieve fever, headaches and other aches and pains, but not inflammation.
Non-steroidal anti-inflammatory drugs (NSAIDs) are a form of analgesics that do tackle inflammation. This type of medication includes aspirin, ibuprofen (Advil) and naproxen (Aleve). NLM reported that NSAIDs fight fever, pain and swelling, such as that from arthritis or a strained muscle.
Beating the Bloat
Antacids and anti-gas products are the third most common OTC medications. Americans bought over 173 million pack units of these medications during 2009.
"Antacids help to treat heartburn (indigestion)," explained NLM. "They work by changing the stomach acid that causes your heartburn."
Common antacids include calcium carbonate (Tums) and aluminum/magnesium antacid (Maalox). Anti-gas medications like simethicone (Gas-X) work to relieve discomfort from excess gas in the gastrointestinal tract.
Moving Digestion Along
The next most common type of OTC medication — laxatives — also deals with digestion. According to ACPM, over 114 million pack units of laxatives were bought in the US during 2009.
These medications come in a variety of forms, including stool softeners, like docusate (Colace), which allow more moisture to enter the stools, softening them to create an easier bowel movement.
Another common form of laxatives are oral stimulants, like sennosides (Senokot), which trigger contractions of the intestinal muscles. These contractions help move the process along and stimulate a bowel movement.
Soothing the Stomach
Rounding out the list of the top five most commonly used OTC medications are diarrhea remedies, of which over 22 million pack units were sold in the US during 2000.
These medications include loperamide (Immodium A-D) and bismuth subsalicylate (Pepto-Bismol). According to the American Academy of Family Physicians (AAFP), loperamide slows down the processes of moving materials through the bowels.
"Bismuth subsalicylate works by balancing the way fluid moves through your intestines," explained AAFP. "It also reduces inflammation and keeps certain bacteria and viruses that cause diarrhea from growing in the stomach and intestines."
Though these products are incredibly common and can be helpful, they are still medications that need to be used carefully and properly.
While ACPM writes that these medications "play an increasingly vital role in our healthcare system and are the most prevalent means of treating the majority of common health problems in the United States," the organization also pointed out some issues in the medications' use.
ACPM reported that while around 95 percent of Americans are thought to read some part of the label on OTC products, only 51 percent are thought to refer to the label for usage information when using an OTC medication for the first time.
In an interview with dailyRx News, Goldina Ikezuagu Erowele, PharmD, RPh, a Clinical Pharmacy Specialist based in Houston, said that the easily accessible nature of these medications does not necessarily mean complete safety.
"Consumers, patients and caregivers assume that because a drug is 'over-the-counter' it means safer, since it is readily available," said Dr. Erowele. But she noted that these medications still may have side effects and could potentially interact with other treatments.
"When a physician or pharmacist asks about medications taken on a daily basis, the medication list must include prescription medications, OTCs, plus herbal, natural supplements," explained Dr. Erowele.
Despite the benefits of easy availability and quick access inherent in OTC medications, there are plenty of potential problems to be considered, including improper use, incorrect self-diagnosis and the potential for medication interactions. These potential problems should be considered when using OTC medications, and directions on labels should always be followed.
"Educating patients and consumers on the role of pharmacist education and recommendations is also critical and imperative to reduce medication adverse effects and improve outcomes," said Dr. Erowele.
Talk to your doctor before starting any new medication.