Posted by William Nunnelley on 2000-04-26

More than 600 health medication products have gone from prescription to nonprescription status with the blessing of the U.S. Food and Drug Administration during the past two decades.

As a result, consumers can purchase over-the-counter (OTC) medications virtually anywhere - from the gas station to the grocery store - not just in a pharmacy.

Does this represent a potentially dangerous situation for consumers?

Yes, says Samford University pharmacy professor Michael D. Hogue, if consumers don't pay attention to the product labeling that accompanies OTC drugs.

"The fact is that OTC drugs are drugs," said Hogue. "They are chemicals that alter the body's function, and even though they are taken to correct minor problems like a headache or cold symptoms, people taking OTC drugs run certain risks."

Hogue, a practicing pharmacist and faculty member at Samford's McWhorter School of Pharmacy, is a spokesman on OTC drug use for the American Pharmaceutical Association. He spoke recently (March 14) at an APhA media briefing in Washington.

OTC drugs are made available when they have been proven safe and effective AND when their manufacturers have provided labeling that is easy to understand. But a consumer who fails to follow such labeling runs the risk of creating new problems while trying to correct an existing malady, or of causing dangerous drug interactions, interfering with other conditions the person may have or even of masking more serious health problems.

Hogue lists several examples of potentially widespread misuse.

1) Ibuprofen. This OTC product can be taken safely for headache or muscle aches and pains if package instructions are followed precisely. But taking a much higher dose for longer than recommended can produce serious ulcers. And certain medications that interact with ibuprofen greatly increase the risk of complications.

2) Antacids. Taking OTC antacids (Maalox, Milk of Magnesia or Tums) is fine for treating upset stomach. But a person fighting infection with prescription antibiotics may render them ineffective by also taking antacids, which prevent certain antibiotics from being absorbed into the blood stream.

3) Herbal medicines. While herbal and nutritional remedies are effective at preventing or treating certain conditions, these largely unregulated products have the potential for drug interactions and disease complications.

4) Pharmacy-hopping. Consumers run a risk by purchasing OTC products from multiple sources (the corner drugstore, chain stores and/or Internet pharmacies). Wherever they buy drugs, they should understand the importance of the pharmacist having their complete medical history.

Hogue suggests that consumers do two things when taking OTC drugs - read the labels and talk to the pharmacist.

This is important, says Hogue, because consumers will increasingly have access to drug products that at one time required a prescription.

"Coupled with the increasing number of prescription agents being added to the market, the potential for OTC and prescription drug interactions is great," says Hogue. "Selecting the right OTC product is not as simple as picking a product off of the shelf."