In the U.S., serious medications are only permitted to be dispensed to consumers with a medical prescription from a licensed physician.
The country has established an electronic electronic platform of communication between pharmacies and medical institutions, which you cannot deceive. When a physician prescribes a particular drug, he or she informs the drugstore you have selected.
There are also medicines that do not require prescription. Such products are known as OTC drugs.
Table of Contents:
- What Is Over the Counter Drugs?
- Historical Background
- When Should You Use OTC Medicines
- What Over-the-Counter Medicines You Should Always Have In Your House?
- What Are The Risks Of Taking OTC Medicines?
- Drugs Labels And What They Mean
- Commonly Abused Drugs Sold Without a Prescription
- What Are The Basic Rules For Using OTC Drugs Properly?
- What If They Don’t Work?
- Lists Of Best-Selling Over-the-Counter Drugs
- Frequently Asked Questions
What Is Over the Counter Drugs?
Over-the-counter (OTC) drugs are those dispensed without a prescription.
OTC drugs are designed to help people fight many unpleasant symptoms and overcome certain diseases in a simple way, without spending too much on a visit to a physician. However, it is important to use these products safely and responsibly.
The US Food and Drug Administration (FDA) defines many drugs as over-the-counter. The most common nonprescription medicines are acetaminophen, ibuprofen, aspirin, dextromethorphan and loratadine. The list also includes toothpastes, mouthwashes, first aid creams and ointments containing antibiotics, dandruff shampoos, vitamins, nutritional supplements and nutraceuticals, etc. Each country has its own a list of medicines sold without a prescription.
Nonprescription drugs are not always well tolerated. For example, diphenhydramine (the OTC antihistamine and sedative mainly used to treat allergies, insomnia, and symptoms of the common cold) can cause adverse reactions that are just as serious as those caused by prescription pills, especially when used in the elderly.
At one time, medicines were mostly sold without a prescription. Before the U.S. Food and Drug Administration (FDA) came along, almost anything could be bottled and sold as a fail-safe drug. Some over-the-counter drugs contained alcohol, cocaine, marijuana and opium without notifying customers. The U.S. Food, Drug, and Cosmetic Act (FD&C) of 1938 gave the FDA certain powers to issue prescriptions but did not clearly define which drugs should be sold by prescription only, and which can be sold without a prescription.
An amendment to the Federal Food, Drug, and Cosmetic Act (FD&C Act), passed in 1951, was intended to clarify the differences between prescription and over-the-counter drugs and to address certain drug safety concerns. Prescription drugs have been defined as chemicals that are addictive, toxic, or unsafe when used without medical supervision. All other drugs were allowed to dispense without a prescription.
As noted in an amendment to the FD&C Act of 1962, over-the-counter drugs must be both effective and safe. However, determining efficacy and safety can be difficult. What is effective for one person may be ineffective for another; in addition, any drug may cause unwanted side effects (also referred to adverse events, or adverse reactions). An organized system for reporting adverse effects of over-the-counter drugs did not exist in the US until 2007, when a new law went into effect requiring companies to report serious adverse events associated with the use of over-the-counter drugs.
When Should You Use OTC Medicines
It is OK to use OTC drugs for most minor health issues or illnesses. If you are not sure which medicine you need and how to use it correctly, ask your physician or your pharmacist:
- Whether an OTC drug is suitable for your condition
- How the drug might interact with other medicines you are currently using
- What side effects can be used by this medicine
- How this medicine works
- How you should store it correctly
- Whether another drug might help you as well or even better
What Over-the-Counter Medicines You Should Always Have in Your House?
Some symptoms and conditions are so easy-to-treat and frequent that it makes sense to treat them without consulting a doctor. OTC medicines can help you with this.
If you are not sure which product you need, your local pharmacy can give you advice. As licensed healthcare professionals, they are able to provide information on how a particular drug works and how to use it properly.
Below is the list of OTC drugs that you should always keep at home in your first-aid kit:
- Pain relievers
- Treatments for indigestion, constipation & diarrhea
- Treatments for cold, flu and hay fever
- Sun protection spray, after sun lotion
- Basic first aid items
You can also purchase over the counter antibiotics. But as they are intended to treat specific bacteria, it is usually recommended to contact a healthcare professional prior to taking any.
If you have kids or pets, please make sure the medicines are stored away from them. While many drugs now have child-resistant packaging, they cannot still be considered 100% safe.
What Are The Risks Of Taking Over-the-Counter Medicines?
Over-the-counter medicines have adverse reactions as well as positive effects, just like any other medication. For instance, there are some nonprescription pain medicines you shouldn’t use if you have heart, stomach, kidney or liver problems, or if you are breastfeeding or pregnant.
Some OTC medicines and alternative health products can interact with other prescription or nonprescription drugs, making them less effective for the patient. Combining certain medicines may boost your chance of having side effects.
Always inform your healthcare provider or pharmacist about all prescription and OTC medicines you are using.
Drugs Labels And What They Mean
The US requires nonprescription medicines to have label instructions that inform the patient about the benefits and risks of using this product, as well as how to use it correctly. The information about the medicine include:
- Active ingredient: It is the component of a medication that’s responsible for its effects.
- Indications: The symptoms that suggest certain medical treatment is necessary.
- Warnings: Information about when you should not use this medicine, when to see your doctor or pharmacist, and what may deteriorate the affects of the drug.
- How to use: Information about how much and how often to take the drug in patients belonging to different age groups.
- Other information: Instructions on how to store the medicine so that it retains its activity.
- Auxiliary inactive ingredients: The medicinal product may contain substances that are added to facilitate the use of the drug, i.e. ingredients used to provide volume or a pleasant taste and smell. Medicines based on the same active substance may contain various auxiliary inactive ingredients. Auxiliary inactive ingredients are usually harmless, but some of them can cause side effects in a small number of people; these people should look for medicines that do not contain these kinds of ingredients.
Commonly Abused OTC Drugs
Regretfully, the accessibility of OTC drugs makes it easier to abuse them. Legal drugs are among the most abused medicines.
One of the most common reasons for OTC drug abuse are their addictive qualities. Patients with chronic ailments are at increased risk of getting addicted.
You can get addicted to the medicine if you take more than recommended. Also, continued use may cause the user to become dependent. Please be sure to read the information on the packaging and leaflets to find out if these negative reactions are likely.
The most commonly abused nonprescription medicines are treatments for:
- Pain (chronic or mild)
- Anxiety, panic attacks
- Insomnia or other sleeping problems
Some symptoms that you may be dependent – or becoming dependent – on your medicinal product:
- You are using the medicine even when it’s not required
- You can’t stop using the product, in spite of your desire to quit
- You’ve developed tolerance to the medicine and need to use a higher dose for the same effect
If you suspect you are becoming addicted to your drug, inform your doctor.
What Are The Basic Rules For Using OTC Drugs Properly?
We have some important tips for using over-the-counter medicines:
- Make sure your diagnosis is correct.
- Choose the formulation which best suits your health condition.
- Choose a drug with the fewest ingredients. Avoid using medicines that treat “many diseases at once”. Such products can expose the person to unnecessary drugs and additional risks. Besides, they tend to be more expensive.
- Read the label instructions for this medicine carefully to understand the correct dose.
- Pay special attention to the precautions to take, including when you should not use this product.
- If you are not sure, ask your healthcare provider or pharmacist what the active ingredient in this drug is.
- Check information about possible drug interactions.
- Ask the pharmacist to inform you about possible negative reactions.
- Do not exceed the recommended dose. Take exactly as much as you need.
- Do not take the product for longer than the doctor or the label directions tell you to. If you feel worse, stop using the drug.
- Keep the medicine out of the reach of children and pets.
What If They Don’t Work?
Your OTC drug may have a guidance printed on the packaging or leaflet that informs the patient how long your symptoms are expected to last. If they don’t, your pharmacist should be able to inform you.
If after this allotted time, you haven’t felt better or your symptoms got worse, you have the options to:
- Contact your healthcare provider
- Go to the drugstore for advice
- Call 911 (for an emergency only – if you are having any serious medical problem (chest pain, seizure, bleeding)
List of OTC Drugs Best Sold in the U.S.
According to the Washington, D.C.-based non-profit Consumer Healthcare Protection Association, the top-selling OTC drug categories in 2022 – 2023 are:
Allergies OTC Drugs
- Benadryl (25mg)
- Benadryl Liquid
- Cetirizine (10mg)
- Chlorpheniramine (4mg)
- Fexofenadine (60mg)
- Fexofenadine (180mg)
- Fluticasone Nasal Spray (60 &120 sprays)
- Ketotifen Eye Drops (Zaditor)
- Loratadine (10mg)
- Pataday Eye Drops (2.5ml, 5ml)
- Triamcinolone Nasal Spray
Cold/Cough/Sore Throat OTC Medicines
- Afrin Nasal Spray
- Ayr Saline Nasal Gel
- Cepacol Sore Throat
- Cepacol Sore throat & Cough
- Chloraseptic Spray
- Cold-Eeze Zinc Lozenges
- Dayquil Caps
- Daytime Cold & Flu Syrup
- DeepSea Saline DropsNeti Pot
- Guaifenesin Syrup
- Mucinex DM
- NeilMed Sinus Rinse Kit
- Nighttime Cough Syrup
- Nyquil Caps
- Q-Tussin DM Syrup
- SinuCleanse (Neti Pot Refill Pkts)
- Sudogest PE
Gastrointestinal Drugs OTC
- Acid Gone Tabs
- Almacone Liquid
- Famotidine (10mg)
- Gaviscon Tablets
- Lactaid Tablets
- Meclizine Tablets (25mg)
- Nexium OTC (14 count)
- Pepcid Complete
- Pepto Bismol – Chewable and Liquid
- Prilosec OTC (42 count)
- Simethicone Tablets (80mg, 125mg)
- Tums Chews
- Zegerid OTC (42 count)
Pain Relief Drugs OTC
- Acetaminophen Liquid (500mg/15ml)
- Acetaminophen (Tylenol, 325mg, 500mg)
- Acetaminophen PM
- Acetaminophen ER (650mg)
- Acetaminophen, Aspirin & Caffeine
- Aspirin (81mg, 325mg)
- Ibuprofen (Advil)
- Ibuprofen Suspension (100mg/5ml)
- Naproxen Sodium (Aleve, 220mg)
- Midol Complete
- Urinary Pain Relief
- Calcium Citrate + D (Citracal)
- Cerovite multi-vitamin/multi-mineral
- EmergenC (1,000mg 10pk Raspberry, Orange)
- EmergenC Energy+ Gummies
- Melatonin (3mg, 5mg, 10mg)
- One-a-day Women’s Vitamin
- Omega 3 Fish Oil (1,000mg)
- Vitamin A (10,000 IU)
- Vitamin B Complex
- Vitamin B-6 (25mg)
- Vitamin B-12 (1,000mcg)
- Vitamin C (500mg)
- Vitamin D3 (2,000 IU)
- Vitamin D3 (400 IU)
- Vitamin D3 1,000 IU
- Vitamin E (400 IU)
Frequently Asked Questions
Are Over-the-Counter (OTC) Drugs Safe To Use?
Over-the-counter medications can still cause side effects and interact with certain drugs, even though they are dispensed without a prescription. This risk is typically due to excessive doses. Users should read the drug label carefully. All patients should see their doctor, pharmacist or other health care provider if they have any questions or doubts concerning nonprescription drug use. Pregnant and breastfeeding women should consult their doctor before taking any drugs, vitamins, or herbal supplements, even if it’s sold without a prescription.
Are There OTC Antibiotics?
You can purchase some topical antibiotics over-the-counter. Some nonprescription topical antibiotics include: Bacitracin (Neosporin), Polymyxin (Polysporin), Neomycin (Neosporin Plus Pain Relief), Pramoxine., Benzoyl peroxide (Proactiv).
Where Can I Buy OTC Drugs?
These drugs are usually located on shelves in pharmacies, grocery stores, and even in gas stations. Some of the best places to buy nonprescription medicines are Walmart,Target, Rite-Aid, CVS, Walgreens, Health Mart, Cigna, UnitedHealth Group, and Kroger, Good Neighbor Pharmacy, Safeway Pharmacy, The Vitamin Shoppe, Albertsons Pharmacy, GNC
Can I Buy Over-the-Counter Drugs Online?
Yes. Many online pharmacies offer OTC medicines, often with free shipping. Examples include Sesame, Amazon Pharmacy, CVS, Pill Pack, Doctor Solve, Capsule, Mail My Prescriptions, Blink Health, Honeybee Health, GeniusRx, Health Warehouse, CanDrugstore, Express Scripts Pharmacy, Rx Outreach, DiRx, BioPlus, and SelectRX.
Does The FDA Review Over-the-Counter (OTC) Drugs?
The review of OTC drugs is predominantly handled by the U.S. Food and Drug Administration’s (FDA) Division of Drug Information (CDER), the Nonprescription Drug Advisory Committee, and the Center for Drug Evaluation and Research. These agencies evaluate and review over-the-counter ingredients and labels. They establish an OTC drug monograph for each class of medicinal product. It contains acceptable ingredients, formulations, doses and labeling.