Over-The-Counter Medicine

What are over-the-counter medicines?

Over-the-counter (OTC) medicines are medicines you can get without a prescription. They’re for conditions you can recognize and manage yourself, or conditions a healthcare provider diagnosed. You can buy them in pharmacies, grocery stores, convenience stores or even online.

OTC medicines are generally safe if you do two things:

• Use them with direction from a healthcare provider
• Follow the instructions on their labels

It’s also important to remember that OTC medicines are for minor ailments only, and you shouldn’t take them regularly. If you feel you need to take them regularly, you should see a healthcare provider. A trained, qualified expert can tell you if something more serious is happening.

What do over-the-counter medicines treat?

OTC medicines treat hundreds of issues, if not more. Some examples of what they treat include:

• Allergies, including seasonal environmental allergies or skin reactions
• Eye and ear issues, including dry eyes, eye irritation or ear pain
• Feet issues like corns and calluses, or ingrown toenails
• Fevers and inflammation
• Hygiene needs, including hair, odor and oral health concerns
• Skin infections, including bacterial, fungal and parasitic infections, and first aid items to prevent infections in cuts and scrapes
• Trouble sleeping
• Lower digestive system issues like bloating or farting, constipation or diarrhea
• Pain, including headaches, muscle aches, ovulation pain, menstrual cramps and more
• Breathing issues, like symptoms from upper respiratory infections
• Skin conditions, including acne or warts, or scalp conditions like dandruff or head lice
• Smoking and vaping quitting support
• Upper digestive system issues like nausea and vomiting

What are some examples of over-the-counter medicines?

Some examples of OTC medicine types include:

• Acid reflux medications, like antacids, H2 blockers and proton pump inhibitors (PPIs)
• Allergy medications, ranging from fast-acting drugs to once-a-day oral and nasal medications for seasonal allergies
• Antiemetic medications, which usually focus on reducing or stopping nausea
• Cough, cold and flu medicines, including cough suppressants, decongestants and expectorants
• Eye drops or ear drops for a wide range of issues
• Infection treatments, like ointments for bacterial, fungal and parasitic infections
• Laxatives and antidiarrhea medications
• Nicotine replacement products
• Opioid overdose rescue medications
• Pain relievers, fever reducers and anti-inflammation medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs)
• Sleeping pills and similar products

Common OTC medications

Some examples of specific OTC medicines include:

Acid reflux or heartburn medications

• Cimetidine (Tagamet®)
• Esomeprazole (Nexium®)
• Famotidine (Pepcid® and higher-dose forms of Zantac®)
• Lansoprazole (Prevacid®)
• Nizatidine (Axid®)
• Omeprazole (Prilosec® and Zegerid®)
• Ranitidine (lower-dose forms of Zantac)

Allergy medications

• Budesonide (Rhinocort®)
• Cetirizine (Zyrtec®)
• Desloratadine (Clarinex®)
• Diphenhydramine (Benadryl®)
• Fexofenadine (Allegra®)
• Fluticasone (Flonase®, Flovent®)
• Loratadine (Claritin®)
• Triamcinolone (Nasacort®)

Antiemetic (antinausea) medications

• Dimenhydrinate (Dramamine®)
• Meclizine (Antivert® or Bonine®)
• Scopolamine (Transderm Scop®)

Cough, cold and flu medicines

• Pseudoephedrine (Sudafed®)
• Guaifenesin (Mucinex®)
• Dextromethorphan (Delsym®)

Nicotine replacement products

• Gum or lozenges (NICOrelief® or Nicorette®)
• Patches (Habitrol®, Nicoderm CQ®, Nicotrol®)

Opioid overdose rescue medications

• Naloxone (Narcan®)

Pain relievers, fever reducers and nonsteroidal anti-inflammatory drugs (NSAIDs)

• Acetaminophen (Tylenol® or Panadol®)*
• Aspirin
• Ibuprofen (Advil® or Motrin®)
• Naproxen (Aleve® or Naprosyn®)

*Acetaminophen isn’t an NSAID, but has some similar properties to them

Sleep aids

• Diphenhydramine (in the PM versions of Advil, Aleve and Tylenol)
• Doxylamine (Unisom®)

What are the top five over-the-counter medications?

The top five types of OTC medicines, ranked by annual dollars spent in 2022, are:

• Digestive tract medications
• Cough, cold and flu medicines
• Pain relievers
• Allergy medicines
• Topical skin medications

Who decides what medicines are available over-the-counter?

In the U.S., the Food and Drug Administration regulates OTC medicines. They regulate these medicines and require that drugmakers follow rules and meet standards when making them.

Many OTC medications started out as prescription-only. They became available over the counter after experts decided they were safe enough for use without a prescription (when taken as instructed). But many other medications go straight to OTC use.

How do I take over-the-counter medicines safely?

All OTC medicines have an instructions label, and following that label is key to using these medicines safely. Pay close attention to these sections on any OTC medicine label:

• Active ingredient(s): These are the main ingredients. Knowing them helps you avoid taking the wrong medicine or too much of the same ingredient in multiple products.
• Purpose(s): This tells you what a medicine does or what drug class it belongs to.
• Use(s): You should only take a medicine for the reasons listed.
• Warning(s): Don’t take the medicine if any of the warnings listed here apply to you.
• Inactive ingredients: These are other substances that are included in the medicine. Examples include flavorings or dyes, or what the capsules are made of. Read these closely, too. This is very important if you have any allergies.
• Directions. This tells you the dose and how to take it. Follow these exactly.

You should read the label to find info on how to store OTC medicines properly. And be sure to check the label so you don’t take expired medicines.

If you have any questions about a medicine label or taking an OTC medicine, ask your healthcare provider or pharmacist. They can answer your questions and help you stay safe.

What are some key tips for finding and using over-the-counter medicines safely?

• Many OTC products contain acetaminophen. Be careful not to take too much acetaminophen if you’re using multiple products. And avoid drinking alcohol when taking acetaminophen.
• Many places limit pseudoephedrine access. In the U.S., it’s a “behind-the-counter” product. You can get it without a prescription, so it’s technically an OTC medicine. But you have to go through extra steps, like an ID check. In some countries, it needs a prescription.
• Decongestants can be dangerous for some people. Don’t take them if you have high blood pressure, cardiovascular disease, thyroid disease, glaucoma or benign prostatic hyperplasia (BPH).
• Don’t take heartburn/GERD products for more than 14 days without talking to a healthcare provider.
• Avoid NSAIDs if you have digestive tract, kidney or cardiovascular conditions. Only take them if your healthcare provider says it’s okay. And don’t take any NSAIDs if you’re 20 weeks pregnant or more.
• Phenylephrine is a common ingredient in many decongestants. But it’s under scrutiny because newer research raises questions about whether it’s effective.
• Avoid drug interactions. Many OTC medicines can interact with antidepressants (especially MAOIs) and cause deadly conditions like serotonin syndrome. Talk to a healthcare provider before taking decongestants or dextromethorphan if you already take an antidepressant.

Your healthcare provider or pharmacist can tell you more about interactions or other potential concerns with any prescription or OTC medicines you take.