Abuse of over-the-counter medicines: a pharmacist’s perspective

Figures & data

Table 1 List of over-the-counter medications abused

Class/therapeutic group	Medication example
Antihistamines^Citation40,Citation41	Diphenhydramine and coricidin
Cough medicines^Citation42	Cough medicines containing dextromethorphan
Codeine-containing products^Citation7	Compound analgesics (codeine with ibuprofen or paracetamol) and cough medicines
Analgesics^Citation43	Aspirin and acetaminophen
Hypnotics^Citation40	Sominex and nytol
Laxatives (oral and rectal)^Citation7,Citation44	Sodium phosphate laxatives and laxatives containing bisacodyl
Decongestants^Citation45	Pseudoephedrine

Table 2 Common strategies used by pharmacists to control over-the-counter medication abuse

Target locations	Pharmacist-initiatied strategies
In a pharmacy	Refusing sales
	Contacting other pharmacies to warn them of the suspicions of a customer who may be abusing a product
	Claiming products were not in stock
	Prevent supplies by hiding medicines
	Supplying only limited amounts
Patient involvement	Counseling customers about the abuse potential of products
	Raising awareness of Internet-based support groups among patients by advising them
	Providing information leaflets
Physician involvement and other services	Working on general practitioner engagement/consultation
	Providing referral to doctors
	Using private clinic services
	Using specialist drug services and drug and alcohol treatment services

Note: Data from Cooper⁷ and Paulose-Ram et al.⁴⁶

Table 3 Medications potential for transition to behind-the-counter category

Indication of medication	Example
High cholesterol	Statins^Citation47,Citation48
Blood sugar level maintaining	Insulin^Citation49
Cold remedies	Pseudoephedrine and ephedrine^Citation48^–^Citation50
Schedule V cough syrups	Certain codeine-containing products^Citation49,Citation50
Emergency contraceptives	Plan B^Citation48,Citation49
Painkillers	Painkillers with small amounts of codeine (up to 12.8 mg per tablet) and aspirin^Citation51,Citation52
Sleep aid/allergy	Diphenhydramine^Citation52

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