Common Misconceptions and Knowledge Gaps about OTC Medications

• OTC drugs are very safe and do not have a risk of causing harmful side effects or toxicity since they can be obtained without a prescription. 
• All OTC medications are safe enough to be taken for as long as I need to treat a certain illness or symptom.
• OTC medications are very different than prescription therapies.
• Since it is an OTC medication, I can use higher doses than indicated in the directions.
• I never need to consult with my doctor or pharmacist before starting an OTC medication.  
• OTC drugs behave the same in adults as they do in children and the elderly.

Since many OTC drugs were once prescription medications, many of them carry similar risks and potential toxicities of prescription products. For example: Tylenol (acetaminophen) which is one of the most widely used OTC pain relievers is responsible for about 450 deaths from acute liver failure, 56,000 emergency room visits, and 2600 hospitalizations each year in the U.S. . Another group of pain relievers known as NSAIDS  (OTC versions Advil (ibuprofen), Aleve (naproxen), Aspirin etc.) are responsible for an estimated 100,000 hospitalizations and possibly up to 20,000 deaths each year. In addition, OTC cough and cold medicines  (decongestants, expectorants, antihistamines, and antitussives (cough suppressants) )are another group of OTC drug products that can cause also cause potential serious harm and should not be used in infants or children under the age of two years. Thus, it cannot be assumed that all OTC medications have an excellent safety record.  Lastly, OTC medications (like all medications) may not behave as predictably in children and the elderly (as they do in adults) which could lead to serious side effects, adverse reactions, medical emergencies or even death. 

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Sources for this post include:

http://www.nytimes.com/2006/12/20/health/20drug.html?_r=2
http://www.ncbi.nlm.nih.gov/pubmed/3066202
http://www.slate.com/articles/health_and_science/explainer/2011/12/emergency_contraceptives_over_the_counter_are_they_more_dangerous_than_other_drugs_.html
http://www.healthsentinel.com/joomla/index.php?option=com_content&view=article&id=2668:more-hospitalized-from-nsaid-bleeding-than-all-american-war-casualties&catid=5:original&Itemid=24
http://pediatrics.aappublications.org/content/123/6/1464.short
http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/drugsafetyinformationforheathcareprofessionals/publichealthadvisories/ucm051137.htm
http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/drugsafetyinformationforheathcareprofessionals/publichealthadvisories/ucm051137.htm
http://pediatrics.aappublications.org/content/59/2/309.abstract?sid=9705c742-f0f4-4973-b6d2-019ce9abb11d
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116839.htm