There’s no shortage of options for over-the-counter medications, which can help improve minor health issues and provide remedies for countless conditions like the common cold, acne, heartburn, cough, allergies, headaches and more. Millions of Americans rely heavily on OTCs because they are cost effective, easily accessible and many work. According to Consumer Healthcare Products Association, “81 percent of adults use OTC medicines as a first response to minor ailments.” In addition, CSPA states, “The availability of OTC medicines — off the shelf, without a prescription — provides symptomatic relief for an estimated 60 million people who otherwise would not seek treatment. Without affordable and accessible OTCs, underserved populations would depend more heavily on the highest cost medical care for minor ailments. One in four Medicaid patients and one in ten uninsured individuals would seek treatment in an Emergency Department as their first recourse for treatment. U.S. consumers make 26 trips a year to purchase OTC products. They only visit doctors, on average, three times a year.”

OTCs not only offer affordable treatment options and help better consumer’s health, but also the nonprescription meds can save the healthcare industry money, the CSPA says, “For every dollar spent on OTC medicines, the U.S. healthcare system saves more than seven dollars.” People lower their healthcare costs as well by using OTCs, according to the CSPA. “86 percent of U.S. adults believe responsible OTC medicine use helps lower healthcare costs for people like them…Consumers and taxpayers could save $5.2 billion annually if half of the unnecessary visits to primary care physicians were avoided by more self-care, including greater use of OTC medicines…By keeping the American workforce healthy and at work, OTC medicines offer $34 billion in potential productivity benefits from avoided doctor’s office visits and time not having to be away from work for medical appointments.”

Although the U.S. Food & Drug Administration states OTCs, “are safe and effective when you follow the directions on the label and as directed by your health care professional,” there can be harmful side effects to be aware of. According to University Hospitals, “NSAIDs sometimes cause bleeding in the stomach and digestive tract. This is true even in normal doses. Talk with your healthcare provider to find out what food to eat before taking certain pain relievers such as NSAIDs.” In addition, some OTC products are ineffective and not worth the money, but there are many that pharmacists recommend to help alleviate symptoms that work.  Eat This, Not That! Health spoke with several pharmacists who share their top OTC picks and why. As always, please consult your physician or pharmacist for medical advice on OTC products. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

Joanna G. Lewis, PharmD, MBA with The Pharmacist’s Guide explains, “When taken in the recommended dosage, OTC products can be a great, effective and safe way to treat an ailment. But, just because a medication is over the counter, does not mean it is safe. Common drugs like Benadryl and Tylenol have multiple interactions and can have serious complications if you take a higher than recommended dose. Herbal supplements are over the counter as well. While many have not been effectively studied, we do have documentation to support the interactions between some medications and diseases. All herbal supplement use should be disclosed to your health care provider so that they can check for interactions.” 

HaVy Ngo-Hamilton, Pharm.D, BuzzRx Clinical Consultant tells us, “OTC products are very effective at treating certain mild to moderate illnesses including coughs and colds, congestion, stomach upset, minor pain, ache, and fever. Generally, OTC products, when used exactly as instructed, are safe for healthy individuals. However, just like any medication, OTC can interact with other drugs leading to low drug levels or unwanted side effects. Not to mention, if you have kidney or liver disease, some of the effects can be quite detrimental.”

Scott McDougall, MPharm with The Independent Pharmacy says, “For a medication to be made available over the counter, it must prove to be extremely safe for general use, with any potential side effects being minimal and ultimately inconsequential. Every medication is obviously intended to be effective, but it’s necessary to err on the side of caution. Due to this, in addition to staple products that reliably work (basic painkillers, for instance), the range of OTC meds also includes some that semi-frequently fail to get results. Through trial and error, at least, people with recurring issues can often find OTC treatments that work for them. When symptoms are too strong (or too unusual) to be effectively treated using such meds, the meds necessary to address them are generally too potent or susceptible to misuse to be sold without professional medical guidance. Alternatively, they may simply be new and unproven.”

Dr. Suzanne Soliman, PharmD, BCMAS & Founder of Pharmacist Moms Group, Chief Health Officer, ACMA, NJ Board of Health Member explains, “If you’re taking an OTC medication for cold and respiratory issues, “It is important to note what the symptoms are before taking a cough/cold medication.  Consider talking to your pharmacist. Some cough/cold products are formulated for the morning while others are nighttime. Morning products typically contain an expectorant like guaifenesin. Those for night time will not have a decongestant because those can make someone stay awake and not let them sleep easily. Antihistamines which have a side effect of sedation or drowsiness are often in the evening formulation.” 

Dr. McDougall lists the following reasons why people take OTC products. 

—“They’re convenient to acquire. For those who only use brick-and-mortar pharmacies, getting their prescriptions filled can be a frustrating process requiring rescheduling and waiting for assistance. OTC medication is sold so broadly that finding the desired product is often as simple as going to the nearest store.

–They aren’t particularly intimidating. Many OTC medications are familiar from childhood, and those that aren’t inevitable feel trustworthy because they’re so readily available. People wary about strong treatments due to their possible side effects may opt to stick with treatments that are safe but potentially ineffective.

–They don’t require consultations. It’s reasonably common for people to avoid doctors and other medical professionals. For some, this is because they fear bad news. Grabbing OTC meds is a low-effort move.

–They’re reasonably cheap. Some medical systems partially or entirely cover the costs of prescription meds. To those who can’t discount their treatments in any way, it can seem reasonable to opt for cheap OTC meds instead of funding expensive niche products. If one OTC product doesn’t work, someone can simply try another.

–They’re often formerly-prescribed treatments. If a prescription treatment enters widespread use and proves highly effective over years without producing any major side effects, the need for a prescription can be removed. This means that long-term users of particular prescription medications can end up getting them in over-the-counter forms.”

Dr. Soliman says, “OTC medications are easily accessible to patients. They also do not require a prescription which allows for patients to access them easier,” while Dr. Lewis shares, “The most common OTC class of products is analgesics or pain relievers. Medications like Tylenol, Advil and Naproxen are great for pain relief, inflammation and for reducing fevers. People also commonly take OTCs for headache relief, constipation, allergies, heartburn and cough, cold and flu treatment.” In addition, “Dr. Ngo-Hamilton says, “Convenience and easy access to OTC drugs at local drug stores is one reason so many people turn to the products. OTC medicine is a more affordable option compared to a doctor’s visit and there’s easy access to the internet where people can look up their symptoms and try to self-medicate.”

Dr. Ngo-Hamilton says, “Even though Tylenol and Advil are two different drug classes, they both can be used for pain relief, and I believe that every household should have both of these medicines on hand. If you have small children, you should keep the oral liquid form of both medicines as this will definitely come in handy when your little one runs a fever late at night. Both medicines can be used for fever, minor aches, and pain; however, Advil is more effective in reducing inflammation and pain. Both medicines are generally safe for most people. Keep in mind that ibuprofen, the active ingredient in Motrin and Advil, is not recommended if you have kidney disease and uncontrolled high blood pressure. And, acetaminophen (Tylenol) can cause liver injury if you consume a large amount of alcohol over a long period of time. If you are not sure which of these two drugs is a safe option for you, it is always a good idea to talk to your local pharmacist or your primary care physician.Wonder if you can use both Tylenol and Advil at the same time? The short answer is yes – you can alternate between these two drugs because they work better together to relieve pain and fever that won’t go away with one medicine. It is important to keep track of the time and the amount of each medication that you take so that you don’t exceed their maximum daily doses.”6254a4d1642c605c54bf1cab17d50f1e

Dr. Lewis tells us, “Tylenol is an analgesic and antipyretic which means it is used for pain relief and to reduce a fever. People commonly take this for body aches, headaches, toothaches, arthritis and fever. Tylenol is also considered one of the more dangerous medications so you need to make sure you are following package directions when you take this medication. It is important to know that Tylenol is included in many combination cough, cold and fever products. When taking one of those products, you should not be taking additional Tylenol and should not exceed 3,000mg daily. Tylenol, when taken in doses higher than recommended, can result in liver failure. Tylenol is responsible for many accidental overdoses and hospital visits each year. “

Dr. Soliman adds, “Pain medications such as Advil, Tylenol, Motrin. It is important to check for allergies. Note that Tylenol should not be used in liver impairment and using it chronically especially at high doses can be bad for the liver. NSAIDs should not be taken for long periods of time either so it is important to determine what pain you are treating.”  

Dr. Ngo-Hamilton states, “Neosporin is a topical antibiotic, it is commonly referred to as the “triple antibiotic.” This topical antibiotic ointment can be used to prevent and treat skin infections caused by minor cuts, scrapes, and burns. This ointment can be used for both adults and children, but I highly recommend having this ointment and different sizes of bandages in your medicine cabinet if you have small children. Please keep in mind that Neosporin is not intended to be used for serious injuries such as animal bites, puncture wounds, and bad burns, a trip to the emergency room or urgent care is warranted in those instances. If your child is younger than 2 years old, you should consult with a doctor first to ensure safety.”

Dr. McDougall shares, “We all suffer cuts and scrapes, and they’re all vulnerable to infections. And though it’s usually enough to clean a wound with soap and water, it’s best to prepare for emergency situations. Topical treatments such as neomycin/polymyxin B/bacitracin (Neosporin) are invaluable for disinfecting wounds and treating infections that have already taken hold.”

Dr. Lewis explains, “Prilosec is a proton pump inhibitor used for heartburn relief. Prilosec is most effective when taken on an empty stomach, first thing in the morning with a full glass of water. Also, it is important to remain upright for 30 minutes after taking this medication (don’t lie down) so that the medication can travel to your stomach. Prilosec can interfere with the absorption of some medications so do not take this without talking to your doctor first – especially if you are taking blood thinners, antidepressants, anxiety, and some heart and anti-seizure medications. Prilosec can cause headache, nausea, stomach pain, constipation and/or diarrhea. Prilosec is also meant to only be used short-term. Discuss with a health provider if you need it for longer than 14 days.” 

According to Dr. Soliman, “Heartburn medications also known as proton pump inhibitors. Certain over the counter heartburn medications can mask the signs and symptoms of gastric cancer. Should not use them for longer than 2 weeks. Can take for a short term but do not want to take long-term without being monitored by your healthcare provider.” 

According to Dr. Lewis, “These medications used to be available by prescription only, but the FDA has deemed them safe for consumer use without that additional health care oversight (you should still let your doctor know, though!). These drugs are antihistamines and treat runny nose, congestion, sneezing, itching and hives. Many people take these medications for seasonal allergies. Antihistamines can cause drowsiness and headache, but most people only experience mild side effects, if any. However, if you develop rash, itching, swelling or trouble breathing, consult your provider immediately. If you have asthma, liver or kidney disease, you also need to consult your provider before taking these medications.” 

The Mayo Clinic states, 

“It’s especially important to talk to your doctor about taking allergy medications in the following circumstances:

• You’re pregnant or breast-feeding.
• You have a chronic health condition, such as diabetes, glaucoma, osteoporosis or high blood pressure.
• You’re taking other medications, including herbal supplements.
• You’re treating allergies in a child. Children need different doses of medication or different medications from adults.
• You’re treating allergies in an older adult. Some allergy medications can cause confusion, urinary tract symptoms or other side effects in older adults.
• You’re already taking an allergy medication that isn’t working. Bring the medication with you in its original bottle or package when you see your doctor.”

Dr. Ngo-Hamilton explains, “Tums, along with other antacids such as Mylanta, Maalox, and Alka-Seltzer are affordable and effective OTC products to relieve symptoms of heartburn and indigestion. Antacids work to neutralize stomach acid. Fatty meals and eating right before bedtime are some of the contributing factors to heartburn; therefore, practicing and maintaining a healthful lifestyle is the goal for everyone. However, in reality, demanding careers and other daily responsibilities, sometimes, get in the way of set meal times and healthy food choices. So, when you experience the unpleasant symptoms of indigestion and heartburn, antacids are great options since they start working within minutes to relieve these symptoms.I can’t emphasize enough the importance of healthy habits. 

Even though Tums and other antacids are relatively safe for most people, they are intended for occasional use only. If you have long-lasting or frequent heartburn and acid reflux, you should reach out to your primary care doctor to discuss different treatment options to go along with lifestyle modifications. And just like any medication, if you have other health problems with or without taking medications for them, the best practice is always to talk to a doctor or pharmacist first before starting taking antacids.”

According to the Cleveland Clinic, some medications can be confused as antacids and states, “Several types of medicines treat heartburn or indigestion but are not antacids because the ingredients work in different ways than those of antacids. Common medicines that are not antacids include:

• Esomeprazole (Nexium ®): Treats acid reflux and ulcers.
• Famotidine (Pepcid ®): Treats stomach ulcers, esophagitis, GERD.
• Omeprazole (Prilosec ®): Treats stomach and esophagus problems.
• Pantoprazole (Protonix ®): Treats stomach and esophagus problems and GERD.
• Simethicone (Gas-X ®): Treats gas and bloating.

Antacids are a great source of relief from symptoms of heartburn and indigestion, especially if you just ate hot wings or spicy food. Always follow dosage instructions on the label and talk with your healthcare provider before taking antacids to see if they will interfere with any medicines that you’re currently taking.”