Over-the-counter Research Articles (Page 1)

Unsafe abortions contribute to approximately 8-11% of global maternal fatalities and predominantly occur in low- and middle-income nations. The Medical Termination of Pregnancy (MTP) Act enacted by the Indian Parliament in 1971, aimed at regulating and ensuring the accessibility of safe abortion services. Following the enactment of this legislation, a legal framework was established for abortion in India. This act delineates the circumstances under which abortion may be performed, the locations suitable for such procedures, and the qualified personnel authorized to carry them out. The World Health Organization (WHO) and the Federation of Obstetric and Gynecological Societies of India (FOGSI) have developed comprehensive guidelines for pre-abortion assessments, including the confirmation of pregnancy, accurate determination of gestational age, and validation of the intra-uterine location of the pregnancy. In spite of the relatively progressive abortion care services available in India, a significant number of women resort to self-medication with unsupervised over-the-counter (OTC) abortion pills for MTP. This practice results in a considerable incidence of unsupervised abortions and potentially life-threatening complications. We present herein a series of case reports documenting instances of OTC abortion pill consumption that led to morbidity and perilous situations, including near-miss cases that necessitated urgent medical and surgical interventions. Furthermore, we illustrate how our support and care have played a pivotal role in fostering resilience and faith in these women.

Owner-led self-medication for companion animals is a growing global practice; however, empirical data from Japan remain limited. Framing medication safety within a One Health perspective, this study aimed to characterize Japanese pet owners’ use of over-the-counter (OTC) drugs and identify possibilities for pharmacists to support rational self-medication. A cross-sectional 13-item online survey was administered to 500 owners in Japan between 30 May and 2 June 2025. Data on owner demographics, willingness to consult pharmacists, veterinary visit behavior, and OTC purchasing practices were summarized. Many owners were receptive to pharmacy support; 65% wished to consult a pharmacist, and 6.8% had already done so. Overall, 15.2% reported using OTCs drugs, primarily for treatment or prevention and prioritized perceived effectiveness and safety when selecting products. Some owners managed mild pet illnesses at home, citing perceived mildness and cost as reasons for not visiting a veterinary clinic. There is an unmet demand for accessible expert counseling at the point of purchase. Leveraging community pharmacies linked with pet specialty pharmacies as first-contact hubs could promote appropriate self-medication; doing so would require veterinary-specific training, establishing a formal credential for veterinary pharmacists, and defining pharmacist–veterinarian communication to ensure safe and effective use.

Parental perspectives on pain detection, assessment, and management in their highly dependent children with cerebral palsy: A cross-sectional study.

Dipyrone induces sex-dependent latent sensitization in a preclinical model of medication overuse headache.

BackgroundAddressing healthcare communication skills through a multimedia approach may enrich undergraduate pharmacy students’ medication counseling competence. This study explored the impacts of a blended classroom teaching approach (incorporating newly designed video-based materials into conventional slide-based lectures) on students’ self-efficacy and performance in over-the-counter (OTC) medication counseling services.MethodsUsing a sequential explanatory mixed methods approach, two cohorts of undergraduate pharmacy students enrolled in the 16-week Introduction to Community Pharmacy course were investigated. The cohort expected to graduate in 2025 served as the control group and received 4 weeks of conventional instruction using PowerPoint slides to introduce professional communication and counseling skills. In contrast, the intervention cohort expected to graduate in 2026 received 3 weeks of PowerPoint-based instruction, followed by an additional week of video-rich learning in OTC counseling. Pre- and post-course questionnaires were administered to assess students’ self-efficacy in OTC counseling. Moreover, their counseling performance was evaluated through role-playing exercises with standardized patients during the final week of the course. Multivariate regression analyses determined the effectiveness of each teaching approach in enhancing self-efficacy and counseling performance. Semi-structured interviews were conducted and analyzed using inductive thematic analysis to gain insights into students’ perspectives and experiences with the two teaching approaches.ResultsBoth cohorts exhibited enhanced self-efficacy in medication counseling through the two approaches. However, the group that received the blended multimedia approach showed significantly greater improvement in counseling performance than its counterpart (p = 0.007). Students in the intervention cohort appreciated how video-based instruction provided visual and auditory cues, helping them grasp the structured flow of OTC counseling. Witnessing real-case scenarios in videos facilitated their understanding and appreciation of counseling techniques in real-life pharmacy settings.ConclusionThe study highlights that integrating multimedia instruction, particularly videos, significantly improved pharmacy students’ OTC counseling performance, while self-efficacy showed improvement without a significant difference compared to traditional slide-based lectures. To better support the development of counseling competence, a blended instructional approach that combines video-based learning with conventional lectures is recommended.

A cross-sectional study was carried out to estimate the number of college going individuals who are under the influence of self-medication and ADR's faced by those individuals. This study helped analyze and interpret which drugs are widely mishandled and taken without proper prescription. Individuals facing such stated ADR's were asked if they reported the respective. Approximately 100+ individuals took this survey and it was found that Analgesics, Antipyretics and Painkillers occupied most of the pie chart followed by antibiotics and vitamins. ADR's faced weren't reported most of the time. This unethical practice raises a significant pharmacoepidemiological concern. The frequent use of Antibiotics without professional consultation is particularly alarming in light of growing antimicrobial resistance. The findings underscore the urgent need for targeted awareness campaigns, student health education, and stricter regulation of OTC drug sales. Future studies could extend this survey to rural areas or diverse population groups to better understand the national scope of the issue.

Background: This study investigates the association between diagnostic delay (DD) and clinical and behavioral variables among Japanese women with endometriosis, and explores an optimal cut-off point distinguishing short and long DD. Methods: a cross-sectional online survey was conducted among 220 Japanese women aged 18–49 diagnosed with endometriosis. Data on healthcare behaviors, economic expenditures, and disease-specific outcomes were analyzed by stratifying participants based on DD length. Multivariate logistic regression models were applied. Results: the mean age at initial symptom onset was 24.3 years, and at diagnosis, 27.7 years. The median DD was 1.5 years, with significant differences between short and long DD groups (p < 0.001). Longer DD was significantly associated with greater use of over-the-counter (OTC) pain medication (p = 0.008) and a higher proportion of Stage IV endometriosis (p = 0.022). Conclusions: diagnostic delays longer than 1.5 years may contribute to disease progression and reliance on self-management, potentially postponing medical consultation. Early intervention strategies, including screenings and public awareness, may promote timely healthcare-seeking behavior. Future studies should prioritize clinical assessments and early diagnosis to reduce the burden of advanced disease.

Estimates of polypharmacy among U.S. adults with systemic lupus erythematosus (SLE) - a relatively young and disproportionately minoritized population - remain sparse. We sought to estimate the prevalence of polypharmacy in SLE and identify the most common medications used. For this cross-sectional study, participants were recruited from a population-based cohort of adults with validated SLE in Atlanta, Georgia. Prescription and over-the-counter (OTC) medications were self-reported at the study visit. Polypharmacy was defined as ≥5 prescription or OTC medications. Estimates of polypharmacy prevalence by key sociodemographic and SLE-related participant characteristics were obtained using crude logistic regression and post-estimation marginals. More than half (56.3%) of participants (N=451; 15.3% ≥60 years old, 91.8% female, and 81.8% Black) reported polypharmacy. Older age (68.1%, 59.8%, and 43.0% for ages ≥60, 40-59, and 18-39), higher vs. lower disease activity (65.8% vs. 46.2%) and cumulative SLE-related damage (68.5% vs. 42.4%), longer disease duration (62.4% vs. 50.0%), and taking 3-5 vs. 0-1 immunomodulating medications (79.6% vs. 38.0%) were associated with higher age-adjusted prevalence of polypharmacy; prevalence was not statistically significantly different by sex, race, or education. While hydroxychloroquine (71.4%), glucocorticoids (44.3%), and other immunomodulating drugs (50.3%) were common, polypharmacy was most often driven by other medications, such as anti-hypertensives (61.9%), non-opioid pain relievers (51.7%), allergy treatments (22.4%), antidepressants (22.2%), and gastric reflux medications (21.7%). Our results underscore the need to address the burden of medication regimens in this population through individualized medication optimization strategies that account for prescription and OTC medications used by those with SLE.

Is it the right time to address the issue of over-the-counter (OTC)and self-medication in Ayurveda?

Medical therapy is recommended in urolithiasis patients at risk for recurrence, but prices can remain prohibitively expensive. Direct-to-consumer (DTC) outlets such as Mark Cuban Cost Plus Drug Company (MCCPDC) offer opportunities for decreased Medicare Part D and beneficiary spending. We compared prices for generic urolithiasis preventative medications across insurance types and with over the counter (OTC) potassium citrate supplements. We estimated potential savings if Medicare Part D plans obtained prices offered under MCCPDC. We simulated the out-of-pocket price for a 90-day supply of seven generic drugs of various public and private insurers/companies. Using the 2022 Medicare Part D Spending dashboard and Q4-2024 Part D formulary and MCCPDC prices for seven medications, we estimated Medicare savings by replacing Q4-2024 Part D unit costs with MCCPDC costs. For potassium citrate, we used price for 90-day supply to calculate cost per 10 mEq alkali citrate for each insurer/manufacturer. Using MCCPDC prices, savings were generated for all drugs at the median prices under Part D except hydrochlorothiazide and tiopronin. Depending on dosage, estimated annual savings at the median percentile prices for part D were: allopurinol $2.3-15.7 million (M), chlorthalidone $14-26M, indapamide $0.9-1.7M, penicillamine $2.3M, and potassium citrate $12.1-19.1M. Cost per 10 mEq alkali citrate ranged from $0.03-$1.07, while cost per 10 mEq alkali citrate for OTC supplements ranged from $0.04-$1.80. DTC online pharmacies offer affordable alternatives for cash-pay customers purchasing urolithiasis medications. Replacing Part D formulary with MCCPDC pricing could yield significant savings for five generic urolithiasis medications.

Paracetamol is the one of the most widely administered drug as an analgesic and antipyretic due to its efficacy, safety, and over-the-counter (OTC) nature and is present in various pharmaceutical forms. Paracetamol usage in children is a global concern yet understudied in Pakistan. The present study was conducted to assess parental awareness regarding paracetamol usage and toxicity, highlighting critical public health risks and informing policy interventions aimed at lowering medication-associated toxicity in low-resource settings. This cross-sectional study aimed at assessing parental awareness in Sialkot city of Pakistan via a Urdu-language questionnaire (adapted from previous literature after pilot testing and expert review) was used as a tool to collect data. Questionnaire was distributed in six pediatric healthcare facilities. 450 parents were approached out of which only 420 gave consent and met inclusion and exclusion criteria. 2 responses were removed due to missing data. A total of 418 parents were interviewed, of which 67 % were mothers. Almost 99 % used it as an antipyretic, 18 % used it as an analgesic, and 81 %(n = 340) of the participants employed its use for the symptoms of illness (cough, flu, and vomiting). Most participants used paracetamol as a syrup. Health-care providers were the primary source of knowledge for paracetamol dosage. Only 32.8 % of participants were aware that a paracetamol overdose can cause harm. Approximately 75.8 % of the 418 participants scored below 66.67 % (4/6 questions) on the knowledge score and are considered to have insufficient knowledge. The current study highlights the lack of knowledge in parents regarding proper paracetamol usage which poses a significant risk of paracetamol poisoning. It underscores the importance of implementation of educational initiatives aimed at reducing the risks of toxicity and increasing awareness and knowledge regarding paracetamol among parents.

Abstract Disclosure: M. Gonzalez: None. J. Guarneros: None. L.M. Cobos: None. Background: Over-the-counter (OTC) medications from Mexico, particularly those marketed as pain relievers, anti-inflammatory agents, and herbal supplements, have increasingly come under scrutiny due to the presence of hidden steroids. These steroids, commonly added to enhance the efficacy of these products, pose significant health risks, especially because consumers are most of the time unaware of the medication’s contents. As a result, many patients are exposed to prolonged glucocorticoid use, increasing their risk of worsening metabolic disorders and developing hypercortisolism and even tertiary hypercortisolism once they stop its use, leading to severe and potentially life-threatening complications. Clinical Case: We report six cases of drug-induced hypercortisolism identified at an endocrinology clinic. These patients initially sought at our clinic for weight gain, worsening diabetes, and for concern for Cushings in the setting of a low Cortisol. During their evaluation, clinically signs and symptoms suggestive of hypercortisolism were present. Notably, all patients had been using over-the-counter supplements from Mexico. Their names are "RM Flex, Omega XL, Ultra Advance, and Arthri King." Patients were taking these supplements primarily for joint aches, which would be greatly improved with these supplements. These supplements did not advertise they contained glucocorticoids and laboratory evaluation for synthetic glucocorticoids was not available, however, clinically patients were cushinoid, biochemically their Pituitary-Adrenal axis was suppressed while taking these supplements and recovered once stopping them, and upon stopping these supplements, clinically they developed glucocorticoid withdrawal syndrome symptoms. After informing patients of the danger of the hidden glucocorticoid, some needed to be transitioned to a glucocorticoid and then wean them off, however, others decided to continue taking this despite informing them of the dangers excess glucocorticoids will lead to due the unbearable pain they get when discontinuing them. Conclusion: Addressing this public health issue requires increased awareness and education about the risks associated with unregulated OTC medications, particularly for populations along the U.S.-Mexico border where these products are more accessible. Although these medications are effective for pain relief, their side effects profile is much more dangerous, and their availability through online websites puts not only the border but the whole country in danger of developing secondary hypercortisolism. As healthcare providers, we have to do a better job of educating our patients about foreign and online supplements, and only through counseling and shared medical decision-making can we make a positive change in our patients. Presentation: Saturday, July 12, 2025

Oseltamivir, an antiviral medication that has been used for influenza prophylaxis and treatment since 1999 and now available as a generic drug, is being considered for over-the-counter (OTC) status to allow individuals to access treatment without a prescription. This proposal has engendered controversy. With the rising availability of at-home diagnostic tests and the ever-present threat of an influenza pandemic, it is timely to revisit issues surrounding this controversy. In this commentary, we examine the potential benefits and risks of reclassifying oseltamivir as an OTC drug to enhance access to rapid influenza treatment. Additionally, we explore alternative models to improve oseltamivir accessibility, potentially utilizing rapid influenza testing. As newer drugs to treat influenza are proven safe and effective, they would be subject to similar considerations.

ObjectiveTo develop and evaluate a patient-centric medication module within a personal health record (PHR) app for capturing medication use, focusing on accuracy, usability, and concordance.Materials and MethodsThe medication module offered 4 entry methods: picklist, National Drug Code (NDC), free-text, and portal import, with the first 2 leveraging RxNorm and openFDA APIs. Patients from an integrated delivery network (IDN) created medication lists and recorded daily use in the app’s diary. Pharmacists evaluated medication accuracy by reviewing patient-uploaded medication images. Usability was measured using the System Usability Scale (SUS). Concordance was assessed by comparing Electronic Health Records (EHR) with diary entries.ResultsOver a 14-day period, 85 patients entered 617 medications, with 533 logged in the diary representing current use. Picklist was the most used entry method. Overall medication entry accuracy was 92% (picklist 97%; NDC 87%; free-text 84%; and portal import 100%). The mean system usability score was 56.5 for the study app (patients) and 80.8 for the medication module (pharmacists). EHR concordance with diary entries was low (25% using the 14-day window; 53% using a 1-year window); most unmatched entries were over-the-counter (OTC) medications.DiscussionAccurate and complete medication records are essential for the safe and effective use of medications. This patient-centric medication module supported accurate capture of prescription and OTC medications. Gaps in EHR data highlight the need to improve medication record accuracy and reconciliation.ConclusionPatient-generated health data can have a central role in creating the “Best Possible Medication History” envisioned by the World Health Organization.

Hearing impairment poses significant challenges in understanding over-the-counter (OTC) medication instructions, often leading to misuse, low adherence, and poor health outcomes. This study aimed to develop and evaluate the QR-Specialized Information Guidance Nexus (QR-SIGN), a QR code-based tool that provides medication instructions through Filipino Sign Language videos to improve knowledge and promote adherence among Deaf individuals. A quasi-experimental, non-randomized pretest-posttest control group design was conducted with 30 Deaf participants from Koronadal City, equally divided into intervention and control groups. The intervention group accessed QR-SIGN, while the control group received no additional support. Results showed significant improvements in knowledge scores— paracetamol (20.00 to 76.67), ibuprofen (26.67 to 71.67), and phenylephrine (33.33 to 63.33)—and adherence (2.95 to 3.72). The intervention group also reported an overall mean satisfaction rating of 4.39, interpreted as Excellent and Very Satisfied. These findings demonstrate that QR-SIGN effectively enhances medication literacy, adherence, and user satisfaction among Deaf individuals.

Acute pain associated with headaches and migraines in children and adolescents may be managed with over-the-counter(OTC) treatments (e.g., paracetamol and ibuprofen); however, there are few studies on their safety and effectiveness in these patients. This narrative review evaluates the use of OTC treatments in children and adolescents with headaches and migraines. A literature search of Embase, MEDLINE, ToxFile, and Derwent Drug File was performed for reviews of clinical studies and meta-analyses (January 2010-October 2023) related to the acute treatment of headaches and migraines in children (1month-11years) and adolescents (12-18years) with OTC analgesics (paracetamol, ibuprofen, aspirin, and naproxen). The results of the literature search were interpreted alongside expert recommendations per real-world clinical experience. Twenty-eight articles were identified, of which half included recommendations that either paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs; typically, ibuprofen) were appropriate first-line OTC treatments for headache and/or migraine in children and adolescents. The remaining studies recommended ibuprofen and/or other NSAIDs (particularly naproxen) exclusively or preferentially over paracetamol. Four studies noted that aspirin was appropriate for adolescent patients > 16years of age. An overall lack of clinical evidence on children and adolescents was noted, particularly regarding combinations of paracetamol and NSAIDs, and adjuvants such as caffeine. Paracetamol appears to be effective for treating headaches and migraines in children and adolescents; however, evidence is inconclusive regarding the equivalence or superiority of NSAIDs for the same indication. Clinical judgment and patient or caregiver preferences should guide medication selection.

In Sweden, oral formulations of diclofenac became prescription-only in 2020, and over the counter (OTC) topical forms were placed behind the counter in 2023. This study investigated the effect of these policy changes on diclofenac dispensed or sold. Aggregated data on diclofenac dispensed against prescription or sold OTC from January 2019 to February 2024 were analysed descriptively. The volume fell substantially after oral formulations became prescription-only. Placement of topical formulations behind the counter had a more modest effect. Policy changes have had a significant effect on the volume of diclofenac dispensed or sold in Sweden, especially the prescription requirement.

One year of Opill: Retail sales of over-the-counter birth control pills in the United States.

Abstract The 2025 iteration of the MarkeTrak survey offers a comprehensive analysis of hearing aid adoption trends in the United States, with a particular focus on the impact of over-the-counter (OTC) hearing aids introduced in 2022. This study explores evolving consumer behaviors, demographic shifts, and clinical and psychosocial factors influencing hearing aid uptake. Findings reveal a continued increase in overall adoption rates, with OTC devices serving as a critical access point for first-time users—particularly younger, more diverse, and cost-sensitive populations. Despite the affordability and accessibility of OTC devices, traditional hearing aids remain the preferred choice among individuals with more severe hearing loss and those seeking professional support. The report highlights key differences in service delivery, satisfaction, and repurchase intentions between user groups, underscoring the enduring value of professional care. Additionally, the emergence of hearing improvement features in consumer electronics, such as earbuds, signals a broadening of the hearing device landscape. These insights have significant implications for clinical practice, marketing strategies, and policy development, emphasizing the need for flexible, patient-centered care models that accommodate diverse consumer pathways and preferences.

For over-the-counter (OTC) formulations to be safe, effective, and compliant with regulations, the active pharmaceutical ingredients (APIs) must be precisely quantified. UV spectrophotometry is unique among analytical methods since it is easy to use, reasonably priced, and appropriate for regular quality control. The principles and use of the calibration curve approach in UV spectrophotometry for the quantitative assay of vitamin C, aspirin, and paracetamol are examined in this paper. It explores the theoretical underpinnings, sample preparation techniques, validation procedures, and comparisons of commercial formulations. The method's benefits and drawbacks are thoroughly examined, as are upcoming developments in pharmaceutical analysis, including automation, chemometrics, and green chemistry techniques. This thorough review emphasizes the reliability and usefulness of UV spectrophotometric analysis in pharmaceutical quality control, particularly for popular over-the-counter drugs.