Over-the-Counter Medicines: How to Choose and Use Them Safely

Over-the-counter (OTC) medicines are medicines you can buy without a prescription, for short-term, common problems such as headaches, colds, allergies, heartburn, minor pain and skin irritation. They are considered safe for self-care when used as directed, but "available on the shelf" does not mean "risk-free". Reading the label, checking the active ingredients and asking a pharmacist when in doubt are the three habits that matter most.

OTC and prescription medicines compared

Some medicines are available both ways, often at a lower strength without a prescription. Some products are kept behind the counter, so you need to ask for them.

How to read the label

In the United States, OTC medicines carry a standard "Drug Facts" panel; other countries use similar layouts. Look for these sections each time, even with a product you have bought before, as formulas can change:

1. Active ingredients: the substances that do the work, with the amount in each dose.
2. Uses: the symptoms the product is meant to treat.
3. Warnings: who should not use it, when to stop, and when to ask a doctor or pharmacist first.
4. Directions: how much to take, how often and the maximum in a day, often by age.
5. Other information and inactive ingredients: storage, plus fillers and colourings that matter if you have allergies.

The doubling-up trap

Many cold, flu and sleep products combine several ingredients in one pack. If you also take a separate pain reliever or allergy tablet, you may end up taking the same active ingredient twice without realising. Compare the active ingredients on every product you are using, including prescriptions, and avoid combining two products that share one. When unsure, line them up on the pharmacy counter and ask.

Who should ask before buying

• Anyone who is pregnant, might be pregnant or is breastfeeding. Our guide to the first trimester explains why existing and new medicines are worth reviewing early.
• Older adults and anyone taking several medicines. Interactions and side effects become more likely, as our piece on caring for elderly parents at home touches on.
• Children. Use products made for children, follow the age or weight guidance exactly and use the measuring device supplied. Some products are not suitable below a certain age.
• People with long-term conditions, such as heart, kidney, liver or stomach problems, high blood pressure or diabetes.
• Anyone about to have surgery or a procedure.

Supplements and herbal remedies count too

Vitamins, minerals and herbal products are not always regulated in the same way as medicines, yet they can still interact with them. Tell your pharmacist and doctor about everything you take. Our beginner's guide to ashwagandha is one example of a popular supplement that is worth discussing before combining with other treatments.

Using OTC medicines well

• Take the lowest effective amount for the shortest time the label allows.
• Keep to the stated gap between doses and the daily maximum.
• Avoid alcohol if the label warns against it, and take drowsiness warnings seriously.
• Store products in their original packs, as described in our guide to storing medicine at home.
• Add regular OTC products to any medicine list you keep for yourself or a relative.

Some effects last longer than people expect, particularly in older adults; our explainer on medication half-life shows why.

Are store brands as good as name brands?

Store-brand or own-label products usually contain the same active ingredient, in the same amount, as the better-known name. The quickest check is to compare the active ingredients section on both packs. The inactive ingredients, flavour, shape and price can differ, which matters mainly if you have an allergy or intolerance to a particular filler or colouring.

When self-care is not enough

See a doctor if symptoms last longer than the label suggests, keep coming back, or get worse despite treatment. Seek prompt help for chest pain, difficulty breathing, a severe headache unlike usual ones, high or persistent fever, blood in vomit or stools, confusion, or signs of an allergic reaction such as swelling of the face or lips.

Questions to ask the pharmacist

1. Is this suitable with my other medicines and supplements?
2. Does anything here duplicate what I already take?
3. How long can I use it before I should see a doctor?
4. What side effects should make me stop?
5. Is there a simpler or single-ingredient option?