What are over-the-counter (OTC) medications?

From the Guidelines

For the treatment of acute migraine, the most effective over-the-counter (OTC) medications are non-steroidal anti-inflammatory drugs (NSAIDs), with the strongest evidence supporting the use of acetylsalicylic acid, ibuprofen, and diclofenac potassium as first-line medications. According to the study published in Nature Reviews Neurology in 2021 1, these medications have proven efficacy in treating acute migraine.

Key Points to Consider

• Acetylsalicylic acid, ibuprofen, and diclofenac potassium are the recommended first-line OTC medications for acute migraine treatment.
• Paracetamol has less efficacy and should only be used in patients who are intolerant of NSAIDs.
• It is essential to follow the recommended dosing instructions and consult a healthcare provider if symptoms persist or worsen.

Additional Considerations

• The study published in the Journal of Allergy and Clinical Immunology in 2022 1 provides information on COX-1 and COX-2 inhibiting medications, which may be relevant for patients with specific conditions, such as aspirin-exacerbated respiratory disease (AERD).
• However, for the treatment of acute migraine, the recommendations from the 2021 study 1 should be prioritized.

Important Reminders

• Always read labels carefully and follow dosing instructions when taking OTC medications.
• Consult a healthcare provider if symptoms persist or worsen, especially if you have underlying health conditions or take other medications.

From the FDA Drug Label

Some NSAIDs are sold in lower doses without a prescription (over-the-counter). OTC NSAIDs are available, but it is recommended to talk to your healthcare provider before using them for more than 10 days 2.

From the Research

Overview of OTC Medications

• Over-the-counter (OTC) medications are products that can be easily accessed by patients to treat common ailments without a prescription and the cost of a doctor's visit 3.
• These medications are generally considered safe, but there is still a potential for adverse health outcomes, especially in older adults 3.
• OTC medications can be obtained at pharmacies, which provides pharmacists and technicians with the opportunity to guide safe selection and use 3.

Common OTC Medications

• The most common OTC medications used by patients include paracetamol and ibuprofen 4.
• A cross-sectional survey-based study found that paracetamol was used by 13.35% of patients, followed by ibuprofen at 2.04% 4.
• Patients can easily obtain OTC medications at pharmacies for self-treatment, but may have little knowledge of potential adverse effects or contraindications 5.

Importance of Pharmacist Guidance

• Pharmacists play a crucial role in guiding safe selection and use of OTC medications, especially for older adults 3.
• Healthcare professionals should pay closer attention to patients' use of OTC drugs and provide education on safe and effective use 5, 6.
• Pharmacist-led minor ailment programs can improve the care of minor ailments and provide value for patients 7.

Patient Education and Awareness

• Patients should be educated about available OTC medications, their effects, and the importance of reading package labeling for appropriate dosing and administration 6.
• An awareness program among community people can be conducted to educate them about OTC drugs and their safe use 4.