Ask the Geriatric Pharmacist: Over-the-Counter and Prescription Drugs

Sunny Linnebur

Sunny Linnebur, PharmD, FCCP, FASCP, BCPS, CGP
Associate Professor
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences 
University of Colorado Anschutz Medical Campus

Certain medications are available only when a doctor recommends them. These are called prescription drugs. To obtain these medications, a doctor or other healthcare provider must give you a prescription or send a prescription for you to the pharmacy. Prescription drugs should be taken only by the patient they are prescribed for. Over-the-counter (OTC) drugs are medications available without a prescription and without a doctor's direction. Some medicines are available both as a prescription and over-the-counter.

Q:  Where can I find over-the-counter drugs?

A:  They can be found in pharmacies, grocery stores, or discount stores. Some of them include Advil (ibuprofen), an anti-inflammatory pain reliever; Benadryl (diphenhydramine), an antihistamine for allergies; and Tums (calcium carbonate), a stomach acid reducer. 

Q:  Is it cheaper to buy a medication over-the-counter?

A:  Not always. OTC medications are generally not covered by health insurance plans and can be expensive. It may be easier to buy OTC medication if you do not have insurance that covers prescriptions. However, it may not be cheap. Buying store brands and using coupons may help to cut costs. If your insurance covers prescriptions, it may cost less to buy medication with a prescription. Getting a prescription, however, usually requires a visit to a healthcare provider and may not be as easy as buying an OTC drug. 

Q:  I have trouble reading the small print on the box. Is anything being done to change the size of the instructions?

A:  The American Geriatrics Society (AGS) is suggesting to the Food and Drug Administration (FDA) a requirement that all over-the-counter labels be written in large print and use language that is easily understood. Because it can be hard to understand the warnings, the AGS is encouraging manufacturers to make instructions easier to understand. In particular, this needs to be done with prescription drugs that are commonly used by older people so that OTC and prescription products can be used safely. In the meantime, ask your pharmacist to read or explain instructions that you cannot read or do not understand.

Q:  My doctor warned me about taking certain OTC products. Do manufacturers list the generic name of the drug on their products?

A:  The generic drug name is not always listed where you can easily find it. Usually, it is listed in the ACTIVE ingredients section in small print. The AGS has also asked manufacturers to clearly label the generic name of the drug, the family of medications it belongs to, and to list the names of drugs that would have similar effects. This information will help you avoid taking too much of the same or similar medications which can cause side effects. For example, if you are taking Celebrex (celecoxib), a prescription for arthritis, and Advil or Motrin IB, which contain ibuprofen, you could increase your risk for stomach or kidney trouble.

Talk to your healthcare provider or pharmacist to make sure you are not taking medications that could cause dangerous interactions.

Q:  If a drug is available over-the-counter, does it have fewer side effects than a prescription drug?

A:  Not always. OTC products still cause side effects, drug interactions, and disease interactions. These medicines may worsen your condition or they may cause another drug you are taking to build up in your body.  

Q:  Do I need to tell my healthcare provider about my use of OTC medications and herbal and nutritional supplements?

A:  Yes, it is important to tell your healthcare provider and pharmacist about your use of these products. They will be able to help you choose the right medicine for your condition or symptom. Your healthcare providers will also need to check for interactions with other drugs you may be taking or drugs they are considering prescribing for you. Sometimes vitamins and supplements interact with medicine too. You can help your provider by bringing in all prescription, OTC, or herbal/nutritional medicines you are taking to your office visits. This is so problems can be identified and prevented.


Last Updated March 2012