OTC drugs that treat serious health conditions

Over 300,000 over-the-counter (OTC) drugs are currently on the market, according to the FDA. This vast number should come as no surprise given that OTC drugs are convenient, readily available, and relatively cheap. In fact, an estimated 4 of 5 US adults commonly use OTC drugs. In 2014 alone, Americans spent an estimated $44 billion on them, which translated to savings of about $102 billion in clinic visits, diagnostic tests, and prescription drug costs. 

OTC drugs are most often used to treat minor illnesses and injuries. But, are they effective against more serious health conditions? 

Here’s a closer look at five serious ailments that can be treated with OTC drugs. 

Venous thromboembolism

Venous thromboembolism (VTE) is a life-threatening medical condition and a common postoperative complication. While anticoagulant therapy is the primary treatment, some researchers have suggested that aspirin may be a viable prophylactic therapy for VTE. 

Although aspirin is an old medication—dating all the way back to 1897—its dosage and efficacy are still being investigated in various surgical contexts, including hip preservation surgery (HPS).

For instance, in one retrospective study, researchers assessed the efficacy of aspirin for VTE prophylaxis in a large cohort of over 600 patients (mean age: 34.3 years) undergoing HPS. Patients received either 325-mg aspirin or 81-mg aspirin twice daily, and were followed prospectively for 90-day postoperative complications (ie, pulmonary embolism, deep venous thrombosis, and major bleeding events). Overall, only two patients developed VTE following HPS. 

The authors concluded that “aspirin is a safe and an effective modality in minimizing the risk of VTE in patients undergoing HPS.”

Migraine

Headache (including migraine) is the fifth-leading reason for emergency department visits resulting in discharge among adults aged 18-44 years in the United States, according to a report from the Agency for Healthcare Research and Quality. 

Headache and migraine also ranks among the top 20 reasons for clinic visits. In the 2011 National Health Interview Survey, nearly 17% of adult respondents reported experiencing migraine or severe headache in the previous 3 months. 

With migraine treatment, prescription triptans and ergotamines immediately come to mind. But, non-prescription treatment appears to be effective, too. For instance, in a study of outpatients with migraine who were given either acetaminophen or placebo, researchers found that 52% of patients treated with 1,000 mg acetaminophen had little or no migraine pain at 2 hours compared with 32% of patients given a placebo.

“Acetaminophen 1000 mg, a nonprescription drug, is an effective and well-tolerated treatment for episodic and moderate migraine headache,” concluded the authors. “In addition, acetaminophen generally provided a beneficial effect on associated symptoms of migraine including nausea, photophobia, phonophobia, and functional disability.”

More recently, in a research review of randomized trials, researchers reported that high-dose aspirin (900 mg to 1,300 mg) is effective against acute migraine when taken at symptom onset. They also found evidence that daily aspirin (81 mg to 325 mg) can prevent recurrent migraine headaches. 

Lastly, antiemetics may also provide moderate migraine relief. OTC antiemetics sold in the United States. include diphenhydramine, and bismuth subsalicylate. 

Gastroesophageal reflux disease

A variety of proton-pump inhibitors (PPIs) are available, including OTC options such as omeprazole (Prilosec), pantoprazole (Nexium), and lansoprazole (Prevacid). Initially intended to treat reflux esophagitis, these potent gastric-acid inhibitors revolutionized the treatment of several syndromes due to acid reflux, acid secretion, or acid hypersecretion.

The use of PPIs has exploded worldwide, with the drugs viewed as relatively safe. Bear in mind that an estimated 5% to 10% of people with untreated gastroesophageal reflux disease go on to develop Barrett’s esophagus, with 1% of people with this precancerous lesion eventually developing esophageal cancer. 

According to the authors of one review published in BMC Medicine: “The overwhelming message is that the problem with PPIs is that they are good, very good. Consequently, there are a lot of valid indications for their use. However, clinicians cannot be complacent, thinking that the overwhelming efficacy of the drugs in the treatment of peptic esophagitis and ulcer disease will be matched in all other putative applications.”

Common cold

No matter how miserable the symptoms, the common cold is often perceived as harmless. But rhinovirus infection can be more than bothersome; in those with weakened immune systems, for instance, it can be deadly.

Fortunately, there are OTC medications that can take the edge off the common cold. Researchers of a survey-based study published in the International Journal of Clinical Practice showed that an ibuprofen-pseudoephedrine combination helped ease common cold symptoms in a dose‐dependent relationship. Moreover, the effects of this combination were best when treatment was started within 2 days of symptom onset.

Burn wounds

For uninfected chronic wounds, OTC topical antimicrobial therapy likely won’t help. This fact flies in the face of what most people think when they reach for a topical antibiotic immediately after sustaining a wound. 

However, topical antibiotics may be effective for the treatment of burn wounds. Some researchers have shown that topical antibiotics—including OTC drugs like mupirocin, bacitracin, iodine, and hydrogen peroxide—can help treat infection and prevent sepsis by eliminating wound bacteria. These agents may also help with neutralizing odors due to non-healing, necrotic wounds. Furthermore, topical antibiotics can be added to systemic antibiotics to treat certain types of ischemic wounds. 

Also, topical antimicrobial therapy may prove beneficial in combating biofilms, which are aggregations of different species of bacteria enveloped in a protective glycocalyx that adhere to the surface of the wound. Although found in only 6% of acute wounds, biofilms are present in more than 90% of chronic wounds. An emerging corpus of research indicates that biofilms may mediate the formation of non-healing wounds.