Over-the-Counter (OTC)

Over-the-counter (OTC) is a term used to describe products, especially medications, that can be purchased without a physician's prescription. Medications that are not over-the-counter must be obtained with a written prescription that must be submitted to a pharmacist for dispensing. Prescribed medications are restricted to the general public. They require special indications and usage as ordered by a health care provider with prescriptive privileges (such as a nurse practitioner). Not all medications are so restricted. These medications are readily available to the public for sale. They can be purchased in any store without a written prescription. The only barrier between a customer and the medication is the counter, hence the term over-the-counter.

Many different types of products are categorized as OTC. Cough syrups and nasal decongestants are typical [Page 414]examples of OTC medications. Other OTC medications include anti-inflammatory and analgesic products such as nonsteroid anti-inflammatory drugs.

When analgesic medications contain narcotics, these medications require a prescription and are not available OTC, because their use must be monitored by the prescribing licensed health care provider. This same type of supervision would apply to medications prescribed to control blood pressure, heart rate, and rhythm. Improper use of these medications could have morbid and fatal consequences for the individuals taking them. Hence, these substances are not available OTC.

In some situations, medications that were once only available with a prescription became available OTC. Classic examples are the gastric acid antagonist medications and some nonsteroid anti-inflammatory drugs. In this aspect, OTC may refer to those substances that have always been available without a prescription and those substances that were once only available with a prescription but have evolved (demonstrated safety and efficacy, and possibly also being made available in a smaller dose) to no longer requiring one. The category of OTC medications should be considered as a dynamic list, because a medication's status may change.