Patients should consult pharmacy staff before taking over-the-counter medications

Logan Franck, PharmD, BCACP, clinical associate professor in the College of Pharmacy at the University of Nebraska Medical Center, discusses his American Association of Pharmacy Technicians session on over-the-counter medications.

Q: What are the considerations for pharmacy technicians when counseling patients on over-the-counter medications?

First and foremost, I would say to ensure that pharmacy technicians do not make recommendations directly to the patient. There should always be a discussion with the pharmacist who is there that day. I agree that pharmacy technicians often have a lot of these answers and can provide a lot of these recommendations, but there may be a little nuance or something small missing that could create a little liability issue.

Managing everything by a pharmacist and having a pharmacist sign off would be better care for our patients. Ultimately, you just have to leave that decision-making to the pharmacist who has been studying these drug interactions and drug nuances for many years.

Q: Why is it important for patients to consult with pharmacy staff about concurrent use of over-the-counter medications with prescription medications?

Logan Frank: It’s kind of a hot topic right now. This is something that often goes unnoticed. It is known that many patients think that anything over-the-counter is safe to take, has no side effects, is very safe and works. This is simply not the case.

Every over-the-counter drug, just like prescription drugs, has drug interactions or side effects associated with taking it. A good example of this is acetaminophen, or Tylenol, which is found in almost every over-the-counter medication, any combination product. It works well to reduce fever and reduce mild pain, but if we take too much, we can cause liver damage. Keeping this in mind and letting patients come to you and ask questions, instead of just grabbing over-the-counter stuff, will benefit them, not to mention the concept of drug interactions.

Over-the-counter drugs do the same thing as they interact with prescription drugs. The pharmacist will benefit from knowing what medications patients are already taking, which will also tell them what type of illness they have and ultimately be able to make more informed decisions about potential safety risks.

Q: For those who aren’t at your presentations, what are the key takeaways you’d like to highlight?

Logan Frank: The 3 takeaways I would say, first and foremost, as you just heard, combination products are not your friends. Over-the-counter medications contain many different things, but you should choose products that contain only one ingredient, and hopefully that single ingredient is all you need to treat a certain symptom or reason for which you are taking the medicine.

Number 2 is that generics are just as good as brand name drugs. So do the patient a favor, recommend them and direct them to the generic instead of the brand name. It’s enough to save them money.

Finally, discuss all recommendations with the pharmacist. Make sure they approve of what is happening and consider the safety of this patient.

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