Over-the-Counter Drugs: Misuse and Safety Implications

Although over-the-counter (OTC) drugs are regarded as relatively safe and effective for self-treatment, their growing prevalence and accessibility raise concerns about misuse, addiction, and adverse health consequences. This narrative review provides a current overview of OTC drugs with misuse potential and their associated safety implications. OTC drugs commonly misused include sedative antihistamines, cough mixtures, caffeine-containing products, fat burners, analgesics, laxatives, antidiarrheal medications, and decongestants, which can be harmful when improperly used, often due to recreational purposes and lack of awareness. Patterns of OTC drug misuse typically start with therapeutic use, followed by dose escalation, and are particularly concerning in vulnerable populations such as pregnant women, adolescents, children, older adults, and individuals with mental health conditions. Effective management of OTC drug use in these groups is constrained by public perception of safety, easy accessibility, insufficient oversight, limited healthcare access, and a lack of adequate professional guidance. Emerging alternatives such as probiotics and nutraceuticals offer safer options for OTC drugs, although further research is still needed to establish their effectivity and safety. Ultimately, a multifaceted, patient centered approach, incorporating pharmacological advancements, behavioral insights, and robust public health interventions, will be crucial to mitigating OTC drug misuse and improving overall health outcomes.