Silent Drug Therapy Problems Caused by Over-The-Counter Medicines: A Clinical Pharmacy Perspective

Abstract

Modern self-care relies heavily on over-the-counter (OTC) medications, which are frequently used to treat minor illnesses without a doctor's direct supervision. Despite the widespread belief that these drugs are safe, there is mounting evidence that improper use of over-the-counter (OTC) pharmaceuticals significantly contributes to drug-related disorders (DRPs), which frequently go unreported and stay clinically quiet. From a clinical pharmacy viewpoint, this narrative review investigates the kind, prevalence, and clinical importance of silent drug treatment issues related to over-the-counter medications. Inappropriate self-diagnosis, improper product selection, excessive dosage or prolonged use, therapeutic duplication, unidentified contraindications, drug–drug interactions, and misuse or abuse—particularly with regard to high-risk drug classes like analgesics, cough and cold remedies, antihistamines, and combination products—are among the major problems found. The analysis also identifies significant obstacles to OTC safety monitoring, such as inadequate recording of nonprescription medication usage, a lack of expert oversight, and methodological flaws in pharmacovigilance systems. Pharmacists are ideally positioned to identify, prevent, and resolve most OTC-related DRPs through systematic evaluation, patient counselling, and prompt intervention, frequently before clinical damage occurs, according to evidence from community pharmacy practice. The results highlight the necessity of implementing standardised counselling models, improving safety surveillance systems, strengthening pharmacist education in nonprescription pharmacotherapy, and formally including OTC drugs into thorough medication reviews. In a time when self-medication is becoming more common, it is crucial to acknowledge over-the-counter medications as pharmacologically active agents rather than naturally harmless goods in order to lower avoidable morbidity and enhance patient safety.