SOME RISKS INVOLVED IN TAKING OVER-THE-COUNTER MEDICATIONS

GRPAHIC -- NEW ON THE SHELF

Medications for everything from fixing heartburn to growing hair have become available over-the-counter in recent months.

Rogaine, Zantac, Pepcid AC, Nicorette, and a variety of cold treatments and hydrocortisone treatments are available without prescription.

That's a good news/bad news scenario for consumers, experts say.

The good news is, needed medications are available without prescription and at a lower cost.

The bad news is that patients may be taking the wrong medication or using the right drug in the wrong way.

Medications are approved for over-the-counter sales only after extensive testing and years of use in the prescription-only market, said Darrell Hanschen, a pharmacist at Medicap Pharmacy in Jackson.

"Normally by the time it becomes over the counter in the States, it's been available for years overseas," he said. "They usually have a lot of data that they can draw on."

But when medications like Zantac, or ranitidine, used by prescription to prevent heartburn by blocking the production of stomach acid, become available over the counter, consumers need a lot of information.

Quite often, Hanschen said, consumers will ask questions when a new over-the-counter medication comes on the market.

"Basically, they want to know how does it compare to the prescription strength? How much do they take? Does it do what the ads say it does? The public asks a lot of questions these days, which is good," he said. "You need to ask, especially with all these new drugs coming out."

Approving medications for over-the-counter sales is one way to control drug costs, said Don Magwitz, pharmacy director at St. Francis Medical Center.

It also opens up a much bigger marketplace for drug manufacturers, he added.

Zantac, manufactured by Glaxo Wellcome, is sold over the counter to treat heartburn in 75-milligram tablets. Zantac's prescription strength is 150 milligrams, and it is the best-selling prescription drug in the world, with sales of $3.6 billion in 1994.

Over-the-counter medications ring up sales in the neighborhood of $11 billion annually, and antacids account for about $1 billion.

With so many new treatments available over the counter, patients wind up self-medicating ailments, and sometimes, they're wrong.

"In some ways it's nice, because they can get things that will help them at a much lower cost," said Dr. Nancy Weible of Cape Girardeau. "The only thing that I'm concerned about as a physician is that they may not seek medical attention for things that are more serious."

Using antacids habitually may mask the symptoms of an undiagnosed ulcer, Weible said.

"Now we know if they have an ulcer, they can effectively treat it," she said. "They can take the antibiotics that are available now."

There's always the risk that consumers will misdiagnose their condition and use the wrong over-the-counter treatment. A common example is the variety of over-the-counter treatments for vaginal yeast infections, Weible said.

"A lot of times they'll think they have a yeast infection when it's really something else," she said. "I've even see physicians that will tell them to just go ahead and use the over-the-counter cream."

Consumers need to follow package instructions when using over-the-counter medications and they need to be aware of how those medications will interact with any prescription drugs they're taking, Magwitz said.

In some cases, consumers may be taking an over-the-counter drug, such as Advil or Nuprin, without realizing they're already taking the same drug -- ibuprofen -- in a prescription dosage.

Ibuprofen and other anti-inflammatory painkillers can help cause ulcers or aggravate existing ulcers. Consumers might be better off getting a prescription painkiller to treat chronic conditions.

Consumers also need to watch the dosage recommendations for over-the-counter medications.

"Some of these are coming out in lower potencies than the prescription dose, and you'll have people taking multiple doses of the medicine to get what they need," Magwitz said.

It's also important that consumers tell their physicians what over-the-counter medications they use. Medications can mask symptoms of serious ailments and may cause dangerous reactions with prescription drugs.

Patients who've suffered a particular ailment before -- heartburn, vaginal yeast infections, fungal nail infections, etc. -- are probably safe using the over-the-counter medications if they know their symptoms and their bodies' reactions, said Weible.

But for a first-time diagnosis, using an over-the-counter treatment without a doctor's recommendation can be risky.

"They're kind of taking a chance on whether they're getting it right or not," Weible said. "It's really the diagnosis part of it, and how accurate that is, that's important."

NEW ON THE SHELF

MEDICATIONS AVAILABLE WITHOUT PRESCRIPTION

Nicorette: A gum containing a low dose of nicotine, used to help smokers kick the habit. Follow label instructions, says pharmacist Don Magwitz, and remember to stop chewing when your tongue starts tingling.

Rogaine: A drug originally used to treat hypertension now helps some people grow hair by stimulating the follicles.

Naldicon DX: A cold preparation for children that's now available over the counter. Parents everywhere should be relieved, Magwitz said.

Aleve: An anti-inflammatory painkiller containing sodium naproxen. Taking sodium naproxen or ibuprofen over a long period could cause ulcers to develop, so call your doctor if pain persists.

Hydrocortisone cream in 1 percent solutions: The creams are used to treat itchy, swollen rashes.

Tagamet, Pepcid AC, and other antacids in the H2 receptor antagonist group: These drugs, used by prescription to treat ulcers, stop the formation of stomach acid, thus preventing heartburn. Tagamet may react adversely with some asthma medications, so ask your doctor or pharmacist before taking it.