Conventional advice, but wrong: A request

I’m preparing a presentation on the evidence-based use of over-the-counter (OTC) medications. The audience will be pharmacists. Given the breadth of the topic, I’m going to focus on OTC treatment myths – and I’d like your input.

What are some myths about OTC medications that refuse to die, despite evidence to the contrary? What conditions, or classes of drugs, would most benefit from some scientific scrutiny? And when it comes to managing self-limiting conditions, what common treatment advice is in greatest need of an evidence check?

Please leave your suggestions in the comments, or pass them on to sciencebasedpharmacy at gmail dot com.

13 thoughts on “Conventional advice, but wrong: A request

  1. Cough syrups – not one of them actually works. If you’ve got the kind of tickly cough that stops you sleeping for weeks you’d be better off with Zolpidem or Zopiclone, to at least get a decent night’s sleep. If you can get a GP to prescribe you a modest supply without reacting as if you’ve asked for crack, of course….

  2. Buckley’s. Guaifenesin. The whole cough and cold category actually. Ovol and Gripe Water. Muscle relaxants. Topical analgesics. Preparation-H. Pepto-Bismol. OTC sleep aids. AfterBite. Polysporin. All weight-loss products.

  3. Dextromethorphan is pretty useless as a cough suppressant. For a persistent cough, the best cough suppressant that is easily obtainable OTC from a pharmacist is codeine, personally – the strongest codeine-containing analgesic product you can find that’s available OTC in your location.

    As far as sleep aids are concerned, something like Valerian is nonsense, but it’s not really a real pharmaceutical. Something like doxylamine is quite common OTC as a sedative, though – and that certainly does work.

  4. Have had several patients in the past few weeks come in to buy Vicks to rub on their feet and then cover them with socks for their chest cough. Hmmmm.. Harmless, I suppose, but they might wake up with nice soft feet!

  5. How about Aspirin for heart attack or stroke prevention? Seems to me people thinks its a miracle drug with no risk

  6. I am constantly seeing advice from other parents at my child’s school for our kids to take Oscillococcinum. This and other homeopathic products are prominantly displayed at all my local pharmacies, which creates a completely false appearance of legitimacy.

    Also, the dietary supplement and vitamin sections are always the largest by far, yet the evidence for benefit from use of these is very, very slim. Apart from counseling clients directly, can pharmacists have any influence of the sale or display of such products or at least the presence of prominant disclaimers indicating the paucity or absence of real evidence that these products have benefits?

  7. One example of a treatment that some people rave about using OTC products is the “gallbladder cleanse,” or “liver flush,” using epsom salts, acidic juices (often lemon), and olive oil (or variants on it). The flushes have been covered on various sites (including quackwatch), but I still meet people who believe firmly that these flushes work.

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