What to Ask Before Starting an OTC Product

The words “available without a prescription” can make an over-the-counter product feel like a simple grab-and-go purchase.

Headache? Pick a pain reliever.

Cough? Find the box with a dramatic picture of someone holding their throat.

Allergies? Choose the package promising that spring will stop personally attacking you.

But an OTC product is still a health product. It contains active ingredients, directions, warnings and situations in which it may not be the right choice.

Before taking the first dose, it helps to ask a few questions.

1. What symptom am I actually treating?

Start by identifying the main symptom.

Is it pain, fever, congestion, coughing, itching, heartburn, diarrhea, constipation or difficulty sleeping?

Try to be specific. “I feel unwell” does not give a pharmacist as much information as:

  • “I have had a dry cough for three days.”
  • “My nose is blocked, but I do not have a fever.”
  • “I have pain in my lower back after lifting something yesterday.”
  • “My eyes are itchy and watery when I go outdoors.”

Also mention how long the symptom has been present, whether it is improving or worsening, and whether anything unusual happened before it began.

Sometimes the most important question is not “Which product should I buy?” It is “Does this symptom need to be assessed instead?”

Severe, unusual, persistent or worsening symptoms may require advice from a pharmacist, doctor or another appropriate healthcare professional rather than continued self-treatment.

2. What is the active ingredient?

The front of an OTC package usually tells you what the product promises to relieve. The Drug Facts Table tells you what is actually inside it.

Check the active or medicinal ingredient and its strength.

Two products with different brand names, colours or package designs may contain the same active ingredient. Combination products may contain several ingredients intended to treat different symptoms.

Taking more than one product containing the same ingredient can result in an unintended duplicate dose.

For a closer look at this step, read Active Ingredient Check: A Simple OTC Medicine Safety Tip.

You can also review Before Buying an OTC Product: Check More Than the Front of the Box for a guide to the active ingredient, warnings and directions sections of the package.

A useful question is:

“Does anything else I take contain this ingredient?”

Do not rely only on recognizing the front of the box. Turn it around. The useful information is often having a quiet meeting on the back panel.

3. Is this product suitable with my other medicines?

Tell the pharmacist about everything you currently use, including:

  • Prescription medicines
  • Other OTC medicines
  • Vitamins and minerals
  • Herbal or natural health products
  • Sleep products
  • Creams, ointments, eye drops and inhalers
  • Products used only occasionally

Some medicines and health products can affect one another. An interaction may increase side effects, reduce how well a medicine works or make a product unsuitable in a particular situation.

A current medication list or clear photographs of the labels can help the pharmacist see the full picture.

Health Canada provides a medication chart that can be used to record prescription medicines, non-prescription medicines and natural health products.

For more on why vitamins and herbal products belong on the list, read Supplements Count Too: Why Your Pharmacist Needs the Full List.

4. Does it fit my health conditions and allergies?

An OTC product that is appropriate for one person may not be appropriate for someone with a different health history.

Tell the pharmacist if you have any medical conditions, particularly those listed in the product’s warnings. These may include conditions involving the heart, blood pressure, kidneys, liver, stomach, breathing, eyes, prostate, blood sugar or thyroid, depending on the product.

Also mention:

  • Medication allergies or previous reactions
  • Pregnancy, breastfeeding or plans to become pregnant
  • An upcoming operation or medical procedure
  • Difficulty swallowing tablets or capsules
  • The age of the person who will use the product
  • Whether the product is for a child or an older adult

The warnings section of Canada’s Drug Facts Table may include headings such as “Do not use,” “Ask a doctor or pharmacist before use,” “When using this product” and “Stop use and ask a doctor if.”

Health Canada explains these sections in its guide to non-prescription drug labels.

5. How should I use it?

Once a product has been selected, make sure you understand the directions.

Ask:

  • How much should I take or apply?
  • How often can I use it?
  • What is the maximum amount?
  • How many days should I use it?
  • Should it be taken with food or water?
  • Could it cause drowsiness?
  • Should I avoid alcohol, driving or operating machinery?
  • What should I do if I miss a dose?
  • Do I need a proper measuring device?

“Take as directed” only helps when the directions are actually understood.

For liquid products, use the measuring device recommended for that product. A household spoon is designed for cereal, soup and occasionally emergency ice cream—not accurate medicine measurement.

Always follow the specific label on the product you purchased. Directions can differ between ingredients, strengths, dosage forms and age groups.

6. How quickly should it help?

Ask when you might reasonably expect the symptom to improve.

Some products work relatively quickly, while others may take longer or require regular use. Knowing what to expect helps prevent taking extra doses too soon, adding unnecessary products or continuing something that is not helping.

A helpful question is:

“When should I notice improvement, and what should I do if I do not?”

Do not automatically increase the dose or use the product more frequently because the first dose did not produce an immediate result.

7. When should I stop using it or seek help?

Read the sections explaining when to stop the product and when to obtain medical advice.

Stop-use instructions vary by product. They may relate to:

  • A new rash or allergic reaction
  • Worsening symptoms
  • Unusual side effects
  • Symptoms lasting longer than the period stated on the label
  • New pain, bleeding, breathing difficulty or other concerning changes
  • Taking more than the recommended amount

Ask the pharmacist which warning signs are most important for the particular product and symptom.

Health Canada’s guidance on using medications safely recommends knowing how and when to use a medicine, how long to use it, possible interactions and the circumstances in which it should be stopped.

What to bring or tell the pharmacist

You do not need to arrive with a colour-coded medical binder and a PowerPoint presentation.

A few useful details are enough:

  • The symptom you want to treat
  • How long it has been present
  • The age of the person using the product
  • Current medicines and supplements
  • Allergies and past reactions
  • Relevant health conditions
  • Pregnancy or breastfeeding status
  • Products already tried
  • A photo of the product you are considering

You can simply say:

“I am thinking of starting this for my symptoms. Can you check whether it is suitable with my medicines and health conditions, how I should use it and when I should stop?”

The Institute for Safe Medication Practices Canada also provides 5 Questions to Ask About Your Medications to help patients and caregivers begin medication-safety conversations.

The simple takeaway

An OTC product may not require a prescription, but it still deserves a few questions.

Before starting it, ask:

  1. What symptom am I treating?
  2. What active ingredient does it contain?
  3. Does it fit my medicines, conditions and allergies?
  4. How should I use it?
  5. When should it help?
  6. When should I stop or seek advice?

The goal is not to make the OTC aisle frightening. It is to make the choice more informed.

No prescription does not mean no questions.

Disclaimer

This article is for general health education only and is not medical advice. OTC-product suitability, dosing, precautions and duration of use vary according to the active ingredient, dosage form, age, symptoms, medical history and other medicines or health products being used. Always follow the specific product label and speak with a pharmacist, doctor or another qualified healthcare professional when you are uncertain, when symptoms are severe or worsening, or before using a product for a child, during pregnancy or breastfeeding, or with existing health conditions.