Over The Counter Medications – Know The Ingredients

There is a dizzying array of over the counter medications. Walk into any pharmacy and you are confronted with an entire wall full of packages. In fact the FDA states there are over 80 categories of non prescription medications and over 100,000 products on the market. Despite the large number of products on the market there are only about 800 different active ingredients.

So where do all these products come from?

There are multiple answers to this question.

First, one manufacturer may market one product in several different strength and dosage forms. For example, regular strength, extra strength, maximum strength, tablet, capsule, gelcap, caplet, children’s suspension and much more.

Second, more than one manufacturer may market the same chemical. Motrin®, Nuprin® and Advil® are all ibuprofen (also available in multiple store brands).

Third, each medication could be combined with other medications to make a combination product. This is especial common in cough and cold formulas.

Reformulations

As if the large number of marketed products were not enough of a problem, the manufacturers sometimes reformulate a product. One example that comes to mind is Kaopectate®. The original product was a combination of Kaolin and Pectin. This formula was changed around 1990 to attapulgite until 2003 when it was changed again to bismuth subsalicylate (the same as Bepto Bismol®). A person who did not read the labels would not be aware the product had changed until the product was opened and they noticed the liquid was different. The new product is not appropriate for children with a fever, people with aspirin allergy or people taking warfarin.

As I was reviewing the shelf for examples I stumbled across a reformulation I had not seen before. Alka-Seltzer Plus® Cold Formula has just been reformulated but the name is the same.

Old Formula – acetaminophen, chlorpheniramine, and phenylephrine

New Formula – aspirin, chlorpheniramine, and phenylephrine

This reformulation could be a problem for some people. It may be a problem if you have an allergy to aspiring, kidney problems, are on daily aspiring therapy, are taking warfarin, or have ulcers or other stomach problems.

Marketing

Manufacturers are always trying to position their products for increased sales. As a result, they will expand their lines or rename a formula.

A line expansion happens when a manufacturer wants to capitalize on its brand name and introduce a different product and maintain brand recognition. One example of an expanded line is Advil PM®. The manufacture has a great reputation with Advil® because it is widely recognized as a high quality brand name product. The addition of diphenhydramine to the ibuprophen in the original product results in a product which treats pain and helps you sleep. The manufacturer wins by instant brand recognition, increased shelf space in the store and increased sales. The problem with this is the customer is now faced with more choices in an already confusing environment. Also, there is the potential for over treatment as the customer may only need a sleep aid and not a pain medicine. They believe the product to be only intended for sleep and end up taking ibuprofen when there is no need.

A renamed formula is the result of a manufacturer who will take an existing product and change the name without making any change to the ingredients. This can occur for a variety of reasons. A slow moving product may need to be marketed differently to stimulate sales or the item is renamed to decrease confusion with another similar package.

Here is just one example of a renamed formula. CoAdvil® is a product that contained ibuprofen and pseudoephedrine. This item has been renamed to Advil Cold and Sinus. Both products have the same ingredients at the same concentrations. Only the name has changed. The customer looking for the old formula would have a difficult time finding the new product.

Regulations

Because the FDA requires specific labeling depending on various uses for a medication, it is difficult for a manufacturer to market a product for more than one indication. For example, diphenhydramine is useful to treat allergies, runny nose, motion sickness, insomnia and hives. Due to labeling regulations and other restrictions it cannot be marketed in a single package for all theses uses. Each use is marketed in a different package and often under a different brand name. (Bendryl®, Sominex®)

Conclusion

If you are looking for a safe and effective over the counter treatment, you have a lot of different options available. Unfortunately, selection of the right product is getting more difficult. It is important to read the package label and know the names of the medications in the package. If you are unsure which product to select check with your pharmacist. They are your best resource for information about over the counter medications and can help you select the best medication.