A Review on Safety and Public Health Implications of Use of Over-the-Counter Pain Medication

Review Article

Abstract

Over-the-counter (OTC) pain medications are widely accessible category of pharmaceuticals used for managing mild to moderate pain. While these medications offer significant therapeutic benefits, their increasing misuse poses substantial public health challenges worldwide. Current epidemiological data indicates concerning trends in OTC medication misuse, with acetaminophen toxicity accounting for 46% of acute liver failure cases in the United States and 40-70% in Europe and Great Britain. The primary focus is on two major classes of OTC pain medications: nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. Their mechanisms of action, particularly through cyclooxygenase enzyme inhibition and prostaglandin synthesis modulation, directly influence their safety profiles. Misuse patterns encompass various behaviors, including self-medication, dosage exceedance, and inappropriate combination with other medications. The health consequences range from gastrointestinal complications and hepatotoxicity to cardiovascular and renal impairment. Recent regulatory measures and healthcare initiatives have attempted to address these challenges through restricted packaging, enhanced labeling requirements, and educational interventions. Nevertheless, the persistent gap between public perception of OTC medication safety and actual risk profiles necessitates continued attention to policy development and implementation of preventive methods