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Over-the-Counter Analgesics in Older Adults

A Call for Improved Labelling and Consumer Education

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Abstract

The use of analgesics increases with age and on any given day 20–30% of older adults take an analgesic medication. Over-the-counter (OTC) analgesics are generally well tolerated and effective when taken for brief periods of time and at recommended dosages. However, their long-term use, use at inappropriately high doses, or use by persons with contraindications may result in adverse effects, including gastrointestinal haemorrhage, cardiovascular toxicity, renal toxicity and hepatotoxicity. Many OTC drugs are also available through a prescription, for a broader range of indications and for longer durations of use and wider dose ranges, under the assumption that healthcare providers will help patients make safe choices about analgesics. Safe and effective use of medications is one of the greatest challenges faced by healthcare providers in medicine. More than 60% of people cannot identify the active ingredient in their brand of pain reliever. Additionally, about 40% of Americans believe that OTC drugs are too weak to cause any real harm. As a result of a recent US FDA policy, the conversion of prescription to OTC medications will result in a 50% increase of OTC medications. To reduce the risks of potential adverse effects from OTC drug therapy in older adults, we propose that the use of analgesics will be enhanced through the use of patient and healthcare provider education, as well as improved labelling of OTC analgesics. Improved labelling of OTC analgesics may help consumers distinguish common analgesic ingredients in a wide variety of preparations and facilitate informed decisions concerning the use of OTC drugs.

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Acknowledgements

This material is based upon work supported by the Office of Academic Affiliations, Department of Veterans Affairs, and the VA National Quality Scholars Program (Dr Roumie); Vanderbilt Center for Education and Research, Vanderbilt Center for Education and Research on Therapeutics, Vanderbilt University School of Medicine, and the Geriatric Research Education and Clinical Center, Veterans Affairs, Tennessee Valley Healthcare System (Dr Griffin).

Dr Griffin serves as a consultant to Merck Inc., as Chair of their endpoint monitoring committee for COX-2 inhibitor studies.

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Authors and Affiliations

  1. Quality Scholars Program, Veterans Administration, Tennessee Valley Healthcare System, Nashville, Tennessee, USA

    Christianne L. Roumie

  2. Division of General Internal Medicine, Vanderbilt University, Nashville, Tennessee, USA

    Christianne L. Roumie & Marie R. Griffin

  3. Department of Preventive Medicine and Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA

    Marie R. Griffin

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  1. Christianne L. Roumie
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  2. Marie R. Griffin
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Correspondence to Christianne L. Roumie.

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Roumie, C.L., Griffin, M.R. Over-the-Counter Analgesics in Older Adults. Drugs Aging 21, 485–498 (2004). https://doi.org/10.2165/00002512-200421080-00001

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