Non-prescription Medicines Alan Nathan BPharm, BA, FRPharmS Freelance pharmacy writer and consultant London, UK

Contents

Preface ix
About the author xi
1 Acne 1
2 Athlete's foot 9
3 Benign prostatic hyperplasia 15
4 Cardiovascular medicines 19
5 Chlamydia (Chlamydia trachomatis infection) 25
6 Colds 29
7 Cold sores 37
8 Constipation 43
9 Corns and calluses 55
10 Cough 59
11 Cradle cap 71
12 Cystitis 73
13 Dandruff and seborrhoeic dermatitis 77
14 Diarrhoea 85
15 Dry skin 95
16 Ear problems 101
17 Emergency hormonal contraception 107
18 Eye conditions 113
19 Fungal nail infection (onychomycosis) 123
20 Haemorrhoids 125
21 Hay fever 133
22 Head lice 145
23 Indigestion 151
24 Insect bites and stings 169
25 Irritable bowel syndrome 175
26 Irritant and allergic dermatitis and mild eczema 181
27 Migraine 187
28 Motion sickness 193
29 Mouth ulcers 199
30 Nappy rash 205
31 Obesity management 209
32 Oral thrush 213
33 Pain 215
34 Pattern baldness 235
35 Premenstrual syndrome 239
36 Scabies 243
37 Smoking cessation products 249
38 Sore throat 261
39 Temporary sleep disturbance 265
40 Threadworm and roundworm 271
41 Vaginal candidiasis 277
42 Vaginitis and vaginal dryness 283
43 Verrucas 285
44 Warts 291
Index 293
viii | Contents
Preface
The first reclassification of a medicine from Prescription-only (POM) to
Pharmacy sale (P) status was in 1983. Since then there has been a steady
stream of POM-to-P transfers, and more than 80 medicines are now available
over the counter (OTC) that previously could be obtained only by a visit to a
doctor. The government has reaffirmed its commitment to making medicines
more accessible to the public and has pledged to continue and increase the rate
of POM-to-P reclassifications and, where appropriate, to further deregulate
medicines to General Sale List (GSL) status to make them even more widely
available.
Pharmacists have traditionally had a major role in the management of
minor illness, which POM-to-P has increased. This role will increase further
as more medicines for preventing and treating more serious conditions are
made available without prescription.
The usefulness of non-prescription medicines and the important role they
play in self-care have tended to be underestimated, and the information
available about them, including in the main reference sources for medical
professionals, is sparse. This book is the only publication in the UK that deals
with non-prescription medicines comprehensively and in depth. Its aim is to
help pharmacists and other healthcare professionals to make well-informed
recommendations and to give their patients sound advice on non-prescription
medicines.
In this book, OTC medicines currently available in the UK are reviewed in
alphabetically arranged chapters on the conditions for which they are licensed
to treat. This book will also be of value to pharmacists and other health
professionals in the Republic of Ireland, because most of the proprietary
branded medicines available in the UK are also available under the same name
in Ireland. Also, patients from the UK, including from Northern Ireland, often
ask for UK products, and these products are familiar as transnational advertising
raises awareness. The classification of non-prescription medicines in
Ireland is generally similar to that it in the UK, but due to licensing restrictions
some medicines that are available without prescription in the UK are not in
Ireland.
Information is provided on the following aspects of products:
* compounds or constituents
* mode of action
* indications
* evidence of efficacy
* side-effects
* cautions and contraindications
* interactions
* dosage
* presentations and formulations
* products available and manufacturers (either all products in a category or,
for categories where there are a large number of products, a representative
selection)
* each section concludes with a summary of key points and suggestions for
the most appropriate products to recommend.
Evidence of the efficacy of medicines is cited where it exists. However, few
clinical trials on medicines for OTC use have been published, and most of the
available evidence comes from the use of medicines as POMs before their
reclassification to P status. In some instances, medicines are licensed for nonprescription
use for different indications and at different doses from their use
as prescription drugs, and caution may therefore be necessary in extrapolating
clinical trial evidence to OTC use. There is very little clinical trial evidence for
medicines that were already licensed for OTC use before POM-to-P reclassifications
began. Such trials as could be found and appear to meet current
methodological standards are cited.
This edition has been completely revised and brought up to date. New
products have been included and assessed, and discontinued products have
been deleted. New chapters on chlamydia obesity, and benign prostatic hyperplasia
have been added.
A feature introduced with the last edition – the publication of 6-monthly
updates on the Pharmaceutical Press website (www.pharmpress.com/onlineresources)
– is continued with this edition.
Alan Nathan
Marc2010

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