ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, November 17, 1996 TAG: 9611180145
SECTION: BUSINESS PAGE: 4 EDITION: METRO
DATELINE: BRADENTON, FLA.
SOURCE: SHELLY SIGO KNIGHT-RIDDER/TRIBUNE
If the number of commercials on television is any indication, it would seem that Americans can't cope with anything.
Just think about the last time you saw an ad for a new antacid or pain reliever.
But face it, drug companies have made our daily stresses easier to swallow by asking the Food and Drug Administration for a plethora of switches from prescription to over-the-counter drugs.
According to the Nonprescription Drug Manufacturers Association in Washington, D.C., 66 ingredients or dosage strengths have switched from prescription to over-the-counter status since 1975.
More than 600 over-the-counter products today use ingredients or dosages available only by prescription just 20 years ago, including Pepcid and Tagamet, which switched last year.
Today, 60 percent of all medications sold are nonprescription and studies indicate that Americans care for their ailments without professional help 60 percent to 95 percent of the time, the American Pharmaceutical Association reports.
That's what worries internal medicine specialist Dr. Paul Barrese about some former prescription drugs now available over-the-counter.
``People gulp these down to help with upset stomach and indigestion,'' said Barrese, president of the Manatee County Medical Society. ``Lots of people might be masking a major problem from an ulcer to stomach cancer.''
And the potential problems don't stop there.
Some people see drugs approved by the FDA available without a prescription and assume they are safe.
``There's a lot of potential for people doing harm to themselves by not using them properly,'' Barrese said. ``Even Tylenol is dangerous if you take too much.''
With drug companies making it easier to choose a remedy, the way to prevent problems is to read drug labels and follow dosage guidelines, according to the Council on Family Health in Washington, D.C., a consumer information organization.
For example, now that it's cold and flu season, many people will look for a variety of cures. Reading the label will help determine which medication is best, said Council President William I. Bergman.
``Medicines, when taken as directed, work well for most people,'' Bergman said. ``That's why it's important to read the drug-interaction warnings on the medicine label every time before taking any medicine.''
But many people don't read the labels, complained Barrese, who has treated people who developed ulcers from overusing over-the-counter drugs.
One patient, he said, took 16 Advils a day for sinus headaches, far exceeding the recommended dosage. Liver problems were discovered when the patient had a physical examination.
Making it difficult for consumers to cope with new-found choices is the fast pace by which the FDA is approving prescription to over-the-counter switches.
In 1995, for example, the FDA approved six over-the-counter drugs. As of Aug. 26 of this year, eight over-the-counter drugs had been approved.
And as many as 120 other switches have been requested, according to the 227,000-member pharmaceutical association.
Some drug companies are switching because of the competition posed by less-costly generic versions.
So consumer confusion about the availability of prescription and non-prescription drugs at the same time is a major problem, the association reported in the August Journal of the American Pharmaceutical Association.
Some people who need prescription-strength medication are opting for the less expensive, lower-dose, over-the-counter version instead.
For example, the Journal found the average cost of nonprescription ibuprofen is $4, while the average cost of the prescription version is $24 and may require the added cost of a doctor's office visit.
Barrese has tended patients who under-medicated themselves switching from prescription to over-the-counter doses to save money.
And as time goes on, he predicts more people will use over-the-counter drugs improperly.
``They will get into trouble from over-using them, mixing them with the wrong pills, or taking a pill and masking a bigger problem,'' Barrese said. ``And by the time they come to the doctor, it will be too late to do something about it.''
HOW TO USE MEDICATION
The Council on Family Health provides these free brochures on the proper use of medication:
* ``The Medicine Label Your Road Map to Good Health
* ``How to Prevent Drug Interactions''
* ``Medicines and You: A Guide for Older Americans''
* ``Ten Guides to Proper Medicine Use''
* ``Non-Prescription Medicines: A Consumer's Dictionary of Terms''
To request a brochure or get more information send a self-addressed, self-stamped envelope to the: Council on Family Health, 225 Park Ave. S., Suite 1700, New York, N.Y. 10003.
FACTS ABOUT OTC DRUGS
* If you don't know what it's for, don't take it.
* Read the label. Follow instructions on the dosage; heed warnings.
* If a problem persists, see a doctor. An over-the-counter drug can mask a serious problem.
* People taking prescription medications should check with a doctor or pharmacist before taking over-the-counter drugs.
* Some over-the-counter drugs may be cheaper than the prescription version, so check with your doctor before making a switch or substitution.
* Some over-the-counter drugs have side effects and can damage organs. Ask your doctor.
* Call a pediatrician for advice about drugs given to children.
* If you had a reaction to the prescription form of a drug, don't assume the over-the-counter version is safe.
* Pharmacists can recommend a generic over-the-counter product that is comparable to the trade name, but less expensive.
* Keep a list of all medications you are taking to show your doctor and pharmacist.
Sources: Dr. Paul Barrese, president of the Manatee, Fla. County Medical Society; the American Pharmaceutical Association; and the Council on Family Health.
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