PERCEPTION OF CUSTOMER, PHARMACIST AND

PHYSICIAN ON USE OF OVER THE COUNTER(OTC)

MEDICINE
Project Work in Pharmacy
Submitted under
The Faculty of Science and Technology
To

PUNYASHLOK AHILYADEVI HOLKAR

SOLAPUR UNIVERSITY, SOLAPUR
By

Ms. Devsani Namrata Dattatray Mr. Dudhal Abhishek Shahaji

Ms. Dhurgude Aishwarya Subhash Mr. Choure Rahul Nanasaheb

Ms. Choukhande Vanita Padamanna Ms. Das Piyusha Vijaykumar

Under the Guidance of

Mr. Krishnamurthy. A. Kamlapurkar
Assistant Professor
Department of Pharmaceutics
D.S.T.S. Mandal’s, College of Pharmacy, Solapur.
2020-2021

1
 PUNYASHLOK AHILYADEVI HOLKAR SOLAPUR
UNIVERSITY, SOLAPUR.

DECLARATION BY THE CANDIDATES

We hereby declare that this project work entitled “Perception
of Customer, Pharmacist and Physician on Use of Over the
Counter (OTC) Medicine” is a bonafide and genuine work
carried out by us under the guidance of Mr. Krishnamurthy. A.
Kamlapurkar, Assistant Professor, Department of
Pharmaceutics, D.S.T.S. Mandal’s College of Pharmacy,
Solapur, Maharashtra.
Place: - Solapur
Date: -
Sr. No NAME CLASS SIGNATURE

1 Ms. DEVSANI NAMRATA Final

DATTATRAY year
2 Mr. DUDHAL ABHISHEK Final
SHAHAJI year

3 Ms. DHURGUDE AISHWARYA Final

SUBHASH year
4 Mr. CHOURE RAHUL Final
NANASAHEB year
5 Ms. CHOUKHANDE VANITA Final
PADAMANNA year

6 Ms. DAS PIYUSHA VIJAYKUMAR Final

year

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 D.S.T.S. Mandal’s, College of Pharmacy, Solapur

CERTIFICATE

This is to certify that the project work entitled “Perception of Customer,

Pharmacist and Physician on Use of Over the Counter (OTC) Medicine”
is a bonafide and genuine work carried out by the following students
Ms. Devsani Namrata Dattatray, Mr. Dudhal Abhishek Shahaji, Ms.
Dhurgude Aishwarya Subhash, Mr. Choure Rahul Nanasaheb, Ms. Das
Piyusha Vijaykumar and Ms. Choukhande Vanita Padamanna of final year
B pharmacy, D.S.T.S. Mandal’s, College of Pharmacy, Solapur under my
supervision during the year 2020-2021. I also certify that the project
represents independent work done by students.

Place: Supervisor
Date: Mr. Krishnamurthy. A. Kamlapurkar
D.S.T.S. Mandal’s
College of Pharmacy, Solapur

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 D.S.T.S. Mandal’s, College of Pharmacy, Solapur

CERTIFICATE

This is to certify that the project work entitled “Perception of Customer,

Pharmacist and Physician on Use of Over the Counter (OTC) Medicine”
is a bonafide and genuine work carried out by the following students Ms.
Devsani Namrata Dattatray, Mr. Dudhal Abhishek Shahaji, Ms. Dhurgude
Aishwarya Subhash, Mr. Choure Rahul Nanasaheb, Ms. Das Piyusha
Vijaykumar and Ms. Choukhande Vanita Padamanna of final year B
pharmacy under the guidance of Mr. Krishnamurthy.A.Kamlapurkar,
D.S.T.S. Mandal’s, College of Pharmacy, Solapur.

Place: Principal
Date: Dr. R. Y. Patil
D.S.T.S. Mandal’s
College of Pharmacy, Solapur

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 Acknowledgement

We indebted to Principal Dr. R Y Patil and the management of

D.S.T.S Mandal’s College of Pharmacy for providing us support.
We are thankful to our guide Mr. Krishnamurthy. A. Kamlapurkar
for helping us in selecting an interesting topic for the work and also
for helping us to carry out the work by giving valuable comments
and suggestions at appropriate time and while preparing the report.

5
 INDEX
Sr.no Content Page no
1 Abstract 7

2 Introduction 8

3 Objectives 11

4 Materials & Methods 12

5 Result and discussions 18

6 Conclusion 36

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ABSTRACT
Aim: The study was conducted to evaluate the perception of customer,
pharmacist and physician on use of over the counter (OTC) drugs and to
determine the awareness and side effects on use of OTC.

Methods: The data was collected by using validated questionnaire which was
based on the usage of OTC drugs in community. Responses were obtained from
the customer, pharmacist and physician to assess knowledge, attitude and practice
towards the OTC medication. Descriptive statistics were used for data analyses.

Results: Frequently used OTC medication were for cough and cold followed by
antacid, analgesic and fever. Most common reason to take OTC medicine was
due to mild nature of illness. According to view point of customer it was found
that ENO and Zandu balm is the widely used antacid and analgesic OTC drug
respectively. According to the view point of pharmacist it was found that antacids
are the mostly sold OTC drugs. It was found that ENO and volini gel are the
mostly sold antacid and analgesic OTC drug respectively. According to view
point of physician Adverse Drug Reporting (ADR) reporting was found to be
necessary.
Conclusion: The study concluded that majority of participants used OTC drug
for self-medication. Majority of participants got satisfactory result of OTC drugs.
Awareness and dangers of misuse and side effects of OTC medications among all
participants was less. This study revealed that inappropriate self-medication
practice with OTC drugs was prevalent requiring early intervention to minimize
the risks.

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INTRODUCTION:
In recent years there has been an increasing trend in self-medication with non-prescription
drugs. Over the counter medicine is also known as OTC or non-prescription medicine. All
these terms refer to medicine that you can buy without a prescription. They are safe and
effective when you follow the directions on the label and as directed by your health care
professional.
OTC Drug Facts Label: Whenever you use an over the counter (OTC) medicine, reading the
drug product’s labelling is important for taking care of yourself and your family. The label tells
you what the medicine is supposed to do, who should or shouldn’t take it, and how to use it. In
the Federal Register of March 1999, the Food and Drug Administration published the OTC
Drug Facts Label regulation. The OTC labelling rule applies to more than 100,000 OTC drug
products.
The FDA also found that consumers thought words like “indications,” “precautions,” and
“contraindications” were confusing and not easily understood. Finding information about
inactive ingredients has also been a challenge for those who may be allergic to an ingredient in
a drug product. The following information must appear in this order: The product’s active
ingredients, including the amount in each dosage unit. The purpose of the product. The uses
(indications) for the product. Specific warnings, including when the product should not be used
under any circumstances, and when it is appropriate to consult with a physician or pharmacist.
This section also describes side effects that could occur and substances or activities to avoid.
Dosage instructions—when, how, and how often to take the product. The product’s inactive
ingredients, important information to help consumers avoid ingredients that may cause an
allergic reaction. The review of OTC medications is primarily handled by the U.S. Food and
Drug Administration’s (FDA) Division of Drug Information (CDER), the Office of Drug
Evaluation, and the Non-prescription Drug Advisory Committee. The monograph contains
acceptable ingredients, doses, formulations, and labelling.
How is India planning to regulate OTC drugs?
The Central Drug Standards Control Organisation (CDSCO) is planning to frame regulations
for non-prescription drugs or over the counter (OTC) drugs. In an attempt to curb their sales,
the government is also planning to ask chemists to stamp prescriptions so that prescriptions are
not reused. The drug consultative committee (DCC) of CDSCO took this decision to “promote
self-care without compromising patient safety, thereby reducing the treatment cost.” According
to this report, the new guidelines will be put in place in a bid to reduce anti-microbial resistance
due to overconsumption of such drugs and to fall in line with globally accepted practices.
Currently, there can be [a] misuse of high-risk drugs as there are no separate regulations. At
present, drugs classified as Schedule X, H, H1 G and K cannot be sold without a physician’s
prescription.” The CDSCO has now decided that OTC drugs will be classified into two
categories⁠—OTC-1 and OTC-2⁠—based on the extent of evidence, safety, therapeutic index,

8
need for accessibility to patients, availability, non-habit-forming nature, present supply chain
mechanism and socioeconomic conditions of the country.
Three criteria that must be met by an OTC drug? • It must be safe, • It must be effective •
It must be for a condition that the patient can manage without supervision by a licensed health
professional. OTC drugs should only be used to treat minor ailments.
OTC Drug Abuse
Some abuse OTC drugs to self-medicate for mental illnesses like anxiety and depression.
Abusing these medications can also give users a euphoric “high” or hallucinations. Any use
outside of what’s recommended is considered abuse. Eventually the user builds a tolerance to
the drugs, needing more of the substance to get the previous effects. Those addicted to OTC
drugs maybe also develop withdrawal symptoms when they stop using. Common symptoms of
OTC drug withdrawal include: Confusion, Irritability, Agitation, Anxiety, Mood changes etc.
OTC drugs like Tylenol and various cough medicines don’t carry the same dangerous image
as illicit drugs like heroin. People don’t always see them as addictive, so many loved ones of
people addicted to OTC drugs don’t know to look for signs of a growing problem. Some of the
signs of an OTC drug addiction include continuing to use the drugs despite known
consequences and spending an excessive amount of time or money using or getting them.
Inappropriate use and adverse effects: An adverse drug reaction (ADR) can be defined as
‘an appreciably harmful or unpleasant reaction resulting from an intervention related to the use
of a medicinal product; adverse effects usually predict hazard from future administration and
warrant prevention, or specific treatment, or alteration of the dosage regimen, or withdrawal of
the product.
The concerns about misuse, adverse effects including dependence (especially to sedatives,
analgesics, antacids, laxatives), drug resistance, and delayed diagnosis of underlying conditions
due to use of OTC medicines pose formidable challenges. As per the National survey data
submitted by Substance Abuse and Mental Health Services administration (SAMHSA) in US,
about 3.1 million people aged 12 years and older have misused OTC medications at least once
in their lifetime (3.7% in < 18 years old).
ADRs resulting from prescription medicines, herbal remedies and OTC medications can all be
reported. If there is any doubt about whether or not an ADR has occurred and should be
reported it is always best practice to submit a report. Adverse drug reactions reporting tools or
monitoring is a process of continuously monitoring of undesirable effect suspected to be
associated with use of medical products. ADR reporting covers all pharmaceutical products,
biological, herbal drugs, cosmetics and medical devices.

A meta-analysis by Frei et al., threw light on the fact that over half a million Australians use
analgesics over the counter for nonmedical purpose and OTC medicines are the third most
common form of substance abuse in Australia. Similarly, in Canada, it was found that OTC
medicines were widely abused. In India, abuse of OTC medicines is not well documented. One
report mentions that cough syrups and antihistamine medications sold over the counter are a

9
prevalent form of drug abuse in India. Despite their importance, instructions for use mentioned
on the labels of OTC medicines are often not adequate, filled in small space and are missed by
patients. As a result, patients do not follow the instructions. An interesting study from India
assessed whether labels of 100 non-prescription medicines complied with the requirements
mentioned in the US FDA guidelines. It was found that 87% of the labels lacked information
regarding contraindications. In 90% of the labels, adverse effects and in 96% information about
their use during pregnancy and breastfeeding were missing.
Benefits of using approved OTC medicines OTC medicines allow greater access to treatment
of people at large at lower cost for minor or self-limiting illnesses. This is extremely useful for
countries like India where the physician to patient ratio is less (1:1800) than other countries.
For ensuring optimum use of OTC medicines, pharmacists can provide a valuable interface by
using their professional knowledge to guide patients.
Drug Side Effects Explained: From the homely aspirin to the most sophisticated prescription
medicine on the market, all drugs come with side effects. Many are minor, some are just an
inconvenience, a few are serious, and some are just plain strange. Perhaps the most common
set of side effects for drugs that work inside your body involves the gastrointestinal system.
Nearly any drug can cause nausea or an upset stomach, though it may only happen to a handful
of people. For drugs used on the outside, skin irritation is a common complaint. To find more
about a drug's side effects, look on the label of over the counter (OTC) products or on package
inserts or printed materials that you get with prescription drugs.
Types of Side Effects
An allergic reaction could happen with any drug. That can range from itching and rash all the
way to a life-threatening anaphylactic reaction. Abusing OTC drugs can lead to health
problems including memory loss, kidney failure, heart problems and death. Some commonly
abused OTC medications include: Cough medicines (Dextromethorphan, or DXM) Cold
medicines (Pseudoephedrine).
Over the counter counselling refers to the counselling that a pharmacist may provide on the
subject of initiating, modifying, or stopping an over the counter (OTC) drug product. OTC
counselling requires an assessment of the patient's self-care concerns and drug-related needs.
The types of drugs that are involved in OTC counselling are, for example, used to treat self-
diagnosable conditions like heartburn, cough, and rashes, though prescription drugs and
professional diagnoses are also relevant to the recommendation process.
To a large extent, the culture of self-medication has promoted due to deregulation of drugs. It
is evident from various studies that self-medication practice is high with OTC drugs. Self-
medication is like a proverbial double-edged sword, in one hand it empowers the patients by
providing them easy access to medication, cutting the medical expenditure by reducing
cumbersome hospital visits; but in other hand sometime it inflicts harm to patients by delaying
the diagnosis and causing different adverse effect. Studies done across the world have revealed
that, there is an upsurge in trend of self-medication and its horizon is ever expanding.

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Pharmacists could play an important role in modifying the behaviour of patients as far as self-
medication is concern because pharmacists and drug dispensers are the final link between
medication and patients. Public finds pharmacist as an easily accessible and acceptable source
of advice and suggestion They can also provide appropriate, understandable and relevant
information to patient about their medications and about various nuggets of OTC.

OBJECTIVES
• Considering the importance of judicious use of OTC drugs and role of drug dispensers
in fostering that practice among patients, we carried out this study to assess knowledge,
attitude and practice of OTC drugs among dispensers working in retail pharmacies.
• To study the extent of use of OTC drugs in the community.
• The main aim of this study was to investigate the general public’s opinion and perception of
OTC medicines, including the misuse/abuse of such preparations.
• To assess the practice of self-medication, prevalence of risky practice and its associated
factors.
• To spread the awareness on use of OTC drugs among the people in society.

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METHODOLOGY
Following ethical approval and a pilot study, all customers, pharmacists & physicians were
invited to participate in a self-completed questionnaire, distributed at a mandatory class.
Descriptive statistics were used for data analyses.

Cross-sectional questionnaire-based study was conducted to assess the knowledge, attitude,

and practice among pharmacists regarding OTC medications.
A predesigned validated questionnaire consisting of 19 questions were used among pharmacist
population, 18 questions were used for customer and few questions to know the perception of
physician towards the OTC drugs.

The questionnaire was regarding

1.category of OTC drugs
2. side effects
3.adverse effects
4.reason to prefer OTC drugs
5.awareness about the use of OTC drugs
6.counselling by the pharmacist and much more

The google form was shared through different social media platforms and responses were
collected.
The responses of pharmacist and physician were taken by face-to-face interaction.

Model of google form

At the start aim and purpose of this survey was cleared. Then it described the simple definition
of OTC drugs. Further-more introduction of team with guide was done. After the basic
questions we moved forward to questionnaire which was different for customer, pharmacist &
physician. For Customers, the form was in Marathi language for ease of understanding. For
pharmacist and physician, the form was in English language.

QUESTIONS FOR CUSTOMER:

-Gender
Male Female
Other
-Age
16-25 26-35 36-45 45 and above

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1)Which category of OTC drugs you mostly use?
a. Antacid
b. Analgesic
c. Cough /Cold
d. Sore throat
e. Fever

2)In which condition you use OTC drugs?

a. Whenever I feel sick
b. When I cannot visit the doctor
c. When the symptoms are minor
3) How you ask for the medicine to the pharmacist?
a. by name
b. by symptoms
c. by reference of TV advertisement
d. other
4) Why do you prefer OTC drugs instead of going to the doctor?
a. Easy availability of drugs
b. To save money
c. To save time
d. Habitual to it
5) Which OTC drug do you prefer for Acidity?
a. ENO
b. Gelusil
c. Digene
d. Gasofast

6)Have you faced any side effects of OTC drugs?

Yes
No

7) Which side effects have you experienced due to use of OTC antacid?
a. Diarrhoea or constipation
b. Flatulence (passing gas)
c. Stomach cramps
d. Feeling sick or vomiting
e. None of the above

8)Which OTC drug do you prefer as analgesic?

a. Volini gel
b. Zandu balm
c. Tiger balm
d. Moov gel

9) Which side effects have you experienced due to use of OTC analgesic?
a. Drowsiness (feeling sleepy)

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 b. Skin itching or rashes
c. Dry mouth
d. Dizziness(unsteadiness)

10) How often you use OTC medicine?

Regularly
Occasionally

11) If you face any side effects of OTC drugs what will you do?
a. Stop the medication
b. Use alternative medicine
c. Consult doctor
d. Search for its information on internet

12)Do you get satisfactory result after using OTC drugs?

Yes
No

13) Does the pharmacist counsel you about the use of drugs?
Yes
No

14) Which type OTC drug do you prefer?

Generic
Brand

15) Which type OTC drug you use mostly?

a. Allopathic
b. Ayurvedic
c. Homeopathic
d. Unani

16) Which category of OTC drugs were used more in COVID-19 period?
a. Fever
b. throat infection
c. immunity booster
d. cough/cold
e. None of the above

17) Have you faced any serious effect due to OTC drugs? (liver problem, kidney problem,
heart problem)
Yes
No

18)Do you think that self-medication without consulting the doctor is harmful?
Yes
No

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QUESTIONS FOR PHARMACIST:
1. Which category of OTC drugs are mostly sold?
Choose any 3 options
a. Antacid
b. Analgesic
c. Cough /Cold
d. Sore throat
e. Fever
f. Nutritional supplements

2. Which is the most preferred drug for Acidity?

a. ENO
b. Gelusil
c. Digene
d. Gasofast

3. Which are the most common side effects of antacid?

a. Diarrhoea or constipation
b. Flatulence (passing gas)
c. Stomach cramps
d. Feeling sick or vomiting

4. Which is the most preferred drug for Analgesic/pain relief?

a. Volini gel
b. Zandu balm
c. Tiger balm
d. Moov gel

5. Which are the most common side effects of analgesic?

a. Drowsiness (feeling sleepy)
b. Skin itching or rashes
c. Dry mouth
d. Dizziness(unsteadiness)

6.Do you think Adverse Drug Reporting is necessary?

Yes
No

7.What are the most common adverse drug reactions by use of OTC drugs?
a. Kidney problem
b. Liver problem
c. Heart problem
d. Other

8.Which is the mostly seen adverse effect of analgesic OTC drugs?

a. Kidney problem
b. Liver problem
c. GIT problem
d. Heart problem

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9.Have any customer reported you the adverse drug reaction of OTC drugs?
Yes
No

10. How many customers visit pharmacy for OTC drugs in a week?
a. 20-30
b. 31-50
c. 51-70
d. >71

11. Choice of OTC medicine is made by;

customer
pharmacist

12. What factors you consider while dispensing the drugs?

a. price
b. quality
c. safety
d. brand

13. Which OTC drugs are preferred by the customers?

generic
brand

14. Which group of OTC drugs have more profitable margin?

generic
brand

15. How does the customer ask for medicine?

a. by name of drugs
b. by telling symptoms
c. by reference of TV advertisements
d. Other

16. What type of OTC drugs are mostly sold?

allopathic
ayurvedic

17. Which category of OTC drugs were used more in COVID-19 period?
a. fever
b. throat infection
c. immunity booster
d. cough/cold

18. Do you counsel the customers about the use of drugs?

yes
no

19. Please provide some points on awareness on use of OTC drugs among the people.

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QUESTIONS FOR PHYSICIAN:
1. Do you think ADR (Adverse drug reaction) reporting is necessary?
Yes
No

2. Which is the most common adverse effect of OTC drugs?

a. Kidney problem
b. Liver problem
c. Heart problem
d. Other

3. Have any patient reported adverse effect of OTC drugs to you? If yes how many cases in
average have been reported in a month?
a. No
b. Yes
c. Less than 10
d. 10-20
e. 20-30
f. More than 30

4. Which is mostly seen adverse effect of analgesic OTC drugs?

a. Kidney problem
b. Liver problem
c. GIT problem
d. Heart problem
e. Other

5.Which is mostly seen adverse effect of antacids OTC drugs?

a. Aluminium intoxication
b. Hypophosphatemia
c. Osteomalacia
d. Other

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 RESULTS and DISCUSSION
Table No. 1 View point of customer /patient on OTC medicine
Sr. Questions Response
No.
1 Gender Male Female
43% 57%
2 Age 16-25 26-35 36-45
71.5% 13.4% 9.4%
3 Which category of OTC drugs you Cough/cold Antacids Analgesic
mostly use? 53.4% 40.1% 25.3%
4 In which condition you use OTC When the symptoms are minor Whenever I feel sick
drugs? 68.2% 21.7%
5 How you ask for the medicine to the By symptoms By name
pharmacist? 58.1% 35.7%
6 Why do you prefer OTC drugs Easy availability of To save time Habitual to it
instead of going to the doctor? drugs 15.5% 12.3%
67.5%
7 Which OTC drug do you prefer for ENO Gelusil
Acidity? 71.1% 17.3%
8 Have you faced any side effects of Yes No
OTC drugs? 14.4% 85.6%
9 Which side effects have you None of the above Feeling sick or Diarrhoea/constipation
experienced due to use of OTC 81.9% vomiting 6.5%
antacid? 7.9%
10 Which OTC drug do you prefer as Zandu balm Moov gel Volini gel
analgesic? 68.2% 20.2% 10.5%
11 Which side effects have you None of the above Drowsiness Skin itching or rashes
experienced due to use of OTC 78.3% 13.7% 5.1%
analgesic?
12 How often you use OTC medicine? Occasionally Regularly
97.1% 2.9%
13 If you face any side effects of OTC Consult doctor Stop the medications
drugs what will you do? 71.5% 18.8%
14 Do you get satisfactory result after Yes No
using OTC drugs? 85.6% 14.4%
15 Does the pharmacist counsel you Yes No
about the use of drugs? 79.8% 20.2%
16 Which type OTC drug do you Brand Generic
prefer? 69% 31%
17 Which type OTC drug you use Allopathic Ayurvedic Homeopathic
mostly? 48.4% 28.9% 20.9%
18 Which category of OTC drugs were Immunity booster Cough/Cold Throat infection
used more in COVID-19 period? 44.4% 16.2% 5.1%
19 Have you faced any serious effect No Yes
due to OTC drugs? (liver problem, 92.4% 7.6%
kidney problem, heart problem)
20 Do you think that self-medication Yes No
without consulting the doctor is 86.6% 13.4%
harmful?

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According to view point of customer/ patient on OTC medicine

We had collected 277 responses in which 43% were male and 57% were female.

From total responders 71.5% were in age group of 16-25yrs,

13.4% were in age group of 26-35yrs,
9.4% were in age group of 36-45yrs.

The drugs which were frequently used for OTC medication were for cough and cold (53.4%)
followed by antacid (40.1%), analgesic (25.3%) and fever (21.7%).

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 Category of Drug Number of customers
Cough and Cold 148 (53.4%)
Antacid 111 (40.1%)
Analgesic 70 (25.3%)
Fever 60 (21.7%)
Throat infection 24 (8.7%)

In our study we found that most common reason to take OTC medicine is due to minor nature
of illness that is the symptoms are mild, some of them preferred OTC whenever they felt sick
or ill, followed by the reason that they found it cumbersome to go to doctor.

Most of the costumers asked for the OTC medicine by the symptoms of illness (58.1%), by the
name of medicine (35.7%), and remaining percentage of customers asked for medicine from
the advertisement.

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It was found that due of easy availability of drug most of the customer preferred OTC drugs.

Among all respondent’s majority of people had taken ENO (71.1%) as an antacid followed by
Gelusil (17.3%), Digene and Gasofast.

The study showed that majority of respondents had not faced any major side effects of OTC
medicine. i.e. (85.6%) respondents and very few respondents i.e. (14.4%) had faced some side
effects of OTC medicine.

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It was found that after taking antacid drug most of people not had any side effects (81.9%) on
the other hand some of them faced side effects like vomiting or feeling like sick (7.9%),
diarrhoea or constipation (6.5.%), Stomach pain (4.3%), cramps in stomach (2.2%).

According to our study majority of respondents preferred Zandu balm as analgesic (68.2%),
followed by Moov gel (20.2%), Volini gel (10.5%), Tiger balm (1.1%).

After taking analgesic medicine majority of respondents (78.3%) not had any major side
effects, while few peoples (13.7%) had dizziness as a side effect. Followed by rashes and
redness of skin (5.1%), dryness of mouth (3.2%), Vertigo (2.2%).

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(97.1%) of the participants used OTC medicine occasionally, it has shown that very few of
them use OTC medicine daily.

After facing the consequences of the side effect of OTC medicine most of the patients preferred
taking prescribed medicine by the physician (71.5%), the other possible solutions were stopped
taking that particular medicine (18.8%) and searched for information of OTC medicine on
internet or used the alternative drug.

Among all respondents majorly (85.6%) participants got satisfactory effect of OTC medicine,
14.4% respondents not got satisfactory effect of OTC medicine.

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According to the study majority of pharmacists (79.8%) provided counselling to customers
about how to use the OTC medicine and remaining (20.2%) pharmacists not provided any
counselling about how take the OTC medicine.

Most of the respondents (69%) preferred to use branded OTC medicine and remaining
respondents (31%) preferred generic OTC medicine.

Majority of respondents given preference to Allopathic (48.4%) type of OTC medicine in

decreasing order of Ayurvedic (28.9%), Homeopathic (20.9%) and Unani etc.

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According to our study during Covid-19 situation these OTC medicines were mostly used,
Category of OTC medicine No. of respondents
Immunity Booster 123
No any medicine 73
Cold 45
Throat infection 14
Cough 11
Fever 11

Majority of respondents (92.4%) not faced any major adverse effect or unwanted effect like
Kidney problem, Heart problem, Liver problem. Few respondents faced some adverse or
unwanted effect (7.6%).
Most of the respondents (86.6%) believed that self-medication may be harmful or dangerous
and (13.4%) respondents believed that self- medication may not be harmful or dangerous.

25
 Table No. 2 View point of pharmacist on OTC medicine
Sr Question Responses
no.
1 Most sold category of OTC Antacids. Cough and cold. Analgesic
drugs. 77.6% 75.3% 69.4%

2 Most preferred OTC drug for ENO Gelusil Digene

acidity. 43.5% 29.4% 14.1%
3 Side effects of antacid. Flatulence Diarrhoea or Feeling sick or
34% Constipation vomiting
34.1% 25.9%
4 Most preferred OTC drug for Volini gel Zandu balm Moov gel
painkiller or analgesic. 41.2% 30.6% 24.7 %
5 Most common side effects of Drowsiness. Dizziness Skin itching
analgesic. 43.5% 37.6% 21.2%
6 Is adverse drug reporting Yes, No
necessary? 83.5% 16.5%
7 Most common adverse drug Kidney problem. Liver problem
reactions of OTC drugs. 60% 29.4%
8 Mostly seen adverse effect of Kidney problem GIT. Problem. Liver problem.
analgesic. 42.2% 36.5% 18.8%
9 Have any customer reported Yes, No
the adverse drug reaction of 56.5% 43.5%
OTC medicine?
10 No. of customer visited 20- 30 31-50 51-70
pharmacy in a week. 34.1% 25.9% 16.5%
11 Choice of OTC medicine is Pharmacist Customer
made by. 64.7% 35.3%
12 Factors considered while Safety Quality Brand
dispensing drug. 72.9% 43.5% 28.2%
13 Type of OTC drug preferred Branded Generic
by customer. 54.1% 45.9%
14 Which group have profitable Generic Branded
margin? 68.2% 31.8%
15 How does customer ask for By telling symptoms By name of drug 18.8%
medicine? 71.8%
16 Type of OTC drug mostly Allopathic Ayurvedic
sold. 90.6% 9.4%
17 Most used OTC drugs in Immunity booster Cough or cold Throat infection. 11.8%
COVID-19. 55.3% 24.7%
18 Do you counsel the customer Yes No
about the use of OTC drug? 91.8% 8.2%

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According to view point of pharmacist on OTC medicine

According to our study these categories of OTC drugs were mostly sold: Antacid (77.6%)
followed by cough and cold, Analgesic, Fever, Sore throat, Nutritional supplements.

According to the pharmacist most preferred Antacid are as follows,

Most Preferred Drug for Percentage of
acidity respondents
ENO 43.5%
Gelusil 29.4%
Digene 14.1%
Gasofast 12.9%

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According to our study we observed most common side effects of antacid Flatulence (40%)
followed by Diarrhoea and constipation (34.1%), Feeling sick or vomiting (25.9%), Stomach
Cramps (24.7%).

According to pharmacists most preferred drug for analgesic was Volini gel (41.2%) followed
by Zandu balm (30.6%), Moov gel (24.7%) and Tiger balm etc.

According to our study it was observed these were common side effects of Analgesic:

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 Side effects of Percentage of respondents
analgesic
Drowsiness 43.5%
Dizziness 37.6%
Skin itching and rashes 21.2%
Dry mouth 12.9%

Most of the pharmacists (83.5%) taught that adverse drug reporting is necessary and very
few pharmacists (16.5%) taught that adverse drug reporting is not necessary.

Among all the pharmacists majority of pharmacists observed most common adverse drug
reaction by the use of the drug were as follows: Kidney Problems (60%) followed by Liver
Problem, Heart problem, Skin rashes and itching, irritation.

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According to majority of the pharmacists these were the mostly seen adverse effects of analgesic
OTC drugs, Kidney problem (42.4%) followed by GIT problem (36.5%), Liver problem (18.8%),
Heart problem etc.

According to the pharmacists most of the customers (56.5%) not reported the adverse drug reaction
of OTC drug and (43.5%) customers reported the adverse drug reaction of OTC drugs.

According to our study maximum number of customers visited pharmacy for OTC drug in a
week, i.e., 20-30 customers.

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 The choice of OTC medicine was made by pharmacists (64.7%) and (35.3%) customers made the
choice of OTC medicine by themselves.

Among all the pharmacists these were the factors considered while dispensing the drug, Safety
(72.9%) followed by Quality, Brands, Price.

Branded OTC drugs were mostly preferred by the Customers (54.1%) and remaining customers
preferred generic OTC drugs (45.9%).
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Among all pharmacists majority of pharmacists (68.2%) taught that generic OTC drugs had more
profitable margin and remaining pharmacists (31.8%) taught that branded OTC drugs had more
profitable margin.

According to the study it was observed that majority of the customers asked for medicine by
telling symptoms (71.8%) followed by telling name of the drug, by reference of TV advertising,
some patients asked medicine by both name and symptoms.

Most of the pharmacists (90.6%) found that allopathic type OTC medicine were mostly sold and
remaining pharmacists (9.4%) found Ayurvedic OTC medicine were mostly sold.

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Following category of drugs were used more in Covid 19 period,

Category of OTC drugs Percentage of

respondents
Immunity Booster 55.3%
Cough and cold 24.7%
Throat infection 11.8%
Fever 8.2%

Among all the pharmacists most of the pharmacists (91.8%) counselled the customer about how to
use the OTC drugs and very few pharmacists (8.2%) not counselled the customers about how to use
the OTC drugs.

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 Table No. 3 View point of physician on OTC medicine
Sr Question Responses
no.
1 Is ADR reporting necessary? Yes No
91.7% 8.3%
2 Most common adverse effect of Kidney problem liver problem Other
OTC drugs. 50% 16.7%

3 Most common adverse effect of GIT problem kidney problem liver problem
analgesic OTC drugs. 50% 25% 16.7%
4 Mostly seen adverse effect of Aluminium Hypophosphatemia Osteomalacia
antacid OTC drugs. intoxication 25%
58.3%
5 Have any patient reported ADR of Yes No
OTC drugs? 25% 41.7%

According to view point of physician on OTC medicine

From the total responders, majority of the participants (91.7%) accepted that ADR reporting
is necessary.

The most common adverse effect of OTC drugs was found to be Kidney problem (50%)
followed by liver problem and heart problem.

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Majority of the participants responded that the most common adverse effect of analgesic OTC
drugs was GIT problem which was 50% in total followed by in decreasing order was kidney
problem, liver problem and nausea and stomach upset.

Mostly seen adverse effect of antacids OTC drugs was found to be Aluminium intoxication in
58.3%, Hypophosphatemia 25% followed by osteomalacia.

41.7% of participants said that no patient had reported adverse effect to them ,25% said that
patients had reported ADR, majorly in a month the number of cases reported were less than 10
in number.

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CONCLUSION:
The study concluded that majority of participants used OTC drug for self-medication. It had
been found that 20-30 patients in a week visited pharmacy to purchase OTC drugs, which gave
an evidence for more use of OTC drugs in the community.
Frequently used OTC medication were for cough and cold followed by antacid, analgesic and
fever. Most common reason to take OTC medicine was due to mild nature of illness. According
to view point of customer it was concluded that ENO and Zandu balm is the widely used antacid
and analgesic OTC drug respectively. According to the view point of pharmacist it was
concluded that antacids are the mostly sold OTC drugs. It was found that ENO and Volini gel
are the mostly sold antacid and analgesic OTC drug respectively. According to view point of
physician ADR reporting was found to be necessary. The most common adverse effect of OTC
drugs was found to be Kidney problem.
The study also concluded that majority of participants got satisfactory result of OTC drugs.
Allopathic type of medicine are the most preferred OTC drugs. Majority of respondents not
faced any major adverse effect of OTC drugs. Awareness and dangers of misuse and side
effects of OTC medications among all participants was less. This study revealed that
inappropriate self-medication practice with OTC drugs was prevalent requiring early
intervention to minimize the risks.

Recommendations:

Proper education should be imparted regarding illness where self-administration of OTC drugs
to be employed.

Pharmacists, being the prime mediators, should be well trained to identify the circumstances
under which OTC drugs may be dispensed and when to refer the patient to a physician.

OTC drug advertising should also be regulated so that the consumers get the correct
information regarding the various OTC medications.
Pharmacist should provide counselling to the patients about the use of medicine.
The awareness on misuse and side effects of OTC drugs should be increased.
Patients should get more knowledge about the OTC drugs and in which condition it should be
used.

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REFERENCES:
1) US Food and Drug Administration. Drug Application for Over- the- Counter Drugs.
Available from: https://www.fda.gov/drugs/types-applications/drug-applications-over-
counter-otc-drugs.
2) “Information for Consumers: Drugs Now Available Without a Prescription,” FDA website,
available at http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm.
3) The OTC drug prescription (Rx) requirement explained available at FSA store.com
4) National Institutes of Health, Over the Counter Medicines Drug Facts. Retrieved from
https://www.drugabuse.gov/publications/drugfacts/over-counter-medicines.
5) Quality Healthcare with OTCs,” CHPA website, available at http://www.chpa‐
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6) World Health Organization. WHO Guidelines for the Regulatory Assessment of Medicinal
Products for Use in Self-medication.
7) Stefania Chiappini, Amira Guirguis, John Martin Corkery & Fabrizio Schifano. Misuse of
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