[kube-system]

OTC drugs should be both available and regulated to be sold in such a way to minimize harm to people who use it.

Honestly, combination drugs are out of fucking control. Some people don't know Advil is ibuprofin. Some people think all Advil is ibuprofin. Both are wrong!

It used to be true that doctors could tell people that it was okay to take [X] brand drug with [Y] brand drug but anymore, there are a half dozen formulations of each in varying combinations on the shelf and half of them have some of the same ingredients. Basically every brand has a "fuck it lets just mix everything together, flu" version on the shelf now.

[tristor]

I agree that drugs should be regulated, but that regulation should be primarily about ensuring that they are effective, safe when taken as instructed, and that they contain the ingredients they say that they do and don't contain ingredients that aren't listed.

It is not the government's responsibility, nor should it be, to try to solve the fact that someone can do something stupid with medication and harm themselves. Medication, by its very nature, interacts with and changes your body: that's the entire point. There is no way for something to be effective and also impossible to abuse or misuse. Regulating drug safety should always be based on following the instructions for how to use that drug.

That's not to say we can't do more the educate people, but ignorance should not lead to inaccessibility. There are tens of millions of people in this country that are fully capable of reading a box and following instructions and they should not have to live a worse quality of life because some people are not willing or able to do so.

[kube-system]

We don't have to prevent people from being stupid, but we do want to mitigate it, because medicine is supposed to be accessible to everyone, and part of the safety profile of a medication plainly is the ability for it to be administered safely.

> safe when taken as instructed

Part of that means that instructions and ingredients should be clear.

I am educated and knowledgeable and a trip to the pharmacy is more complicated than it needs to be. You damn near have to pick up every damn box to see what is actually in things, if your pharmacy doesn't have things locked up, and half of the time I ask a pharmacist for pseudoephedrine even they give me combination drugs instead.

I don't think we should take anything off the shelf (except oral phenylephrine). If anything, I think we should make more drugs available OTC.

[BeetleB]

I blame doctors and nurses. At least the ones I personally know tell patients "Advil" and "Tylenol" and never mention ibuprofen or acetaminophen. Actually, it's true for pretty much all OTC medications - they just use the branded names Immodium, not loperamide. Claritin. Zyrtec. Benadryl. Dramamine (drowsy/non-drowsy). The list goes on.

When asked, they always tell me one of two things:

1. They were trained on these names instead of the ingredient (scary!)

2. They want the "easiest" thing for the patients (i.e. so they don't have to look at the label).

[kube-system]

Eh, from what I gather from the healthcare professionals I know, I think that is mostly doctors adapting to the language accessible to their clientele. I don’t think it’s about being “easy” as much as it is “doable”. I’ve heard that it’s often hard to even get an accurate list of current medications out of a person, brand name or not.

Now I suppose ibuprofen/acetaminophen is common enough that people may be familiar with it, but I could see how in a clinical setting defaulting to brand names is the only reasonable default for accessibility.

I’ve had multiple doctors remark specifically about my use of generic drug name in discussion. “So I presume you’re a little bit familiar already”, etc.

[BeetleB]

> I’ve had multiple doctors remark specifically about my use of generic drug name in discussion. “So I presume you’re a little bit familiar already”, etc.

And since I was always more familiar with acetaminophen and ibuprofen, when a doctor would say "Take Tylenol", I would have to ask what the active ingredient is because I didn't know.

They'd actually have to think about it before telling me.

Tylenol is second nature to them. Acetaminophen makes them think.

Oh, and forget about something like dramamine. I'd be told "Non-drowsy dramamine". I'd ask "So you mean meclizine?", and I've literally been told (multiple times) "I actually don't know what the ingredient is."

Ditto for some of the antihistamines (I still don't know what Claritin vs Zyrtec is - are they the same?)

[kube-system]

I haven't had that experience. I use generic names with all of my doctors and family who work in healthcare; they follow suit.

Also meclizine causes drowsiness and you should have been warned that this is a common side effect, I was warned when I was prescribed this (it's also on the drug information sheet that comes from the pharmacy). So it might just be that your doctor isn't that good.

[BeetleB]

Regular dose shouldn't cause much drowsiness in most people. I take it all the time when flying (even double dose sometimes). I once took a double dose of regular dramamine and I was out within 30 minutes.

I just checked - Dramamine actually calls it "less drowsy". They have non-drowsy be ginger, which is mostly a placebo (there's a lawsuit about it!).

But this highlights my point: Telling someone "less drowsy" dramamine and there is a good chance they'll buy either the regular or the non-drowsy. Just tell them the ingredient to look for!

[kube-system]

Most side effects don't happen to people taking a drug. The warning isn't because of the likelihood of drowsiness, but the magnitude of risk caused by someone who may become drowsy when doing some other dangerous activity.

Either way, what you describe doesn't sound like a good experience. When I had some issue that necessitated meclizine, the PA wrote a prescription, explained what it was, warned me to be aware of drowsiness until I knew how it affected me, and I picked it up for $1-2 after insurance.

If I had a provider who was anything less than 100% confident and knowledgable about what they wanted me to take, I would be seeing someone else.