OTC medications don’t seem to make a difference

Are over-the-counter (OTC) medicines all that they’re cracked up to be?

GPs and other health professionals are encouraged to recommend OTC cough medicines as the first line of treatment for acute cough, but trial evidence so far doesn’t support this.

A recent study set up to determine whether OTC cough remedies are effective for acute cough in adults showed that, even when the studies had significant positive findings, the size of the effects were small and probably not important.

Across 15 trials involving 2166 patients, OTC antihistamines seemed to be no better than placebo. Also, there was conflicting evidence as to the effectiveness of antitussives, expectorants, antihistamine plus decongestant combinations and other drug combinations vs placebo.

The trial, carried out by Bristol University’s division of primary healthcare, suggests that the advice from NHS Direct to use OTC medicines should be restricted until there’s more evidence to show just how effective these medicines really are.

Acute cough is a common symptom; it’s also big business – worth £94 million in 1998-99 (BMJ, 2002; 324: 329-31).