Epocrates: PDA medical software

Clinical Editorial
by Anne Meneghetti, MD, Director of Clinical Communications
Reaching for OTC Relief

Sometimes it's the little things that matter to patients most. A woman on a business trip calls to ask, in between sneezes, which allergy medicine will not raise her blood pressure or her blood sugar. A coughing child who spits out any medicine that is not grape flavored keeps an entire family awake at night. A man on a fixed income wonders if there is an over-the-counter heartburn medication that is less expensive than his current monthly prescription co-pay.

If you've recently walked the aisles of a pharmacy, you've seen the bewildering array of multi-colored boxes and bottles sporting names that evoke symptom relief. Imagine a patient with the flu wandering down the aisle, armed with a handout from the doctor's office listing confusing chemical names to seek or avoid in the microscopic print of product labels. The ability to recommend specific product names to patients makes that trip down the pharmacy aisle a little easier. Browsing Epocrates “By Class” now opens up a list of prescription and OTC options to consider. Certain health plans, including selected Medicaid plans, cover or discount some OTC products as a benefit; check the Formulary feature for the details.

Some OTCs contain 4 or more active ingredients, substantially increasing the potential for interaction with prescription drugs. A JAMA study on patients aged 57 to 85 reported that prescription and OTC drugs are commonly used together: 1 in 25 individuals were potentially at risk for a major drug-drug interaction as a result. Running the drug interaction checker against a patient's existing meds is one way to make recommending OTCs safer. OTCs can also interact with each other: FDA recently highlighted the risk for overdose when patients combine multiple products that contain the same active ingredient.

The prescribing landscape has become more complicated in recent years, as some drugs shift from prescription to OTC status, and multi-ingredient OTCs shift formulations and names. Adding hundreds of commonly used OTC drugs to Epocrates Rx will bring at least a little welcome relief to prescribers and patients alike. We look forward to hearing about your experience with this new feature.