Best Practices for OTC Recommendations for Osteoarthritis


OTC guidelines for osteoarthritis have evolved over time.

Current osteoarthritis (OA) management is focused on relieving symptoms and improving quality of life, and pharmacists must stay up to date on current American College of Rheumatology (ACR) guidelines on OTC medication treatment recommendations.

A poster1 presented at the APhA 2022 Annual Meeting & Exposition evaluated the evolution of ACR OA recommendations and guidelines, with a focus on OTC products. The most recent of these guidelines—the 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee—included strong recommendations for oral nonsteroidal anti-inflammatory (NSAIDs) medication use, conditional recommendations for oral acetaminophen, and mixed recommendations for topical NSAIDs and topical capsaicin based on the location of the patient’s arthritis.

Although widely available, the risk-benefit profile of OTC analgesics must be managed, and warning labels should be heeded. Before recommending an OTC product, pharmacists should confirm either the presence of OA or a physician diagnosis. Pharmacologic treatment options should take into consideration the specific joints included, the level and type of pain, and clearly defined risk factors as identified on the product label under “Warnings.

“Pharmacists, especially those in the community setting, play a pivotal role, as they are the frontline healthcare providers working closely with patients and are often asked for their professional recommendations in OTC medication management,” the authors concluded. “As the ACR guidelines continue to evolve, it is critical for pharmacists to be aware of the updates in OTC medication treatment recommendations to better serve their patients.”


  1. Iqbal A, Petruschke R, Kenneally A, Bissonnette S. The evolution of osteoarthritis guidelines with a focus on over-the-counter treatment options. Presented at: Americah Pharmacists Association 2022 Annual Meeting & Exposition; March 18-21, 2022; San Antonio, TX
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