OTC: Most-Read Stories of 2025

The over-the-counter (OTC) landscape is undergoing a transformation, shifting from simple convenience to a vital pillar of public health. This year’s top stories highlight how expanding OTC access is closing reproductive health gaps and revolutionizing migraine relief, while also presenting new challenges in digital safety and toxicity management.

From the rise of herbal pain alternatives to the risks of legacy drugs like Benadryl, here are the 5 most-read OTC articles from this year.

Half of Patients Have Used Online Pharmacies but Under 10% Identified Safe Sites

There is a significant safety gap in digital health care, with 52% of respondents to a survey saying they have purchased medications online, but fewer than 10% knew how to identify authorized, safe pharmacy sites, according to a study published in the Scandinavian Journal of Primary Health Care. This lack of awareness leaves patients vulnerable to substandard or falsified medicines, which can lead to toxic effects, treatment failure, and the spread of antimicrobial resistance.

The researchers noted that younger individuals were more likely to purchase prescription-only medications online. Women and patients with higher levels of education were also more likely to use an online pharmacy. To mitigate these risks, the study emphasizes the urgent need for providers to educate the public on recognizing official pharmacy logos and sourcing medications from verified outlets.

Expansion of OTC Contraceptive Could Fill Reproductive Health Disparities

OTC oral contraceptives serve as a vital resource for underserved populations, with 22.5% of the 497 survey participants utilizing OTC options, reported a study published in Contraception. The data shows that Black patients were 13.2% more likely and Hispanic patients 7.8% more likely to use OTC pills compared with prescription alternatives, often due to lower health care agency or lack of insurance. These users were also more likely to reside in rural areas or be covered by Medicaid, emphasizing that OTC access bypasses barriers like clinical stigma or limited provider availability. Ultimately, the study concluded that expanding OTC options is a key strategy for reducing reproductive health disparities and improving autonomy for those with prior negative health care experiences.

Prescription-to-OTC Switch of Triptans Showed Positive Public Health Impact

In Germany, transitioning triptan migraine medications from prescription to OTC status yielded significant public health and economic benefits, according to a systematic review published in the Journal of the American Pharmacists Association. The switch improved patient autonomy and quality of life while reducing the burden on the health care system by allowing pharmacists to take on a larger role in patient counseling. However, researchers noted that while the transition is safe for healthy adults, it necessitates careful pharmacist oversight to prevent misuse in high-risk populations and to ensure diagnostic accuracy.

Overall, the study suggests that the prescription-to-OTC pathway offers a valuable opportunity to maximize clinical services in community pharmacies and provide faster relief for the 10% to 15% of the population suffering from migraines.

Complementary, Alternative OTC Drugs Pivotal in the Treatment of Acute Pain

An article published in US Pharmacist highlights the growing importance of OTC complementary and alternative medications (CAMs) as safe, effective supplements for managing acute pain. While traditional options like acetaminophen and nonsteroidal anti-inflammatory drugs are effective, they contribute to significant health risks, including thousands of emergency department visits and hospitalizations annually due to toxicity. The researchers identified caffeine and turmeric as standout CAMs, noting that caffeine can enhance the efficacy of standard analgesics while turmeric offers potent anti-inflammatory benefits with fewer adverse effects. Because many supplements lack strict FDA quality-assurance standards, the study emphasizes that pharmacists must play a pivotal role in educating patients on the proper use of these products to ensure safety and prevent escalation to opioid therapy.

Are Benadryl-Associated Toxicities Enough to Pull It From Shelves?

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In response to dangerous trends like the "Benadryl Challenge" and rising overdose rates, medical experts are calling for a reexamination of diphenhydramine’s widespread OTC availability. While the drug has been used for nearly 80 years, researchers warn that its narrow therapeutic window and anticholinergic properties can lead to severe side effects, including seizures, heart problems, and links to dementia. Experts suggest that second-generation antihistamines like cetirizine and loratadine offer comparable efficacy with significantly fewer safety risks. Because diphenhydramine is found in over 300 formulations, pharmacists are urged to play a critical role in steering patients toward these safer alternatives and educating them on the potential for toxicity.

“This is a medication that's been around for nearly 80 years, and a lot of people use it and [have] very good effects,” James Clark, MD, assistant professor of otolaryngology-head and neck surgery at the Johns Hopkins University School of Medicine, told Drug Topics. “The pharmacist is often the person who is one of the few people who meet and confront a lot of patients, and I think it's just making sure that patients are aware of the risks associated with it.”