Drugs Aging 2004; 21 (8): 485-498 CURRENT OPINION 1170-229X/04/0008-0485/$31.00/0  2004 Adis Data Information BV. All rights reserved. Over-the-Counter Analgesics in Older Adults A Call for Improved Labelling and Consumer Education Christianne L. Roumie 1,2 and Marie R. Griffin 2,3 1 Quality Scholars Program, Veterans Administration, Tennessee Valley Healthcare System, Nashville, Tennessee, USA 2 Division of General Internal Medicine, Vanderbilt University, Nashville, Tennessee, USA 3 Department of Preventive Medicine and Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA The use of analgesics increases with age and on any given day 20–30% of older Abstract adults take an analgesic medication. Over-the-counter (OTC) analgesics are generally well tolerated and effective when taken for brief periods of time and at recommended dosages. However, their long-term use, use at inappropriately high doses, or use by persons with contraindications may result in adverse effects, including gastrointestinal haemorrhage, cardiovascular toxicity, renal toxicity and hepatotoxicity. Many OTC drugs are also available through a prescription, for a broader range of indications and for longer durations of use and wider dose ranges, under the assumption that healthcare providers will help patients make safe choices about analgesics. Safe and effective use of medications is one of the greatest challenges faced by healthcare providers in medicine. More than 60% of people cannot identify the active ingredient in their brand of pain reliever. Additionally, about 40% of Americans believe that OTC drugs are too weak to cause any real harm. As a result of a recent US FDA policy, the conversion of prescription to OTC medications will result in a 50% increase of OTC medica- tions. To reduce the risks of potential adverse effects from OTC drug therapy in older adults, we propose that the use of analgesics will be enhanced through the use of patient and healthcare provider education, as well as improved labelling of OTC analgesics. Improved labelling of OTC analgesics may help consumers distinguish common analgesic ingredients in a wide variety of preparations and facilitate informed decisions concerning the use of OTC drugs. Analgesics are among the most commonly con- easy availability of these drugs centres around their sumed drugs in the world. [1] On any given day, these ability to cause serious adverse effects. [5-8] Older medications are used by 20–30% of people over 65 adults are at increased risk for experiencing adverse years of age in developed countries. [2,3] The numbers events due to analgesics in general, and NSAIDs in of both over-the-counter (OTC) and prescription particular. A higher rate of NSAID-related adverse analgesics available and consumed have grown rap- effects with aging is related to several factors, in- idly over the last 20 years. [1,4] Concern about the cluding relatively high use and higher baseline prev-