A 2004 survey about the use of OTC medications showed that many Canadians do not seek full information about products they take. Forty per cent read the label for the active ingredients, and 23 per cent read the side effects. The symptoms a medication can treat are read by 26 per cent. Only 18 per cent read the directions!

Knowing the details about any medication you take is essential, even if it is bought without a prescription. Your pharmacist is a medication expert. These health care professionals are ready to help you in choosing any pharmacy product. By getting advice, you have the information you need to choose the best treatment and use it safely.

Drug schedules

In Canada, most medications fall into one of three groups. These groups, called drug schedules, outline where and how medications can be sold. Drug schedules exist to make sure medications are used safely and effectively. They are largely the same across the country, although some differences exist from province to province.

How a medication is classified depends largely on the National Drug Scheduling Advisory Committee (NDSAC). The NDSAC consists of health care professionals and representatives from Health Canada and the Consumers Association of Canada. They make recommendations after carefully considering a drug’s safety and potential for misuse.

If the NDSAC feels that a drug cannot be safely used without medical supervision, it is placed in Schedule I. Schedule I drugs are only sold with a doctor’s prescription. They include everything from penicillin to medications used to treat chronic conditions like asthma, diabetes, and high blood pressure. Certain drugs, including narcotics, have more restrictions on how they are prescribed and sold.

Drugs that can be sold without a prescription are called non-prescription or over-the-counter (OTC) medications. Although bought without a prescription, they are still real medications. They can have serious effects if not used properly. Like prescription medications, OTC medications are not right for everyone. They can be misused, cause side effects, allergic reactions, or react with foods, alcohol and other medications. As a result, many OTC drugs can only be sold according to certain rules in Canada.

Where and how medications can be sold
	Requires a prescription	Sale required to be recorded on a patient's medication profile by the pharmacist	Located behind the dispensary counter and requires involvement of a pharmacist when sold	Sold only in a pharmacy when a pharmacist is present	Can be purchased at any retail, non-pharmacy location
Unscheduled	No	No	No	No	Yes
Schedule III	No	No	No	Yes	No
Schedule II	No	Varies *	Yes	Yes	No
Schedule I	Yes	Yes	Yes	Yes	No
* As of April 1, 2007, Alberta pharmacists are legally required to record the sale of all Schedule II medications on a patient's medical profile.

Schedule II involves the OTC medications kept behind the pharmacy counter. By law, the pharmacist must ask questions and counsel anyone buying one of these medications.

Some medications can cause serious side effects, drug interactions, or make an existing medical condition worse. If the label cannot fully explain these issues, it may be placed in Schedule II.

Some medications are kept behind the counter because they can mask symptoms of a more serious medical condition, and might delay getting advice from a doctor. Finally, OTC drugs that can be abused or should be monitored by the pharmacist are also placed in Schedule II.

Schedule III drugs are OTC drugs that can only be sold in a licensed pharmacy. These products must be stored in an area under direct supervision by the pharmacist. If the pharmacy is in a grocery or department store, they can only be bought when the pharmacist is on duty. This ensures a pharmacist is available to help discuss their proper use. These medications must be locked up when the pharmacy closes.

Most Schedule III drugs treat conditions that can resolve on their own like a cold, diarrhea, indigestion, or a headache. They include enough information on the label to be used safely and appropriately. However, these medications are sold only from pharmacies because they can be misused. Read the label carefully. In many cases, information and help from the pharmacist is useful in selecting one of these products.

Questions to ask

When using any OTC medication, it is important to get the right information. Ask the following questions before using any OTC medication.

What ingredients does it contain?
Am I allergic to any of its ingredients?
What symptoms or illness is it meant to treat?
How do I take it? When? How often? For how long?
Will it interact with any foods, medications (prescription and non-prescription), herbal products, vitamins or alcohol?
What side effects can it cause?
When is it not safe for me to use this medication?
Am I already taking an OTC medication containing the same ingredients?
Can it affect an existing medication condition?
Can I take this medication if I am pregnant or breastfeeding?
Can I safely treat my symptoms on my own or should I see my doctor?

A pharmacist can help you answer any of these questions. As well, consider symptoms, medical history and additional medications in deciding what product is best for you. In some cases, the pharmacist may refer you to your doctor or suggest non-drug measures to help treat your condition.

It is very important to consult your pharmacist before using an OTC product if you take any prescription medications. Talk to your pharmacist if you have asthma, diabetes, high blood pressure, heart disease, or are pregnant or breastfeeding. It is also a good idea to check with your pharmacist before giving a child any OTC medication.

Remember, just because a medication is available without a prescription does not make it safe or appropriate for everyone. Your pharmacist is an excellent resource. With help, you can make the right choices about effectively treating yourself. Take advantage of this informed and available health care professional.

You may also want to visit the www.bemedwise.ca website for additional information about using OTC medications safely and appropriately.

Pseudoephedrine and crystal meth - what is the connection?

Pseudoephedrine is an ingredient found in many cold and allergy products. It is used to treat nasal and sinus congestion due to colds, sinus infections and allergies. Unfortunately, it is also one of about 15 ingredients used to make the illegal drug crystal meth. Also known as ice, crystal, glass and tina, crystal meth is a form of the stimulant drug methamphetamine. Smoked or injected, it gives a ‘rush,’ an intense feeling of pleasure. It is highly addictive and can cause severe health effects in users. Paranoia, hallucinations, delusions, memory loss, strokes, heart attacks, and permanent brain and heart damage may all occur. Aggressive behaviour and violence are also often associated with meth use.

Crystal meth is a growing problem across North America. In Canada, the number of crystal meth ‘labs’ shut down by the RCMP grew from two in 1998 to 40 in 2004. The highest numbers were in British Columbia and Alberta. As well, a recent Health Canada survey has found two per cent of teens have already tried crystal meth.

Making crystal meth is very dangerous. Small home labs are at risk of fire and explosion. They also pose a risk to the environment. Recipes for making crystal meth using common household ingredients are easily found. The pseudoephedrine in OTC cold and allergy products is one key ingredient for making crystal meth in home labs.

Due to growing concern about crystal meth production, products containing pseudoephedrine alone were put behind Canadian pharmacy counters in 2006. In many provinces, products containing pseudoephedrine are now in Schedule III and can only be sold from pharmacies. Pharmacists are able to monitor and limit the sale of pseudoephedrine only to those that legitimately need it.

Many drug makers have started to replace pseudoephedrine in their products with other decongestants, such as phenylephrine.

For more information about crystal meth, visit the following websites.
www.methwatch.ca
cbc.ca/crystalmeth

Over-the-Counter Medication Why must I ask for that?

﻿Like prescription medications, OTC medications are not right for everyone. They can be misused, cause side effects, allergic reactions, or react with foods, alcohol and other medications. As a result, many OTC drugs can only be sold in Canada according to certain rules.

Drug schedules

Where and how medications can be sold

Questions to ask

Pseudoephedrine and crystal meth - what is the connection?

Over-the-Counter Medication
Why must I ask for that?

Like prescription medications, OTC medications are not right for everyone. They can be misused, cause side effects, allergic reactions, or react with foods, alcohol and other medications. As a result, many OTC drugs can only be sold in Canada according to certain rules.