With the recent expansion of prescription to overthe- counter (OTC) switch medications—including norgestrel (Opill; Laboratoire HRA Pharma), a progesterone-based oral contraceptive, and naloxone (Narcan; Emergent BioSolutions Inc), an opioid antagonist—we must begin to understand the impact on the community pharmacy practice.
Although the public may only think of the community pharmacy as a place where they go to pick up their medications, it is so much more. Community pharmacists are among the most accessible health care professionals involved in patient education and medication safety. The recent approvals of norgestrel1 and naloxone2 as OTC medications expand access to these medications, but it does not mean that the public is aware of their benefits and limitations.3 This is where community pharmacists and student pharmacists have the greatest potential to ensure patient safety and proper use of these medications. This commentary aims to discuss how student pharmacists are uniquely positioned to help educate members of their community, support community pharmacists, and help educate other health care professionals.
Community members most frequently receive updates on OTC medications via public advertisements. Although this initial exposure is essential to raise awareness, it may not answer a patient’s more profound questions about these medications. That is where registered and student pharmacists step in to play a vital role in providing reliable information about these medications. For example, the approval of naloxone as an OTC medication is a significant step to destigmatize opioid-related respiratory emergencies, and pharmacists are essential to enhance this messaging. Registered and student pharmacists are uniquely positioned to destigmatize the use of naloxone further and educate members of the community about how to properly administer and identify opioid-related respiratory emergencies and risk factors that may increase the incidence of these emergencies. Student pharmacists. are equipped with the knowledge and skills to provide this lifesaving patient education and significantly supplement the pharmacy workflow.
Pharmacy workflow in the community setting has recently taken on greater challenges that can strain personnel, such as increased immunizations and tasks such as patient counseling, prescription verification, and other essential pharmacy services. With the recent additions to the OTC medication armamentarium, students can help pharmacists with counseling efforts to relieve the strained pharmacy workflow. As a student pharmacist, I have provided counseling on OTC medications to members of my community. For example, I worked with a patient who came in looking for an OTC recommendation for a mild headache and joint pain. After talking with him about his medications and medical conditions, he revealed that he had kidney disease and was on anticoagulation for a blood clot he had a few months prior. This allowed me to educate the patient on the appropriate OTC medication for him and explain that others, such as nonsteroidal anti-inflammatory drugs, should be avoided due to the increased risk of severe bleeding. This counseling has enabled me to work with members of my community to address questions and concerns and ensure that they can confidently and safely use these medications at home. This is essential when expanding any class of drugs, whether prescription or OTC.
With new products in OTC market, I have noticed that although there are advertisements to inform the public about them, many community members and health care professionals are not always aware of these changes in OTC medications and their impact on patient care. For example, when talking to some of the health care providers within my community, they were unaware that in July 2023,1 the FDA approved the formerly prescription-only norgestrel oral contraceptive as an OTC medication. Laboratoire HRA Pharma shipped the medication to major retailers in March 2024, with expectations of a launch the same month.4 As a once-daily oral contraceptive, norgestrel can provide members of the community with an easily accessible contraception option. Both students and registered pharmacists are well positioned to educate patients and fellow health care workers about the intricacies of these medications. A patient’s health literacy is another factor to consider and should be addressed when providing education.
About The Author
Alexis E. Figueroa is a PharmD candidate at Midwestern University Downers Grove in Illinois and is a pharmacy intern at Walgreens. He is also the project chair of Operation Immunization, a patient care project in Midwestern University’s American Pharmacists Association-Academy of Student Pharmacists chapter.
All in all, student pharmacists can improve community awareness of OTC medications, positively impact pharmacy workflow, and support registered pharmacists to ensure that community members, patients, and providers alike, are aware of the expansion of OTC medications marketplace and who they are appropriate for. As we continue to strive for more accessible health care, we can expect that there will likely be additions to the list of OTC medications. Student pharmacists will play a crucial role in ensuring patient safety and community awareness as these options become available.
References
FDA approves first nonprescription daily oral contraceptive. News release. FDA. July 13, 2024. Accessed March 12, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-firstnonprescription-daily-oral-contraceptive
FDA approves first over-the-counter naloxone basal spray. News release. FDA. March 29, 2023. Accessed March 12, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-first-overcounter-naloxone-nasal-spray
Catlin JR, Brass EP. The effectiveness of nonprescription drug labels in the United States: insights from recent research and opportunities for the future. Pharmacy (Basel). 2018;6(4):119. doi:10.3390/pharmacy6040119
Perrigo commences shipments of Opill to retailers nationwide, empowering millions to enter a new era of reproductive health access in the United States. News release. Perrigo. March 4, 2024. Accessed March 12, 2024. https://www.prnewswire.com/news-releases/perrigo-commences-shipments-of-opill-to-retailersnationwide-empowering-millions-to-enter-a-newera-of-reproductive-health-access-in-the-united-states-302077710.html