Researchers from the University of Montreal recently discovered that taking common painkillers like ibuprofen for only a week can increase the risk of a heart attack.
The data linked 5 forms of painkillers – ibuprofen, celecoxib, diclofenac, naproxen, and rofecoxib – to heart problems. It raises the question of the safety of over-the-counter drugs, and as a nation are we self-medicating to the detriment of our health?
In South Africa over the counter (OTC) medicines include unscheduled medicines (schedule 0) and schedule 1 and 2 (S1 and S2) medicines. Medications for cold and flu, antihistamines and anti-inflammatories are considered schedule 1 and 2 medicines.
"While you don’t need a prescription for schedule 1 and 2 medicines, in SA these medicines 'must' be dispensed by a pharmacist, and pharmacists are required by law to write down your name and the name and quantity of the medicine," says Professor Mahmoud E. Soliman, dean of the University of KwaZulu-Natal's School of Health Sciences.
An expert in biochemistry, Soliman explains that self-medication products are those not requiring a doctor's prescription and sold to consumers to be taken at their own risk. He also adds that responsible self-medication can be used to prevent and treat symptoms and ailments that do not need medical consultation.
However, he raises issues that need to be taken into account when self-medicating. "Any self-medication product should be safe for use, but self-medication drugs are known to interact with many prescription-only drugs, alcohol and foods.
"In many instances, OTC medicines are being misused by drug addicts. One common example of this are cough syrups that contains codeine or sedatives," noted Soliman.
There is also the danger of heavy reliance placed on OTC analgesics like paracetamol. He points out that even continuous use of normal doses of analgesics has long been associated with chronic renal failure.
Then there's the issue of marketing. Self-medication products in many communities are perceived as alternative medicines, food supplements, vitamins, etc, which is not always the case. Many are also sold in pharmacies or health food stores and have not been clinically tested and do not have a scientific basis for their recommended medicinal use.
But Soliman also points out that responsible self-medication can be used to prevent and treat symptoms and ailments that do not need medical consultation or oversight. And, sometimes patients are not able to afford medical consultation or healthcare services are out of reach.
Soliman then adds that OTC drugs also "reduces pressure on medical services, especially in areas where access to medical services may be difficult such as remote or disadvantaged areas."
Self-medication can facilitate access to medicines and reduce healthcare costs. However, this needs to be in conjunction with more health awareness programmes in order to raise the community knowledge on the benefits and risks of self-medication, says Soliman.
He concludes that the combined efforts of the pharmacutical industry and regulators must provide products that are safe, effective, good value for money, and with sufficient relevant information that can be understood by the average person.