Making the switch.

Prescription drugs go over the counter.

believe it or not, there are more than 100,000 non-prescription drugs on the American market today, and consumer demand and manufacturers' drive for profit keep pushing the number higher.

Americans, of course, demand convenience. They love to dash into a store, car motor running, and grab something off the shelf before heading off to the next activity. They're also infatuated with maintaining a healthy lifestyle, obsessively educating themselves about diet, exercise and self-medication. No wonder then that the average American handles the everyday aches and pains of life by rushing to the drugstore, the grocery store or nearby gas station for non-prescription medications to handle that runny nose, heartburn, dandruff, headache or rash.

Government reports estimate that Americans buy five billion OTC drugs every year and handle 57 percent of all health problems with non-prescription drugs. And the number is only going to get higher.

Many products and ingredients that were formerly prescription have been switched to non-prescription. The Consumer Healthcare Products Association reports that about 700 ingredients in today's OTC drugs were considered prescription 20 years ago. That's why our medicine cabinets contain a wider choice of non-prescription drugs for a wider array of problems than ever before.

Take Monistat, for example. Once a prescription-only medication used for vaginal yeast infections, it is now available on drugstore shelves. Women used to make a doctor's appointment (which often couldn't be scheduled conveniently or promptly), pay the doctor $65, get a $25 prescription and then make a trip to the pharmacy before they found any relief. Today, the problem can be handled by a trip to the local drugstore for a $10-to-$12 tube of medicine. In general, the average cost of an OTC medicine is about $5 compared to the $25 charge for a prescription medicine.

"OTC drugs save time and money, and patients like that," says Dr. Gail Newton, associate professor of pharmacy practice at Purdue University and a co-author of "New OTC Drugs and Devices: A Selective Review" in the April 2000 issue of Journal of the American Pharmaceutical Association.

But there's another potent reason, as well, Newton says--"manufacturers' profit." Drug companies can extend the life of their seven-year patent for three years if the U.S. Food and Drug Administration (FDA) approves a drug for over-the-counter use. Other companies aren't permitted to make the drug during this period. Not only does the company keep hold of the drug, but--as they expand into the OTC market--they also give their brand name wider consumer exposure.

Most Americans favor the idea of being able to get more drugs without visiting the doctor. Pharmacists are more cautious. Newton says the American Pharmaceutical Association is advocating for a third class of drugs that would fit in between prescription and OTC; these would be sold at pharmacies by pharmacists. Obviously, drug manufacturers aren't happy about this idea. At the very least, the APA is requesting that recently switched drugs be put in a transition class under the control of pharmacists until they know it's safe for consumers to buy off the shelf without asking any questions of a health professional.

Last April, Newton reviewed some of the newest and most innovative OTC drugs and devices and says there are some exciting new products on the market.

ReliefBand NST is a wristband that looks a bit like a watch and is used to relieve nausea and vomiting caused by motion sickness. It supplies tiny electrical impulses to a point on the wrist--an acupuncture point that has been used in Chinese traditional medicine for more than 2,500 years. Pilots have worn them for years, says Newton, but this is the first time it has been available over the counter. The wristband is also being investigated for use by pregnant women and patients coming out of anesthesia.

AvoSure PT. This test kit allows patients to monitor their blood clotting time. This ability to monitor is especially important for people on blood thinners who have to worry about blood being too thick, which can cause strokes and heart attacks, or too thin, which can cause hemorrhaging. AvoSure is a boon to people who need to test their blood frequently. Before this product came out, people who needed careful monitoring had to go to a lab once a week to twice a month for a blood draw.

Previously a prescription-only drug, Lamisil AT is a topical cream for minor cases of athlete's foot where the toenails are not involved. Newton says it's most exciting for the consumer because it can produce a cure in as short a time as a week.

ThermaCare is a disposable heat pack with a Velcro fastener that comes in different sizes and shapes for the abdomen, lower back, neck and knees. Wrapped in a foil packet, the heat pack works when the pellets inside are exposed to air; the pack stays warm for 8 to 12 hours. "It's not glamorous, but I really like it," says Newton, who once tried the product on a long drive to help her with neck pain, and discovered she was much more comfortable.

Newton also says there are also some "provocative" developments on the horizon. The FDA is currently considering approving two drugs for OTC use that have wide impact. The first category is statin drugs under the names Mevacor and Pravachol. Statin drugs are used for lowering cholesterol.

Although making statin drugs nonprescription has advantages, Newton says the idea is controversial, since these drugs are only indicated for men over 40 and post-menopausal women whose cholesterol fails between 200 and 240. In addition, to use these products wisely, you must have an accurate cholesterol count.

The second product being studied is Claritin, the only non-sedating antihistamine on the market.

No matter what drug becomes nonprescription, the consumer should always read the label, stresses Newton, repeating the pharmacist's mantra: "No drug is completely safe."