The good and bad of going over-the-counter Physicians often have mixed feelings about drugs going OTC. This article gives a nice balance and puts the decision into appropriate perspective. I will briefly discuss 2 drug classes.

Women can now self treat for candida vaginitis. Most women know when they have it, and the treatment usually works well. However, other infections can cause vaginitis. Some vaginitis is not infectious. So some women will waste money and time by self treating incorrectly.

Proton pump inihibitors (Prilosec, Prevacid, Aciphex and the hated Nexium) are a class of drugs which inhibit acid secretion in the stomach. The give relief to ulcers, simple gastritis, and most important GERD (gastroesophageal reflux disease - known to most as the disease associated with heartburn). We already have the histamine 2 blockers OTC (Tagament, Pepcid, Zantac) for these conditions. PPIs work better. So what is my concern? Heartburn or abdominal pain may herald a more serious condition. I believe that my history taking would give me some clues to evaluating some patients further. Gastroenterologists see the worse cases of GERD - which often have complications like stricture or even cancer. If patients self treat for years, they may miss the opportunity for better diagnosis and treatment. On the other hand, OTC equals lower prices for PPIs. The article gives the right balance. I do want OTC Prilosec, but I want patients to still talk to me about the problem periodically.