The Basics

Over-The-Counter (OTC) Medicines

Left Chevron
Over-The-Counter Medicines

Differences Between Prescription and OTC Medicines

A medicine is a substance intended for use in the diagnosis, treatment, or prevention of disease. Here are the main differences between prescription and OTC medicines.

Prescription Medicine OTC Medicine
A doctor’s prescription is required; other licensed healthcare providers, such as nurse practitioners or physician assistants, can also write a prescription for medicine (under the authority of a doctor) Does NOT require a prescription to purchase
Can only be dispensed from a pharmacy (community, online, or mailorder) by a licensed pharmacist Available for purchase on store shelves in a pharmacy and in stores such as supermarkets or small convenience stores
Prescribed for and intended for use by one person only OTC medicines can be used by more than one person; however, because of the risk of contamination, some OTC medicines are NOT recommended for sharing (e.g., eye drops, ointments)
Requires a medical diagnosis and decision by a licensed healthcare professional as to which medicine is used Relies on self-diagnosis; product is chosen based on self-care decision
Usually more powerful than OTC medicines OTC medicines have a wider margin of safety than prescription medicines
Can be used to treat both minor ailments and more serious diseases and illness Used to treat minor ailments
Can be harmful if misused Also can be harmful if misused
There are some prescription medicines that are available as OTC medicines in lower dosages. For example: “Prescription strength” hydrocortisone ointment (2.5 %) is available by prescription only, but a lower dosage form (0.5%) can be purchased OTC. 

prescription hydrocortisone cream

Prescription-strength hydrocortisone

OTC hydrocortisone

OTC-strength hydrocortisone

Restricted OTC products (behind the counter)
Sudafed OTC Sudafed contains pseudoephedrine and is kept behind a pharmacy counter.

Some products are legally classified as OTC medicines, although they are available only in a pharmacy “behind the counter." For example, some cold and allergy medicines containing ephedrine and pseudoephedrine are stored behind the counter. These products have been moved “behind the counter” to help prevent illegal drug production. The ingredients, ephedrine and pseudoephedrine, are used to make methamphetamine—a powerful, highly addictive stimulant often produced illegally in home laboratories.