OTCs Today
Daniel L. Krinsky, RPh, MS
The COVID-19 crisis is affecting our lives in more ways than we could possibly imagine. As accessible health care providers on the front lines, pharmacists are being sought for their expertise and guidance. We have a great opportunity to help our patients navigate the maze that is COVID-19 and to assure all who need us that our services are available.
Hand-washing is key
One of the easiest and most effective ways to help stop the spread of COVID-19 is by washing your hands regularly with soap and water for 20 seconds—especially after going to the bathroom, before eating, and after coughing, sneezing, or blowing your nose.
Hand sanitizer is next-best option
If soap and water are not available, CDC recommends using alcohol-based hand sanitizers containing at least 60% alcohol.
The alcohol in hand sanitizer works best when you rub the hand sanitizer all over your hands, making sure to get between your fingers and on the back of your hands. Do not wipe or rinse off the hand sanitizer before it is dry. Do not use hand sanitizer if your hands are visibly dirty or greasy; wash your hands with soap and water instead.
Hand sanitizers are FDA regulated as OTC drugs. If you use alcohol-based hand sanitizers, read and follow the Drug Facts label, particularly the warnings section.
Store hand sanitizer out of the reach of pets and young children, especially toddlers, who may be attracted by its pleasant smell or brightly colored bottles. Drinking even a small amount of hand sanitizer can cause alcohol poisoning in children. Children should use it only with adult supervision.
If you think your pet has swallowed hand sanitizer, call your veterinarian or a pet poison control center right away.
On a related note, because of the limited supplies of alcohol-based hand sanitizers and pharmacists’ ability to compound this product, FDA has taken timely steps to address this need. The agency has approved a policy allowing for temporary compounding of certain alcohol-based hand sanitizers by pharmacists in state-licensed pharmacies or federal facilities and registered outsourcing facilities.
Additional information is available on FDA’s website (www.fda.gov/media/136118/download).
NSAIDs: To use or not?
Another concern being expressed by some health care providers and many in the media is that ibuprofen may worsen COVID-19 symptoms. Much of the initial hype was based on a Lancet publication that reviewed initial risk data from patients with COVID-19. FDA released a Drug Safety statement dispelling these concerns, as there is no scientific evidence connecting use of NSAIDs like ibuprofen with worsening COVID-19 symptoms.
For those who wish to use treatment options other than NSAIDs, multiple prescription and OTC medications, such as acetaminophen, are approved for pain relief and fever reduction.
See this month’s On the Shelf (page 14) for more information on NSAIDs and COVID-19.
Vitamin C: No clear evidence of benefit
Last, there has been some discussion that vitamin C may be effective at preventing or reducing the severity of COVID-19. Yes, some patients with COVID-19 here in the United States and overseas have received high-dose I.V. vitamin C with the hope that its antioxidant properties would reduce sepsis severity. However, these are very unique situations that have occurred in the intensive care setting, and as of this writing, there is no clear evidence vitamin C provides benefit.
As far as using oral vitamin C as a preventive measure, again there is no evidence of benefit, and high doses involve risks, such as GI adverse effects and the potential to develop renal stones.
We’re here to counsel patients
During these stressful and uncertain times, we will continue to field questions from patients about how they can protect themselves and help prevent the spread of the virus.