Assessment of Pharmacologic Ingredients in Common Over-the-Counter Sinonasal Medications Article

Full Text via DOI: 10.1001/jamaoto.2020.1836 PMID: 32672802 Web of Science: 000573926400008

Cited authors

  • McCoul, Edward D.


  • Question Is there ambiguity regarding pharmacologic ingredients in common over-the-counter sinonasal remedies? Findings In a cross-sectional study of over-the-counter sinonasal medications in US pharmacies, 14 common brand names represented 211 unique products. These products consisted of 1 or more of only 8 active nonanalgesic ingredients; brand-name redundancy is pervasive, and labeling does not distinguish products based on the pharmacologic agent. Meaning This study found that the labeling of over-the-counter sinonasal remedies was nonspecific and ingredients were often redundant, which could interfere with effective communication between patients and clinicians.; Importance Sinonasal remedies are the most frequently purchased category of over-the-counter (OTC) drugs in the United States. A variety of options for relief are available under proprietary names, although the actual number of available options may not be readily appreciated by the consumer or the clinician. Objective To determine the prevalence of specific ingredients in OTC sinonasal products. Design, Setting, and Participants This cross-sectional study took physical inventory of brand-name and generic OTC drugs marketed as sinus, cold, allergy, or nasal remedies. Retail pharmacies in New Orleans, Louisiana, commercial websites, and the Drugs, Herbs and Supplements section of MedlinePlus and were searched. Data were collected and analyzed from July 1 to 31, 2018. Main Outcomes and Measures Frequency of active ingredients in OTC formulations. Results Five pharmacies were visited to identify 18 brands, for which the commercial websites were then searched. The 14 most common brands represented 211 unique products. Only 8 unique nonanalgesic ingredients were identified among these products, with many products sold under the same brand name and with the same active ingredient. Phenylephrine hydrochloride, dextromethorphan hydrobromide, pseudoephedrine hydrochloride, guaifenesin, chlorpheniramine maleate, brompheniramine maleate, diphenhydramine hydrochloride, and doxylamine succinate were the common active ingredients, with all available OTC sinonasal remedies consisting of 1 or more of these ingredients. The frequency of occurrence of each ingredient ranged from 10 to 261 different products. Combinations of 2, 3, or 4 active ingredients occurred frequently in OTC sinonasal products. Conclusions and Relevance These findings suggest that proliferation of brand extension products under a common name is pervasive. Clinicians should be aware of the large array of redundant OTC formulations and lack of specificity when discussing brand-name sinonasal remedies with their patients.; This cross-sectional study assesses the prevalence of specific ingredients in over-the-counter sinonasal products found in US pharmacies.

Publication date

  • 2020

International Standard Serial Number (ISSN)

  • 2168-6181

Start page

  • 810

End page

  • 815


  • 146


  • 9