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RX FOCUS 32 PharmacyTimes.com December 2015 Rx-to-OTC Medications Anyssa Garza, PharmD Year in Review A s 2015 comes to an end, sev- eral medications have made the switch from prescription to over the counter. This feature discusses the medications that have hit the OTC shelves within the past year. For a list of these medications, their date of approval, and their dosing, see Table 1. 1 This list includes 3 intranasal corticosteroids for allergic rhinitis (AR), a transdermal patch to treat overactive bladder (OAB), and a proton pump inhibitor (PPI): • Oxytrol for Women • Nasacort Allergy 24HR • Nexium 24HR • Flonase Allergy Relief • Rhinocort Allergy Spray As these medications show up on OTC shelves, pharmacists need to be prepared to counsel patients on them, as well as understand the implications these switches will have on health care and the patients we serve. Oxytrol Oxytrol is the first OTC treatment for OAB for women. It is available as a patch and is applied to the abdomen, hips, or buttocks every 4 days. Each patch delivers 3.9 mg of oxybutynin per day, continuously, for 4 days and nights. 2,3 Prescription versus OTC: • It contains the same strength as pre- scription Oxytrol. • Prescription Oxytrol recommends application twice weekly (every 3-4 days). • The formulation intended for the treat- ment of men will continue to require a prescription. Counseling Points: • Oxytrol may cause sleepiness, dizzi- ness, and blurry vision. Alcohol may intensify these adverse effects (AEs). Patients should be advised to avoid driving or operating heavy machinery until they know how this medication affects them. • Oxytrol may cause itching, rash, or red- ness at application site. Patients should be instructed to rotate the application site. • Patients should be instructed to apply the patch under their clothes and not expose it to sunlight. • Patients should be instructed on proper application. • Apply to a clean, dry, smooth area of the skin. • Do not put the patch on oily, damaged, or irritated skin. • Do not put the patch on skin covered with oils, lotions, or powders because they could keep the patch from sticking to your skin. Nasacort Allergy 24HR Nasacort Allergy 24HR was the first intranasal steroid approved for the man- agement of AR. It is available as a nasal spray and is used once a day. 4,5 Prescription versus OTC: • It contains the same strength as pre- scription Nasacort AQ. Counseling Points: • Some symptoms may get better on the first day of treatment. It may take up to 1 week of daily use to achieve maxi- mum benefit.