Over-the-Counter vs. Prescription Drugs: What Are the Similarities & Differences?


Prescription and over-the-counter drugs provide a wide range of benefits for their users. If you look at over-the-counter vs. prescription medications, there are several similarities and differences.

In this article, we'll define and compare over-the-counter and prescription drugs. Read on to learn more about these two crucial types of medications.

What Are Over-the-Counter Drugs?

Over-the-counter (OTC) medicines are those that can be purchased without a doctor's authorization. The global OTC medicine market was estimated at $124 billion in 2021. People are expected to be able to use over-the-counter drugs based on their drug facts labels, without additional assistance from a doctor or pharmacist.

OTC drugs are usually the first medications people think of to alleviate itches, aches and pains. But they also treat a wide variety of ailments like constipation, allergies, nausea, colds and flu. Some OTC medications can cure diseases like athlete's foot or prevent issues like tooth decay. Others can relieve recurring conditions like migraines, vaginal yeast infections and minor arthritis pain.

The Consumer Healthcare Products Association says that 81% of adults in the United States rely on over-the-counter drugs as their first defense against minor ailments. The five top-selling OTC medications in the U.S. are:

  • Upper respiratory treatments

  • Oral pain relievers

  • Toothpaste

  • Antiperspirants

  • Heartburn medications

Oddly enough, the answer to the question, "Do you need a prescription for over-the-counter drugs?" is sometimes. In certain circumstances, doctors will prescribe medicine that is available over-the-counter. When the dosage is high enough, some OTC drugs, like Prilosec and hydrocortisone ointment, require a prescription.

What Are Prescription Drugs?

Prescription drugs can only be used with the authorization of a licensed medical professional. The global market for prescription medications was around $1.03 trillion in 2021.

Prescription medicines treat illnesses ranging from acne and anxiety to cancer and heart conditions. The most commonly prescribed drugs in the U.S., based on the number of prescriptions, are:

  • Hydrocodone (in combination with acetaminophen) — a pain reliever

  • Generic Zocor — a cholesterol-lowering statin drug

  • Lisinopril — a blood pressure drug

  • Generic Synthroid — synthetic thyroid hormone

  • Generic Norvasc — an angina/blood pressure drug

The types of healthcare professionals who can prescribe drugs can include family physicians, nurse practitioners, physician's assistants and clinical psychologists. In the U.S., the list of licensed prescribers varies by state.


What Are the Similarities Between Prescription and Over-the-Counter Drugs?

The main similarity between prescription and over-the-counter drugs is regulation by the U.S. Food & Drug Administration. Both are strictly monitored for safety and adverse effects.

Besides the possibility of adverse effects, another similarity is that OTC and prescription drugs can carry significant risks such as drug interactions, in which one medication interferes with another. For this reason, patients must inform their doctors of all medications — prescription and nonprescription — they're taking.

Unfortunately, a similarity between over-the-counter and prescription drugs is that both are subject to misuse. This can include crushing pills, mixing medications with alcohol and taking more than the recommended dose.

Another similarity is that people can purchase both OTC medications and prescription drugs from reputable online pharmacy referral services.

What Is the Difference Between OTC and Prescription Drugs?

The main difference between OTC and prescription drugs is that OTC drugs don't require a prescription. People can buy over-the-counter products straight off the shelves at retailers like grocery stores and convenience stores. Prescription medicines, on the other hand, can only be purchased from pharmacies.

Also, prescription medications are meant for the use of only one person, while numerous people can use the same OTC medicine. Another difference is that OTC drugs generally have a lower dosage than prescription drugs.

There are a few instances in which a prescribed generic drug is less expensive than an OTC medicine. But a common differentiator in OTC vs. prescription medications is that prescribed drugs are frequently much more expensive than over-the-counter products. One way to save on prescriptions is to purchase them from a reliable online supplier.

In the U.S., another significant difference in over-the-counter vs. prescription drugs is the approval process. Prescription medications are regulated by the FDA using the New Drug Application (NDA) process. This is a formalized process requiring analyses of all animal and human data as well as details on the drug's behavior in the body and its manufacturing process.

Many over-the-counter products are approved using OTC monographs. These cover acceptable ingredients, formulations, doses and labeling. The FDA regularly updates OTC monographs with new information. Drug manufacturers may market medications that conform to a monograph without additional FDA approval. If the FDA determines that an OTC drug doesn't conform to a monograph, the manufacturer must go through the NDA process.

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The content on this page is for informational and educational purposes only and does not constitute professional medical advice. Patients should not use the information presented on this page for diagnosing a health-related issue or disease. Before taking any medication or supplements, patients should always consult a physician or qualified healthcare professional for medical advice or information about whether a drug is safe, appropriate or effective.