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Over-the-Counter (OTC) Medicines

Over-the-counter (OTC) medicines are those that can be sold directly to people without a prescription. OTC medicines treat a variety of illnesses and their symptoms including pain, coughs and colds, diarrhea, constipation, acne, and others. Some OTC medicines have active ingredients with the potential for misuse at higher-than-recommended dosages.

Misuse of an OTC medicine means:

  • Taking medicine in a way or dose other than directed on the package
  • Taking medicine for the effect it causes—for example, to get high
  • Mixing OTC medicines together to create new product

Two OTC Medicines Are Most Commonly Misused:

  • Dextromethorphan (DXM) is a cough suppressant found in many OTC cold medicines. The most common sources of misused DXM are “extra-strength” cough syrup, tablets and gel capsules. OTC medications that contain DXM often also contain antihistamines and decongestants. DXM may be swallowed in its original form or may be mixed with soda for flavor, called “robo-tripping” or “skittling.” Users sometimes inject it. These medicines are often misused in combination with other drugs, such as alcohol and marijuana.
  • Loperamide is an anti-diarrheal that is available in tablet, capsule, or liquid form. When misusing loperamide, people swallow large quantities of the medicine. It is unclear how often this drug is misused.

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