What Over-the-Counter Medicine Labels Really Mean

“Ultra-strength,” “non-drowsy,” “PM”—do you know what you’re actually getting from over-the-counter drugs with these package labels? Be a smarter shopper at the drugstore with this handy guide to what OTC drug labels really mean

otc drugs

When we’re sick, we all want to feel better as quickly as possible. So we reach for drugs that claim to be “fast-acting” or “extra-strength,” when in fact, those medications might not deliver everything their package labels promise. The Food and Drug Administration doesn’t check label claims for drugs already considered safe, so there are no standard definitions for most label claims on OTC medications. Use this handy guide to help you navigate the endless sea of labels on drugstore shelves—without making your headache even worse.

Extra strength 
This term simply means the formula has more of the active ingredient than the regular version. Ditto for “maximum strength” and “ultra strength.” With the increase in milligrams of active ingredients, however, the risk of side effects also increases. Read the label instructions carefully to figure out how much of the product you can safely take.

24 hour
Drugs that claim to be “24 hour” are extended-release versions of drugs, which allegedly keep working over the course of an entire day and night. One daily dose should be all you need. However, watch out for non-specific language, such as “all day.” Two doses may be required if the label only refers to the part of the day when you’re usually awake.

While some OTC drugs specify “24 hour” or “12 hour” on their labels, drugs advertised as “long-acting” or “fast-acting” give no specific time frame for the release of the active ingredients over a period of time. There might be a maximum number of pills you should take over a certain period, so pay careful attention to the label instructions.

Most OTC pain relievers today also have PM versions. They usually contain one of two sedating antihistamines: diphenhydramine, which is found in Benadryl Allergy, or doxylamine. Both of these active ingredients can cause you to feel drowsy, but don’t rely on PM drugs longer than a few days if you have trouble sleeping—they may worsen your sleeping problems.

Unlike PM drugs, non-drowsy formulas don’t contain sedating antihistamines, such as diphenhydramine or doxylamine, but instead contain stimulating ingredients, such as pseudoephedrine. These stimulants will keep you from getting tired, but may also cause insomnia if you take the drug in the afternoon or evening. Steer clear of caffeine in combination with these medications.

Dual action
Drugs that claim to be “dual action” are multi-symptom pain relievers that include two drugs working through two different mechanisms, such as an antihistamine and a decongestant. However, the more drugs you’re taking in one pill, the more likely they will work at cross-purposes or cause side effects. 

Visit Consumer Reports for more information.

Sources: Joe Graedon, peoplespharmacy.com; Consumer Reports