Hacker News Reader

Comment by refurb | Hacker News Reader

For a drug to make the switch from Rx to OTC, you need to prove a lot of things. Can consumers understand how to correctly diagnosis the disease it treats? Can consumers correctly dose themselves? Will consumers knows when to stop treatment and seek professional help.

You have to remember that not everyone follows directions or uses medications correctly. I don't blame the FDA for not making a drug OTC unless they can prove it will be used safely.

View on HN

Both those drugs are very easy to use.

For Nystatin: Does your baby have a rash that looks like raised red dots?

For Mebendazole: Did you drink or come in contact with potentially infected water?

There are plenty of OTC drugs with far more complicated symptoms. It's really completely arbitrary - or more accurately, it's driven by companies wanting to expand their market into OTC (as soon as it goes off patent) rather than anything actually medical.

Take Nexium for example: It was prescription only (and very expensive) till the patent ended. The day the patent expired it turned OTC.

From wikipedia: "Mebendazole has been associated with a risk of agranulocytosis in rare cases."

Kind of a severe side effect, no?

Nexium was available OTC right after the patent expired because the company that made it went through the OTC approval pathway. It was actually a sales strategy because plenty of people will buy brand name OTC drugs where if the got an Rx most pharmacies require the generic be provided.

The thing about those two drugs is there are already OTC drugs that treat the same thing.

And surprisingly those OTCs have worse side effects!

How does that make any sense?

And what would you use instead of nystatin - a broad spectrum antifungal?

Mebendazole is OTC in almost all countries except the US - it's even given routinely without evidence of infection.

I guess my comment about it being OTC in other countries is that there have been plenty of drugs approved in other countries that were eventually pulled. Luckily the US never approved them.

athletes foot cream (which depending on the type there are 2-3 drugs to choose from. clotrimazole, tioconazole, Miconazole... When my husband had jock itch they just told him to use OTC athletes foot cream on it.

Nystatin is used for babies diaper rash, not athletes foot. It's a different organism - the stuff for athletes foot doesn't work as well.

There's also terbinafine which works better than the 3 you listead (but more expensive).

Diaper rash is not alway a fungal infection (and could potentially be a bacteria infection in addition to/instead of a fungal infection). It is usually a contact dermatitis and a fungal infection is only a secondary infection.

Reply on news.ycombinator.com