Sihvo S, Klaukka T, Martikainen J, Hemminki E
Stakes National Research and Development Centre for Welfare and Health, Health Services Research, Helsinki, Finland.
Eur J Clin Pharmacol. 2000 Sep;56(6-7):495-9. doi: 10.1007/s002280000145.
To explore the frequency of continuous use of over-the-counter (OTC) drugs among the Finnish adult population and the potential for harmful interactions between OTC drugs and prescribed (Rx) drugs.
Data were extracted from a 1995-1996 population-based interview survey on health care (n = 10,477, response rate 86%). The drug interaction classification system from the Swedish Drug Compendium FASS 1997 was used to identify OTC drugs likely to have clinically significant interactions with prescription drugs. Logistic regression was used to study factors related to continuous use and risks for interactions.
Seventeen percent of the population had used OTC drugs and 15% had used OTC vitamins during the 2 days prior to the interview. Daily use of OTC drugs and of vitamins was reported by 7% and 9%, respectively. Continuous use of OTC drugs was related to older age, female gender, higher education, poor health status, long-term morbidity, psychosomatic symptoms (fatigue) and use of prescription drugs, but not to poor lifestyle. Four percent of the OTC drug users had taken drug combinations with potential for clinically significant interactions. Interactions were most common for ketoprofen (15% of ketoprofen users), ibuprofen (10%), and acetylsalicylic acid (ASA) (6%). The number of prescription drugs, long-term illness and lower education best explained the risk for interactions.
Continuous use and potentially harmful Rx/ OTC drug interactions occur among OTC drug users. Further studies should be done to investigate whether potential combinations will actually lead to clinical problems. The possible interactions of non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics with prescription drugs should especially be taken into account in drug information.
探讨芬兰成年人群中连续使用非处方药（OTC）的频率以及非处方药与处方药（Rx）之间发生有害相互作用的可能性。
数据取自1995 - 1996年基于人群的医疗保健访谈调查（n = 10477，应答率86%）。使用瑞典药物手册FASS 1997中的药物相互作用分类系统来识别可能与处方药发生具有临床显著相互作用的非处方药。采用逻辑回归研究与连续使用相关的因素以及相互作用的风险。
在访谈前2天内，17%的人群使用过非处方药，15%的人群使用过非处方维生素。分别有7%和9%的人报告每日使用非处方药和维生素。连续使用非处方药与年龄较大、女性、高等教育、健康状况差、长期患病、身心症状（疲劳）以及使用处方药有关，但与不良生活方式无关。4%的非处方药使用者服用了可能具有临床显著相互作用的药物组合。相互作用在酮洛芬使用者中最为常见（占酮洛芬使用者的15%），布洛芬使用者中占10%，乙酰水杨酸（ASA）使用者中占6%。处方药数量、长期疾病和较低的教育水平最能解释相互作用的风险。
非处方药使用者中存在连续使用以及潜在有害的Rx/OTC药物相互作用。应进一步开展研究，以调查潜在的药物组合是否真的会导致临床问题。在药物信息中，尤其应考虑非甾体抗炎药（NSAIDs）和镇痛药与处方药之间可能的相互作用。
