• linkedin
  • Increase Font
  • Sharebar

    The switch to OTC: Are urologic drugs next?


    Are there any herbal remedies like saw palmetto or testosterone-like substances that you feel should not be freely available?

    Herbal remedies are available and used frequently by patients for urinary tract consideration. The most recent “herbal supplements” getting some play have been the cranberry extracts. Patients ingest them maximally.

    Also see: Do you ‘feel the Bern’? What a single-payer system portends

    I’ve served on the FDA advisory panels related to testosterone use, and I have grave concern about products that have anabolic effects and the general public’s relative lack of appreciation of those negative effects. Unfortunately, anabolic steroids have received a lot of positive play from the body building community and there’s been a fair amount of promotion of anabolic steroids for male health issues and male andropause.

    To put an anabolic steroid or an agent that has anabolic steroid-like effects in the OTC world would, in my opinion, be a significant risk for patients in terms of the downstream effects on the blood, liver, and cardiovascular system.


    “Behind the counter” is not a standard classification for drugs in the U.S. but is a category in Canada and the UK. Do you think that in some gray areas, there would be a place for behind-the-counter drugs empowering the pharmacist for some urology medications in the U.S.?

    I think that’s coming as we see greater involvement of pharmacists in ambulatory care. We’re seeing that with the advent of the various clinics in the larger pharmacy chains, and more importantly, the empowerment of pharmacists to actually go out from behind the counter and advise and help patients make selections. I think it’s a natural outgrowth of the expansion of registered pharmacists and their perceived role.

    Could it be done in a way that’s safe and reasonable? Yes, I think it could be. In essence, we’re already doing that with some of the decongestant medications because of concerns not so much about the medication for individual use but the use of the medication for illicit purposes.

    More from Urology Times:

    Survey: Urologists weigh in on MIPS, APMs, burnout

    Top 12 practice management articles of 2017

    In-office andrology: Videos show office-based hydrocelectomy, vasectomy reversal

    Subscribe to Urology Times to get monthly news from the leading news source for urologists.

    Philip M. Hanno, MD, MPH
    Philip M. Hanno, a Urology Times editorial consultant, is professor of urology at the University of Pennsylvania, Philadelphia.


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available