About Behind-the-Counter Drugs and Medications: What You Need to Know

Looking for effective symptom relief? Consider looking outside the aisle. Learn more about behind-the-counter products, and how to purchase them.

What does Behind-the-Counter mean?

Behind-the-counter or BTC refers to a subgroup of over-the-counter medication available without a prescription behind the pharmacy counter. Unlike other OTC medicines sold in-aisle, these products require the assistance of a pharmacy employee to purchase. Many people use these behind-the-counter medications to relieve their symptoms; they are safe and effective when used as directed.

Why Are certain medications only available for Behind-the-Counter purchase?

Many cough, cold/flu, sinus, and allergy products contain a nasal decongestant called pseudoephedrine as an active ingredient. As a decongestant, pseudoephedrine acts on nasal passageways to narrow blood vessels that are causing nasal congestion. Because pseudoephedrine is of the amphetamine chemical class, it has been misused for illicit methamphetamine manufacture. This potential misuse is why decongestant medications containing pseudoephedrine are kept behind the pharmacy counter at your local store.

Note that regulations on behind the counter products and ingredients vary on a state-by-state level. Click here for FDA information on legal requirements for legal requirements for the sale and purchase of pseudoephedrine-containing products.

Are Behind-the-Counter products safe and effective?

When used as directed, behind-the-counter drugs and medications are recognized by the FDA as safe and effective treatment options for your symptoms. For example, pseudoephedrine is a great option for congestion relief related to the common cold, flu, and allergies. When paired with other active ingredients such as acetaminophen and dextromethorphan, like in Extra Strength TYLENOL® Cold & Flu Multi-Action Day/Night Caplets, temporary symptom relief can include the following:

  • Fever reduction
  • Minor aches and pains
  • Headache
  • Sore throat
  • Nasal congestion
  • Cough
  • Relief from sinus congestion and pressure

Always read and follow the safety and dosing information on the product label before use. Talk to your doctor or pharmacist to learn more.

How Do I Purchase Behind-The-Counter Products?

Rather than finding your medication in-aisle and purchasing at the main register, behind-the-counter products must be purchased at the pharmacy counter with the assistance of a pharmacy employee. You may find product cards in the aisle, which can be taken directly to the pharmacy for purchase of a specific product. Currently, these medications are unable to be purchased through online retailers.

Retailers and federal law control the sale of these products, placing limitations on purchase quantity/frequency and minimum age, as well as requiring a government-issued photo ID when purchasing BTC products. Stores retain personal information of purchasers of pseudoephedrine-containing products for a minimum of two years as required by the Combat Methamphetamine Act of 2005. Learn more here.