The availability of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) sold over-the-counter (OTC) to the public without prescription has become an issue of major concern in recent years. The problem has been highlighted in the UK, USA and other countries because of the continuing high rates of cases of poisoning and the influence of switching from prescription-only status for many NSAIDs to OTC sale brought about, in a large part, by governments and health maintenance organisations (especially in the USA) anxious to save on costs of these drugs. Concern in the UK about poisoning from paracetamol and the appreciable morbidity and mortality from aspirin was such that a major review was initiated in 1996 by the UK government's Medicines Control Agency (MCA). Doubtless, many other governments have also undertaken reviews of the safety issues concerning OTC analgesics and NSAIDs. In the UK the situation has culminated in the decision announced in August 1997, as this book was going to press, that the number of tablets/capsules of the solid dosage forms of paracetamol and aspirin would be limited for sale OTe. This decision was essentially based on the need to limit the unit quantity of these drugs so as to reduce the likelihood of poisoning with paracetamol and the development of gastrointestinal and other more serious side-effects from aspirin. Time. will tell whether these new regulations will influence the occurrence of these adverse events.

The availability of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) sold over the counter (OTC) to the public without prescription has become an issue of major concern in recent years. The problem has been highlighted in the UK, USA and other countries because of the continuing high rates of cases of poisoning and the concern over the switch for many NSAIDs from prescription-only status to OTC sale, brought about, in large part, by governments and health maintenance organisations (especially in the USA) anxious to save on the costs of these drugs. This Symposium, held at the South San Francisco Conference Center (USA) on March 17, 1997, enabled leading authorities from around the world to come together and discuss the central issues concerning the safety and efficacy of OTC analgesics and NSAIDs at what was a timely period, for the reasons outlined above. The conference opened with a series of presentations on the central themes - overall safety evaluation and assessment of the current status, the clinico-epidemiological evidence of adverse drug reactions from different drugs, pharmacokinetic and pharmacotoxicological mechanisms, and the expanding use of the drugs for pain and other states. Particular interest was addressed to the potential for NSAIDs to be used prophylactically to prevent certain chronic inflammatory/degenerative diseases (e.g. Alzheimer's and related dementias, colon cancer). The extensive debate which followed the formal presentations, summarized in the book, was exciting for enabling the core issues to be examined and assessed by experts who have been at the cutting edge of regulatory, medical and scientific evaluations of OTC analgesics/NSAIDs.Audience: General physicians, rheumatologists, pharmacologists, health policy makers.