Investigating Public Awareness About the Effect of Over-the-Counter Drugs on the Heart in Benghazi City, Libya

Authors

  • Mohamed K. A. Elkawafi 1 Basic Medical Sciences program, School of Health and Medical Sciences, Libyan International University, Benghazi, Author
  • Mahmoud A M Elmansourya Basic Medical Sciences program, School of Health and Medical Sciences, Libyan International University, Benghazi, Author
  • Zainab. O. Benamer Basic Medical Sciences program, School of Health and Medical Sciences, Libyan International University, Benghazi, Author
  • Sajeda. A .Al-Majbri Basic Medical Sciences program, School of Health and Medical Sciences, Libyan International University, Benghazi, Author
  • Rana Abdalmajeed Basic Medical Sciences program, School of Health and Medical Sciences, Libyan International University, Benghazi Author
  • Nuha. A. El-Naas Basic Medical Sciences program, School of Health and Medical Sciences, Libyan International University, Benghazi, Author
  • Nouri Mumash podiatric department, Tobruk Medical Center Author

DOI:

https://doi.org/10.54361/LJMR.20.1.14

Keywords:

over-the-counter drugs, . nonsteroidal anti-inflammatory drugs (NSAIDs), Heart, Cardiovascular effect

Abstract

Background: Over-the-counter (OTC) medications are widely used for self-treatment without medical supervision. While considered generally safe, some OTCs— such as nonsteroidal anti-inflammatory drugs (NSAIDs), decongestants, and certain pain relievers — have been associated with adverse cardiovascular effects, including hypertension, arrhythmias, and increased risk of heart attacks. Despite this, public awareness about these risks remains limited, especially in developing countries like Libya, where regulation and health education are often insufficient. Benghazi, as a major city, presents an important context for assessing such awareness. Aim: To assess the awareness of the public of Benghazi about the effect of OTCs on heart health. Methods: This descriptive cross-sectional study is composed of two main sections: Section A – Pharmacist Survey: A short Google Forms questionnaire consisting of four questions was distributed among pharmacists to identify the most commonly dispensed OTCs and understand local usage trends. The same data collection period and analysis methods were applied as in Section B.– Public Survey: A structured online questionnaire was shared via social media platforms to assess public knowledge, behaviors, and attitudes concerning the use of OTCs and their cardiovascular impact in Benghazi. Sample Size: 385 participants (determined using Cochran’s formula). Exclusion Criteria: Medical doctors, medical students, and individuals with cardiac conditions.  Data Analysis: Descriptive statistics and reliability testing using SPSS.Results: 328 participants completed the survey and were included in the present analysis. 53.9% of the participants were female, with the majority (34.2%) aged between 21 and 30 years old. Additionally, 85.6% attended university, 20.7% reported having chronic diseases. Conclusion: The findings of this study are consistent with both local and international research, highlighting the critical need to bridge the gap between awareness and behaviour. Comprehensive educational initiatives and regulatory improvements are essential to reduce cardiovascular and systemic risks associated with inappropriate OTC medication use

Downloads

Download data is not yet available.

References

1. Research C for DE and. Over-the-Counter OTC | Nonprescription Drugs. FDA. Published May 18, 2020. https://www.fda.gov/drugs/how-drugs-are-developed-and-approved/over-counter-otc-nonprescription-drugs

2. Westerlund, T., Barzi, S., Bernsten, C.. (2017), Consumer views on safety of over-the-counter drugs, preferred retailers and information sources in Sweden: after re-regulation of the pharmacy market. Pharmacy Practice. 15(1), 1-8DOI:

3. ‌Goyal A, Gaur A, Chhabra M, Deepak K. Knowledge, Attitude and Practices of over the Counter (OTC) Medicines among rural Population - A Cross Sectional Study. Asian Journal of Pharmacy and Pharmacology.;4(2):227-231. doi: https://doi.org/10.31024/ajpp.2018.4.2.21

4. Center for Drug Evaluation and Research. Understanding Over-the-Counter Medicines. FDA. Published August 14, 2019. https://www.fda.gov/drugs/buying-using-medicine-safely/understanding-over-counter-medicines

5. Over-the-Counter Medicines. Medlineplus.gov. Published 2019. https://medlineplus.gov/overthecountermedicines.html

6. Aloudah, N., Alhumsi, A., Alobeid, N., Aboheimed, N., Aboheimed, H., Aboheimed, G. (2020), Factors impeding the supply of over-the-counter medications according to evidence-based practice: A mixed-methods study. Schneider CR, ed. PLOS ONE. 15(11):e0240913. DOI: https://doi.org/10.1371/journal.pone.0240913

7. Sánchez-Sánchez, E., Fernández-Cerezo, F.L., Díaz-Jimenez, J., et al. (2021). Consumption of over-the-Counter drugs: Prevalence and type of drugs. International Journal of Environmental Research and Public Health. 18(11): 5530. DOI: https://doi.org/10.3390/ijerph18115530

8. Alshahrani, S.M., Alakhali, K.M., Al-Worafi ,Y.M, et al. (2020)A. Awareness and use of over the counter analgesic medication: A survey in the Aseer region population, Saudi Arabia. International Journal of Advanced and applied sciences. 7(3):130-134. DOI: https://doi.org/10.21833/ijaas.2020.03.015

9. Brabers, A.E.M., Van Dijk, L., Bouvy, M.L., De Jong, J.D., (2020), Where to buy OTC medications? A cross-sectional survey investigating consumers’ confidence in over-the-counter (OTC) skills and their attitudes towards the availability of OTC painkillers. BMJ Open. 2013;3(9):e003455. doi: https://doi.org/10.1136/bmjopen-2013-003455

10. Fendrick, A.M., Pan, D.E., Johnson, G.E., (2008), OTC analgesics and drug interactions: clinical implications. Osteopathic Medicine and Primary Care. 2(1). DOI: https://doi.org/10.1186/1750-4732-2-2

11. Scheiman, J.M., Fendrick, A.M., (2005), Practical approaches to minimizing gastrointestinal and cardiovascular safety concerns with COX-2 inhibitors and NSAIDs. Arthritis Research & Therapy. 7(Suppl 4):S23. DOI: https://doi.org/10.1186/ar1795

12. Ruschitzka, F., Borer, J.S., Krum, H., et al., (2017), Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. European Heart Journal. 38(44): 3282-3292. DOI: https://doi.org/10.1093/eurheartj/ehx508

13. Koffeman, A.R., Valkhoff, V.E., Çelik, S., et al. (2014), High-risk use of over-the-counter non-steroidal anti-inflammatory drugs: a population-based cross-sectional study. British Journal of General Practice. 64(621): e191-e198. DOI: https://doi.org/10.3399/bjgp14x677815

14. ‌Trelle, S., Reichenbach, S., Wandel, S., et al. (2011) Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ. 342(jan11 1): c7086-c7086. DOI: https://doi.org/10.1136/bmj.c7086

15. Ghlichloo I, Gerriets V. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/

16. ‌Wongrakpanich, S., Wongrakpanich, A., Melhado, K., Rangaswami, J., (2018), A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly. Aging and Disease. 9(1):143-150. DOI: 10.14336/AD.2017.0306

17. ‌García Rodríguez, L.A., González-Pérez, A., Bueno, H., Hwa, J., (2011), NSAID Use Selectively Increases the Risk of Non-Fatal Myocardial Infarction: A Systematic Review of Randomised Trials and Observational Studies. Ross J, ed. PLoS ONE. 6(2):e16780. DOI: https://doi.org/10.1371/journal.pone.0016780

18. Fanelli, A., Ghisi, D., Aprile, P.L., Lapi, F., (2017), Cardiovascular and cerebrovascular risk with nonsteroidal anti-inflammatory drugs and cyclooxygenase 2 inhibitors: latest evidence and clinical implications. Therapeutic Advances in Drug Safety. 8(6):173-182. DOI: https://doi.org/10.1177/2042098617690485

19. Hippisley-Cox, J., Coupland, C., (2005), Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: population based nested case-control analysis. BMJ. 330(7504):1366. DOI: https://doi.org/10.1136/bmj.330.7504.1366

20. ‌García Rodríguez, L. A., González-Pérez, A. (2005). Long-term use of non-steroidal anti-inflammatory drugs and the risk of myocardial infarction in the general population. BMC medicine, 3(17): 1-6. DOI: 10.1186/1741-7015-3-17

21. McGettigan, P., Henry, D., (2013), Use of Non-Steroidal Anti-Inflammatory Drugs That Elevate Cardiovascular Risk: An Examination of Sales and Essential Medicines Lists in Low-, Middle-, and High-Income Countries. Turnbull FM, ed. PLoS Medicine.10(2):e1001388. DOI: https://doi.org/10.1371/journal.pmed.1001388

22. British Heart Foundation. Ibuprofen and heart failure. Bhf.org.uk. Published November 2019. https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/behind-the-headlines/ibuprofen-and-heart-failure

23. Singh, G., Wu, O., Langhorne, P., Madhok, R., (2006), Risk of acute myocardial infarction with nonselective non-steroidal anti-inflammatory drugs: a meta-analysis. Arthritis Research & Therapy.8(5):R153. doi:https://doi.org/10.1186/ar2047

24. Grosser, T., Fries, S., FitzGerald, G. A. (2006). Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunities. The Journal of clinical investigation, 116(1), 4–15. DOI: 10.1172/JCI27291

25. Shampe, R., Gdara, A., Gdara, A., Hefzy, S., (2024), Awareness Assessment of Over-The-Counter Analgesics among Zawia University Students, Libya. Alq J Med App Sci. 7(4):1386-1392. DOI: https://doi.org/10.54361/ajmas.247467

Downloads

Published

01-01-2026

Issue

Section

Articles

How to Cite

1.
Elkawafi M, Elmansourya M, Benamer Z, Al-Majbri S, Rana Abdalmajeed R, El-Naas N, et al. Investigating Public Awareness About the Effect of Over-the-Counter Drugs on the Heart in Benghazi City, Libya. LJMR [Internet]. 2026 Jan. 1 [cited 2026 Feb. 9];20(1):86-97. Available from: https://ljmr.ly/index.php/ljmr/article/view/509

Most read articles by the same author(s)

Similar Articles

51-60 of 108

You may also start an advanced similarity search for this article.