As a nurse, can I recommend over-the-counter medications?

Over-the-counter (OTC) medications do not require a prescription and nurses may recommend or administer them to a patient. However, in some practice settings, legislation or organizational policy might require an order.

If you decide to recommend an OTC medication, you are accountable for the recommendation and for any outcomes of that recommendation. Whether you should recommend or administer OTCs depends on the following factors:

Applicable legislation

Although OTCs usually do not require a prescription, some legislation requires an order. For example, the Fixing Long-Term Care Act, 2021 requires medication must be ordered by an authorized prescriber.

Nurses are accountable for being familiar with and practicing under relevant legislation that applies to their practice setting. This accountability is outlined in the Code of Conduct.

Organizational policy

Employers determine the scope and responsibilities of their employees, including whether nurses can recommend and administer OTCs to patients. Nurses are accountable to comply with organizational policy and, if needed, work with their employers to develop policies that align with CNO’s standards of practice and are in the interest of patient safety.

Your knowledge, skill and judgment

If legislation and employer policy permits nurses’ recommending and administering OTCs, nurses must then ensure that they have the knowledge, skill and judgment to do so safely and ethically. This includes reviewing that the recommended OTC product does not interact or pose a contraindication to the client’s ongoing medications or medical conditions.

Nurses must ensure their medication practice is informed by evidence and that they follow the accountabilities in the Medication practice standard. This includes assessing whether the medication is appropriate by considering the patient and the environment. Nurses should also educate the patient about the medication.

For more information on determining whether a procedure or activity, such as recommending and administering OTCs, is within your scope of practice, see the Ask Practice FAQ: Understanding Your Scope of Practice and your nursing accountabilities.