I have been following these medicines for more than a decade, and I want to highlight a pattern that is becoming increasingly consistent.
Prednisolone, Diclofenac, Cetirizine, Chlorpheniramine, Amoxicillin, Omeprazole.
Let us focus on prednisolone, diclofenac, and omeprazole because of their heavy use in most healthcare facilities.
These are among the most commonly sold medicines in the community pharmacies I have visited, and in many cases, it is the client not the prescriber who requests them.
My aim is not to accuse, but to help us know more, learn more, and at least begin thinking about how we can respond better to what is happening.
I know that many pharmaceutical technologists and pharmacists have dispensed these medicines over the counter without fully exploring why the patient is buying them. The consistently high usage may be a surface indication of a much deeper and growing problem within our community.
When I was an intern in a hospital setting, I remember doing inventory in the main pharmacy. I noticed that medicines such as amoxicillin, cotrimoxazole, antihypertensives, and others came in very large quantities, while a particular brand of omeprazole arrived in only two packets. At the time, I wondered, “There must be very few patients with conditions that require this medicine.”
Later, I realized that although omeprazole was prescribed for short periods usually one to two months it was prescribed far less frequently compared to antihypertensive or antidiabetic medicines.
However, after I started working in the community, I observed a steady increase in the use of both omeprazole and diclofenac over the years.
This raises an important question: what is driving this increased and sustained use?
One explanation could be population growth, leading to higher overall demand. But my bigger concern is the continuous and repeated use of these medicines. Many people do not adhere to recommended dosages, and even among those who follow treatment properly and feel better, the problem often returns after a few months.
This clearly points to issues of poor compliance, inappropriate use, and possible treatment failure.
What stands out is that many people are struggling with pain, gut health, and respiratory problems.
For now, I will set respiratory issues aside and focus on pain and gut health.
Pain
Pain can be a major obstacle to daily life. While everyone experiences pain at some point, chronic pain is different it forces people to rely on painkillers for long-term relief.
The painkiller of choice, unfortunately, is almost always diclofenac.
Its use has become so common that it is widely recommended from one person to another, even for something as simple as a headache. Painkillers, especially potent ones like diclofenac, should not be used without proper diagnosis and monitoring, yet this medicine is being used casually and repeatedly.
Gut Health
For many people who do not prepare meals at home, stomach problems have become a regular occurrence. What starts as a simple stomach upset or diarrhea often progresses, over time, into chronic gastric problems and ulcers.
Food safety standards are frequently ignored. Cooking oil is recycled excessively, hygiene is compromised, and cost-cutting takes priority over quality. Many people eat what is available, not what is healthy, and this gradually takes a toll on their gut health.
Water quality also plays a role. Inadequately treated drinking water may be contributing significantly to widespread gastrointestinal problems.
These are observations and speculations, not conclusions but they are important signals. They highlight areas that deserve closer examination, data collection, and deliberate decision-making.
Conclusion
What is clear so far is that many people are struggling with persistent pain and poor gut health, yet the underlying causes are rarely addressed. Instead, we are repeatedly treating symptoms with the same medicines—often without adequate assessment, follow-up, or patient education.
As pharmacy professionals, we are in a unique position to notice these patterns early. If we pause, ask better questions, and engage patients beyond the sale, we may begin to shift from simply dispensing medicines to genuinely improving health outcomes. These medicines are not the problem on their own but how, why, and how often they are being used should concern us all.