Weight loss drugs like Ozempic and Wegovy are more popular than ever, leading people to seek options that are quicker, cheaper and involve less prying questions than a traditional in-person doctor visit.

But here’s a statistic that should give you pause: Casey Zaring, RPh, PharmD, a clinical pharmacist at OSF HealthCare, says a 2023 audit by the U.S. Food and Drug Administration [FDA] found 95% of online pharmacies were not legitimate. This leads to concerns about getting bilked out of money or taking a counterfeit drug that could bring serious side effects.

“It skips a lot of checks and balances,” Zaring says of the online outlets. For one, he says, these websites typically don’t have a pharmacist check your full medical history to make sure you’re getting the right drug.

Legit or not?

Some red flags to look for when deciding to buy prescription drugs online:

• Is the website based outside the United States?
  
• Do you start on one website and get pushed to another to complete the transaction?
  
• Does the site guarantee you cost savings? Zaring says it may look like a deal up front, but the final price tag might not be so good. Or, you might unintentionally sign up for auto-renewals. Zaring recommends first checking to see if your insurance will cover a medication.
  
• Have other people or agencies flagged the outlet for possible problems? Zaring recommends the websites safe.pharmacy and BeSafeRx to check if the pharmacy is registered with the National Association of Boards of Pharmacies and complying with the law.
  
  “How we know an online pharmacy is legal is they require a prescription by a licensed practitioner. You have a pharmacist review things, and the consumer has access to a pharmacist to ask questions,” Zaring explains. “Look for the outlet to be based in the United States and have a license in your state. Some online pharmacies will provide medications for patients even though they don’t have a license in the patient's state.”

Another law pharmacies have to follow is the Drug Supply Chain Security act. Zaring says this ensures all medications are logged and accounted for as they move from the manufacturer to the distributor. This makes sure all medications in the supply chain are legitimate and safe.

“In December 2025, the Food and Drug Administration warned about fake Ozempic,” Zaring recalls, noting what can go wrong if laws aren’t followed. “It looked almost identical to real Ozempic. It had lot numbers and expiration dates. But what they had done is created a syringe that looked similar and put on fake stickers.

“What pharmacists do then is go through and scan every medication that enters the pharmacy to ensure it’s directly from the manufacturer,” Zaring adds.

Consequences

Zaring says pharmacists’ biggest fear with these websites is someone putting something non-legitimate or harmful in their bodies. Is the syringe sterile? Has the drug expired? Is the dose correct? Is it properly diluted? Is it interacting with my other medications? Ingesting fake medications could lead to infections or other serious side effects.

Speaking on weight loss drugs: “If something is off by a decimal point, it’s a tenfold error. It can cause lack of movement in your gastrointestinal tract, obstructions and gallbladder attacks,” Zaring says. “If a person isn’t aware of the risks and talking to a pharmacist, they can upgrade their dose too quickly and cause more adverse effects like dehydration. Also with some of these online websites, there’s not continuous monitoring by a health care provider. No labs, check-ins or follow ups.

“The cost saving may be up front, but at the back end there may be an overall greater cost of having to see more health care providers because of adverse reactions or infections,” Zaring also warns.

If you’ve done business with an online pharmacy and have concerns, Zaring recommends talking to your primary care provider or a pharmacist at an in-person, well-recognized business. You can even bring the medication for them to inspect. You can also report pharmacies to the FDA at the BeSafeRx website.

Learn more

Read more about how OSF HealthCare pharmacists bring medication to you safely on the OSF HealthCare website. Some OSF HealthCare locations also have retail pharmacies that can be used regardless of whether you’re an OSF patient.

Interview clips

Frequently asked questions

As summer temperatures climb, pharmacists say the heat can do more than make people uncomfortable – it can also reduce the effectiveness of medications and increase the risk of dehydration and other heat-related health problems.

Lisa Heiken, PharmD, a pharmacist, medications exposed to extreme temperatures can lose their effectiveness, particularly those that require refrigeration, such as insulin.

Any medication, if it's left in extreme temperatures, can degrade the effectiveness. Heiken says that includes over-the-counter meds such as Tylenol, ibuprofen, or supplements such as vitamin C or magnesium.

She adds that heat and cold can damage refrigerated medications, making them potentially less effective when patients need them most.

Many people also unknowingly store medications in one of the worst possible places – the bathroom. Although medicine cabinets are common, the humidity created by showers can break down tablets and capsules over time.

Don’t use a medicine cabinet

“A lot of bathrooms unfortunately do have medicine cabinets, and we don’t recommend you leave medication in the medicine cabinet as those rooms tend to have high humidity and the humidity is what breaks down medication.”

Instead, she recommends storing medications in a cool, dry location elsewhere in the home, such as a hallway closet.

Summer errands can also put medications at risk.

“Like leaving your child in the car, same with your medications. Your medications can be affected, even by short times in extreme temperatures so we do recommend that if you’re stopping by the pharmacy that you make your next stop at home, especially if you have refrigerated medications.”

Heiken advises anyone who accidentally leaves medication in a hot car not to throw it away immediately. Instead, patients should contact their pharmacist, who can assess factors such as how long the medication was exposed to heat and whether it may still be safe and effective to use.

Meds can make you vulnerable to heat/sun

Beyond proper storage, some medications can make people more susceptible to heat-related illnesses.

“A lot of heart and blood pressure medication can cause people to become dehydrated faster or dizziness as a side effect in general and so when you add heat and dehydration on top of that, that obviously will compound that problem,” Heiken explains.

Heiken encourages anyone taking antibiotics and certain other medications, to make sure to use sunscreen, wear protective clothing or stay out of the sun because the drugs can make you more sensitive to sunlight.

Bottom line, Heiken says, don’t blow off a discussion with the pharmacist when you begin taking a new medication.

“Opting into the counseling will allow you to better understand your medication and prevent future issues like dehydration and dizziness.”

As temperatures remain high throughout the summer, Heiken said a few simple precautions — proper storage, staying hydrated and understanding medication side effects — can help keep medications effective and people safe.

Lisa Heiken is the manager of OSF Eastland Pharmacy in Bloomington, Illinois.

Video clips of Lisa Heiken

B-roll-Medication and weather

OSF HealthCare has become the first mid-to-large size integrated health system in the United States to earn the prestigious ASHP (American Society of Health-System Pharmacists) Certified Center of Excellence™ in Medication-Use Safety and Pharmacy Practice designation.

The certification process is used by health care organizations in the United States to accurately assess their level of performance in relation to established standards and to implement ways to continuously improve. Pharmacies which achieve this ASHP certification demonstrate the highest levels of pharmacy practice, medication safety, and pharmacy patient care services.

OSF earned the designation for 16 hospitals, six community pharmacies, one specialty pharmacy, one home infusion pharmacy, one ePharmacy, and the integrated distribution center.

“OSF Healthcare Pharmacy Services has worked over the last eight years to innovate and elevate pharmacy care to deliver consistent safe, quality, cost-effective care so that all the communities we serve have access to the same standard of care. We tested our model and outcomes with external feedback from the single national certification body for such rigor. Delivery of high-quality care to our patients is a strong motivator for our OSF pharmacy Mission Partners (employees),” said Sandra Salverson, Senior Vice President Pharmacy Services, OSF HealthCare. “While it is common for tertiary academic medical centers to achieve such certification, it is important to additionally demonstrate and validate excellence can be delivered in rural communities, community hospitals, and through novel models of care delivery such as our ePharmacy. This certification confirms the quality OSF pharmacy services offer and provides external peer feedback for on-going professional growth and innovation. All of this aligns with the Mission and values of OSF HealthCare.” 

Becoming an ASHP Certified Center of Excellence™ in Medication-Use Safety and Pharmacy Practice allows organizations to differentiate themselves from others and demonstrates the following:

•       Reflects use of contemporary best practices for hospital and health-system pharmacy practice

•       Demonstrates commitment to excellence, continuous quality improvement, and practice advancement

•       Provides evidence of current, innovative pharmacy services leading to high quality care and improved patient 
         outcomes

•       Validates pharmacy services externally through rigorous certification process

•       Enhances credibility and value of pharmacy services to physicians, nurses, healthcare leaders, policy makers

Whenever you feel a headache coming on or you tweak your back, it’s common to reach into the medicine cabinet for a couple of acetaminophens (Tylenol) or ibuprofen (Advil). But does it matter which one you take? And is there anything wrong with taking both to fight off what ails you?

Acetaminophen is an analgesic, which is a type of drug that reduces pain signals within your nervous system. It’s used to treat discomfort like headaches and joint pain, and to reduce fever.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically used to tackle issues such as back pain, menstrual cramps and toothaches. It also works to decrease fever.

Sarah Sheley is a pharmacist with OSF HealthCare. She says it’s important to know that ibuprofen helps with inflammation and acetaminophen can’t do that.

“The difference between the two is the fact that the ibuprofen, that anti-inflammatory component, reduces pain by affecting the production of certain hormones in your body that cause inflammation,” she says.

But each pain reliever comes with its own risks.

Acetaminophen is typically safer to use for most people. Some side effects include nausea, vomiting and headache. But it’s a drug that's absorbed by your liver so it’s not the best option for people with liver problems.  

The side effects of ibuprofen include heartburn, nausea and stomach pain (it’s important to take it with food). Taking ibuprofen for a long time or at high doses can increase the risk of blood clots, kidney damage and ulcers.

“With ibuprofen there is more concern with patients using it if they had renal insufficiency, heart failure, GI (gastrointestinal) issues like Crohn's or IBS; they could cause a lot of irritation in the GI tract or stomach,” Sheley says. 

If you are taking a blood thinner ibuprofen can increase your risk of bleeding so opt for acetaminophen instead.

Sheley says that acetaminophen and ibuprofen are appropriate choices for children with fevers. However, stick with acetaminophen for infants 3 months or younger. The correct dose for your child is based on their weight, not their age. Do not guess their weight — acetaminophen and ibuprofen can be dangerous when given in the wrong dose. Check with your pediatrician before giving your child any pain relievers. 

Since the two pain relievers work differently, Sheley says it’s fine for most adults to use them interchangeably.

“As long as you don't have any kidney or liver issues, you can alternate between the two. It is safe,” she says. “You want to keep the doses four to six hours apart to help maintain and it probably is a good thing to alternate those, if you want to hit the pain from two different mechanisms.” 

Sheley says the most important tip is to know why you’re taking a particular pain reliever and don’t overdo it. The recommended maximum dosage for adults is 3,000 milligrams a day for acetaminophen and 2,400 milligrams a day if you’re taking ibuprofen.

Additionally, other factors such as your medical history and underlying cause of pain also help determine which pain reliever is best for you.

“Making sure that you know the source of your pain is important, and make sure that you are aware of a total daily dose that you should be taking of either medication prior to starting it,” Sheley says. 

Be aware that ibuprofen and acetaminophen can have a negative interaction with some prescription and over-the-counter drugs. If you have any concerns or questions, consult with your primary care provider or your pharmacist.

For more information, visit the OSF HealthCare website.

Interview clips

B-roll

Migraines are a part of life for many. From stress to dehydration to a woman’s menstrual cycle and even more serious issues such as a stroke, the headaches can pop up often. And they’re something you should know how to manage.

Amber Oberheim, APRN, a primary care provider at OSF HealthCare, says migraines can often be treated with ibuprofen (Advil is a common brand name) or naproxen (Aleve), plus lifestyle changes including better sleep. But, an online search will also yield plenty of non-medicinal, at-home remedies. Experts will remind you that these aren’t cure-alls. But it’s important to know what works and what doesn’t.

Myth vs. fact

• A cold or warm cloth on the head and neck: Stick to cold, Oberheim says.
  
  “One of the theories for why migraines happen is vasodilation, or increased blood flow to your brain,” Oberheim explains. “So we talk about using a cold compress over your eyes, on the back of your neck or at the top of your head. That cold sensation constricts blood vessels, thereby decreasing blood flow.”
  
  Oberheim adds that there are even migraine caps that stay in the freezer until use. Those are available over the counter at retail outlets.
   
• Rest and deep breathing: Oberheim says there’s no guarantee that your migraine will be gone when you wake up from a nap. But, she says rest and deep breathing can’t hurt. Take a break in a cool, dark room, and avoid screens and loud noises.
   
• Caffeine: It’s good general advice to ingest caffeine in moderation for heart and mental health. But, Oberheim says a soda might help with that headache.
  
  “We look at medications in Excedrin Migraine [pills]. Caffeine is one of them,” Oberheim says. “Caffeine has been proven to be effective sometimes in early management of migraine headaches.”
   
• Supplements: There’s a lot to choose from in this aisle of the pharmacy. And experts warn that you should choose with provider guidance since supplements aren’t regulated like others under the eye of the United States Food and Drug Administration. However, Oberheim says some research has shown that taking vitamin B2 (also called riboflavin) and magnesium daily can help with the number of migraines.
   
• Massaging your head: It’s a tactic some of us learned when we were kids. Massaging your temples (the area between your eyes and the top of your ears) could help with head pain.
  
  “I don’t think there’s any data that would support that. I think it’s more of a comfort,” Oberheim says. “When you’re experiencing pain and you can have a sensation that’s not pain somewhere on your body, it might help lessen the pain.”
  
  For example, Oberheim says when her patients are getting a blood draw through an IV in their elbow, a provider might scratch their upper arm (between the point of pain and the brain) to “confuse” the pain signal and lessen the discomfort. The same logic applies to rubbing your head during a migraine.
   
• Taking a shower: It depends, Oberheim says.
  
  “I could see if stress or muscle tension is creating a headache. Taking a warm shower or bath to relax might help,” Oberheim says. “However, if we’re thinking about a classic migraine with the theory of increased blood flow to the brain, taking a hot bath or shower might actually make it worse.
  
  “It never hurts to try, but I think it’s going to be patient-specific,” she adds.

When in doubt

Oberheim says some people have a history of migraines and know how to manage them. But if the headaches suddenly increase in frequency or intensity, you should see a health care provider. Also, talk to a provider if you have questions about starting or changing at-home treatment. The provider can determine what works for you. You don’t want new medications to negatively interact with drugs you’re already on, for example.

“Often, a migraine can last for longer than a typical headache. It can be accompanied by symptoms like nausea, light sensitivity and noise sensitivity,” Oberheim says, warning of the dangers if migraines are not treated quickly. “There are certain types of migraines that can also affect your vision.”

Temporary decreased function of your limbs is another rare, but possible side effect, Oberheim says.

Learn more

Read more about how to spot and treat a migraine on the OSF HealthCare website.

Interview clips

Related stories

Prepare for warm weather and migraines
One big headache
Learn about National Migraine and Headache Awareness Month
Sneaky signs you may be dehydrated
Phenylephrine or placebo?
Watch your caffeine
Common causes of daily headaches
What are the health benefits of magnesium?
A good calendar can help fight headaches
Seven reasons to get a massage
Three steps to help with frequent headaches
When should you see a specialist for headaches?

Spring allergies will be here soon. If you’re suffering from a runny or congested nose, watery or itchy eyes or sneezing, it’s tempting to grab the first medicine that catches your eye at the pharmacy or rifle through the bathroom drawer for some pills you’re hanging on to.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall. She says it’s important to know what to take and when in order to avoid side effects that can be serious.

What to take

Draper says an antihistamine like Astepro, Zyrtec, Allegra or Benadryl is a typical first line of defense.

“There are also decongestants for severe nasal congestion or sinus pain and pressure,” Draper adds. Sudafed is a well-known decongestant.

If a more severe case brings symptoms like face swelling or wheezing, Draper says treatment could be a steroid like Flonase or prednisone.

For more chronic (in other words, long term) allergy cases, the U.S. Food and Drug Administration says a provider may recommend immunotherapy to build up a tolerance. This could be an injection or a tablet under the tongue.

Misuse

It may not seem like over the counter allergy medications are ripe for misuse, but it can happen.

Draper says antihistamines, especially Benadryl, can make you drowsy. If you take too much or take it at the wrong time, you could, for example, find yourself sleepy behind the wheel. Or your attentiveness at work or school could suffer.

On the flip side, Draper says Sudafed can make you jittery, irritable or cause heart palpitations (the feeling of an irregular heartbeat). This could be a big issue, she says, for people with a heart condition.

“We want to avoid nasal sprays for people with nasal trauma. Things like a deviated septum or nasal sores,” Draper adds. “Putting something up the nose could cause further tissue damage.”

Draper says to take medication as directed by your provider. Or if it’s over the counter, follow the label instructions. She says these medications typically take a couple days to start working. So don’t be tempted to take an extra dose if you’re not seeing relief right away.

Think of the children! (and seniors)

Children and seniors may be more impacted by the side effects of allergy medications. An older adult who takes Benadryl, for example, may be drowsy to the point that they fall and suffer a serious injury.

So, Draper says providers will typically start with an antihistamine that doesn’t make you super drowsy. She says Zyrtec is approved for ages six months and up, and that’s often where providers will start.

“Any antihistamine label is going to tell you to consult your provider for use under the age of two,” Draper says. “So you’ll need to be seen by a provider or your pediatrician.” This could be a virtual visit or a message to your provider in your patient portal.

Plan ahead

Draper says knowing your allergy triggers and acting accordingly is key to avoiding unpleasant symptoms. For example, you know grass clippings will cause an allergic reaction, but you have no choice but to mow the lawn.

“Primary care providers and allergists typically recommend starting the medication prior to exposure,” Draper explains. “If you know you’re going to be outside on that windy, dry day to mow, start the antihistamine a couple days prior so it can fully take effect.”

If you can’t get a handle on a known allergy, or if you have unexpected allergy symptoms, Draper says it’s never a bad idea to go to an urgent care.

Or if you find yourself looking for an over the counter medication option: “Just ask the pharmacist,” Draper suggests. “They’ll give you recommendations.

“There’s usually a specific aisle for allergies,” she adds. “Find the right antihistamine. Flonase is another big one we see people use.”

Interview clips

Related stories

Prepare for warm weather and migraines
Phenylephrine or placebo?
Late to the allergy party
First foods: Allergen introduction 101
Allergic rhinitis is a year round concern
Breathe in fresh air

Here’s an eye-opening observation from John Rinker, MD: Some people think just because you can get a medication over the counter, you can play fast and loose with its use.

“Because it’s widely accessible and they can easily get it from their grocery store, they sometimes don’t even view it as actual medicine,” says Dr. Rinker, an internal medicine physician at OSF HealthCare. They view it more like a vitamin, he says.

Complicating matters: Due to issues like a lack of mobility, older adults might skip getting the right prescription from a health care provider in favor of a pharmacy shelf option. Dr. Rinker warns that route could lead to unintentional medication misuse and possibly deadly side effects. Luckily, there are tips to steer your loved one back onto the right path.

Common barriers and issues

A big issue for older adults is not being able to move like they used to. So, if someone is dealing with a health problem (back pain, for example), it’s tempting to skip the long drive to the doctor’s office and just go to the pharmacy a block away. Or, the person might have medication delivered and not leave home at all.

Seniors can also be more forgetful or have trouble reading medication labels, leading to instances where they take too much of a drug. And Dr. Rinker says as we age, our ability to break down medicine and clear it from our body diminishes. The liver and kidneys just don’t work as well as they used to.

“That’s why we often adjust doses of medicine for adults as they age. We deescalate the dose. Less is more in certain cases,” Dr. Rinker explains. “The dose can last longer. The byproducts of the drug are more likely to create another problem.”

Some common over the counter medicines that are unintentionally misused, according to Dr. Rinker:

• A pain reliever like ibuprofen or Aleve (the technical term is a non-steroidal anti-inflammatory)
  
  “If it’s used temporarily, it’s probably not problematic. That’s how those drugs are meant to be used. But so many people have chronic conditions like arthritis. They’ll take these drugs for long lengths of time,” Dr. Rinker says. “That’s when we start to run into more of those long-term effects. You worry about gastric ulcers or bleeding in your gastrointestinal area. If you have underlying kidney issues, those drugs can make that more harmful.”
   
• Acid reflux medication like Nexium or Prilosec (technical term: proton pump inhibitor). Again, Dr. Rinker says a person might keep taking these drugs past their intended use.
  
  “This can create issues with how you absorb nutrients like calcium and vitamin D. It can lead to bone and kidney problems,” Dr. Rinker warns.
   
• Sudafed (also called pseudoephedrine) or Afrin for nasal congestion.
  
  “If you have an enlarged prostate, [overuse of Sudafed] can create more of an issue. You’ll have more problems urinating,” Dr. Rinker warns. Sudafed can also raise your blood pressure, he says.
  
  Afrin, meanwhile, should only be used for a few days, Dr. Rinker says. If you use it longer then stop, he says you can actually get “rebound congestion” that’s worse than before.
   
• Benadryl (also called diphenhydramine) for allergies or to aid sleep.
  
  “It can impair cognition and increase the risk of a fall,” Dr. Rinker says. Falls can lead to serious injuries in seniors like hip fractures.

And for all medications, Dr. Rinker adds they can negatively interact with each other. For example, he says you shouldn’t take ibuprofen with a blood thinner because it could impact how the blood thinner works and make you more prone to internal bleeding.

Strategies to stay healthy

Things for seniors and their caregivers to consider:

• Look into ways to remove the travel barrier to visit your health care provider. See if a friend, family member or social service agency can give you a ride. Or, see a provider virtually. Dr. Rinker says this could be as simple as calling or messaging your provider on your patient portal and asking, “Is it safe for me to take this drug?”.
   
• Caregivers should closely watch their loved one’s medication use and their behavior afterward. For example, did one particular pill make grandma woozy? It’s worth looking into if the regimen should be changed. Don’t be afraid to ask tough questions like, “I saw you take that pink pill earlier today. Are you sure you need another?”.
  
  “Just because they’ve taken it for a while doesn’t mean the drug is OK,” Dr. Rinker says.
   
• When you do visit a health care provider, make sure they know your health history and which medications you’re taking.
  
  “You can read medicine packaging, but sometimes it’s really difficult to understand the language. It’s not always clear cut for the average person,” Dr. Rinker points out. “So, your primary care provider is the best person to ask questions of. They’ll have your chart and other information. They can give you a response that’s tailored to your needs.
  
  “Your provider might have a different prescription medication or a safer over the counter alternative that works well for you. Or maybe they can figure out a way for you to take your current drug in a healthier manner,” Dr. Rinker adds.

Learn more

Read more about staying healthy in your golden years on the OSF HealthCare website.

Interview clips

Related stories

Lifespan vs. health span
How old is too old to drive?
Caring for someone with dementia
Keep medicine mighty with smart storage
Confounding compounding
Sending reflux back where it belongs
Allergic rhinitis is a year round concern

The "PE" comes from the drug’s active ingredient, phenylephrine (phen-uh-leh-frin), marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter products contain this ingredient, including items under the brand names NyQuil, Benadryl, Mucinex, and more.

Jason Scheid, the director of pharmacy services for community and specialty programs at OSF, says the FDA is now seeking public comments on the proposal into 2025. He offers a few other alternatives you can try to lessen congestion.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID, and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There are also nasal steroids and antihistamines—this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Scheid says more natural remedies, like standing in a hot shower or using a cool mist humidifier, can help ease congestion.

Video Version With Chyrons

Video Version Without Chyrons

Sudafed has been a household name for decades, with the drug’s active ingredient pseudoephedrine being around since the 1920s.

Recently, the U.S. Food and Drug Administration (FDA) claimed Sudafed PE, one of Sudafed’s more popular items, is not effective and should be banned from over-the-counter use. The announcement came roughly a year after a panel of advisors to the FDA unanimously said phenylephrine doesn’t work to clear up congestion when taken orally.

The PE in Sudafed PE comes from another active ingredient, phenylephrine, marketed as a product taken by mouth that should provide temporary relief of nasal congestion. Many other over-the-counter (OTC) combination drugs contain phenylephrine, including some items under the brand names NyQuil, Benadryl and Mucinex.

The FDA advisor panel’s decision led CVS pharmacy to pull common cold and cough medicines from store shelves in October 2023, which list phenylephrine as the main ingredient.

“It is the FDA’s role to ensure that drugs are safe and effective,” said Patrizia Cavazzoni, MD, director of the FDA’s Center for Drug Evaluation and Research (CDER). “Based on our review of available data, and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”

The FDA points out that while phenylephrine is found in many nasal sprays as well, its recommendation is only related to orally administered phenylephrine.

Entering public comment period

Jason Scheid, the director of Pharmacy Services for Community & Specialty Pharmacy for OSF HealthCare, says the FDA is now seeking public comments on its proposal until May 7, 2025. A final order will be issued after the 180-day comment period.

“At that point (after the 180 days) the FDA will provide the manufacturers with their due warning whether they have to pull the products or reformulate it to find an alternative that meets the labeling requirements,” Scheid says.

Scheid anticipates if drugmakers wanted to reformulate these products, and wanted them to remain as oral decongestants, the companies would have to put pseudoephedrine into the products. This would push more products behind the pharmacy counter, like the original Sudafed.

“If you’re looking for an oral decongestant, the original Sudafed is a good alternative,” Scheid adds. “You have to show your ID and there are purchase limitations. It has shown itself to be an effective alternative. There are nasal decongestants you can try, like Afrin. There’s also nasal steroids and antihistamines, this gets more into the allergy nasal sprays that can help prevent congestion symptoms. You can pick any of those up over the counter at a local pharmacy.”

Phenylephrine or Placebo?

The FDA clarifies that while it’s proposing these products be banned from store shelves, there aren’t any safety concerns attached to them. They’re simply just not effective. Many medications will claim to offer multiple benefits. For example, Mucinex Sinus-Max® claims to clear sinus congestion and relieve headaches, while thinning and loosening mucus. But the drug also has Acetaminophen and Guaifenesin in it. Scheid says this proposal simply targets the phenylephrine component when considering nasal decongestion, so other benefits might still be possible.

“It might provide you a placebo-type effect. You might just feel better because of the other ingredients in it, but that one (phenylephrine) solely is not meeting the effectiveness criteria to remain over the counter,” Scheid says.

Natural treatment options that can relieve symptoms

“Using that hot shower or cool mist humidifier will add moisture to where you are to help with that congestion,” Scheid says. “Something as simple as saline nasal spray will add some moisture to the nasal cavity and give some relief.”

It’s always important to clean your humidifier after each use to prevent mold and other bacteria from being released in the air.

Don’t overdo it on the nasal sprays

Another reason why it’s important to read labels is the effect nasal sprays can have if they are used longer than their intended use. Most nasal decongestant sprays will recommend using the product for three days or less.

“What happens is a rebound nasal congestion, where you lose the effectiveness of the medication to relieve that pressure, and it causes more pressure if it’s used more than just a couple days,” Scheid says.

If congestion is caused by allergies

About one quarter (25.7%) of American adults have a seasonal allergy, according to the Centers for Disease Control and Prevention (CDC), while nearly one in five (18.9%) children are affected. Scheid says treating nasal congestion for those with allergies is a longer-lasting issue.

“You’re looking at longer-term solutions then. You’re either using a long-term nasal steroid spray or antihistamine spray, or oral antihistamine.”

Scheid says if the FDA’s proposal goes through in May, pharmacy shelves will look a whole lot different than they do now.

Another way to clear congestion is to stay hydrated. Drinking water will help thin out mucus discharge from the nose and loosen up any phlegm in the lungs, making it easier to cough up.

Video Interview Clips

The updated COVID-19 vaccine is expected to be available at pharmacies around the country in the coming weeks. 

The mRNA vaccine is not a booster, says Doug Kasper, MD, an infectious disease specialist with OSF HealthCare. He says it's recommended  for a much broader portion of the population, everyone six months and older, as a one-time, once a year vaccine. 

This vaccine does not prevent you from getting COVID-19, but the goal is to prevent severe illness from the virus. 

Dr. Kasper says it's totally fine to get the COVID-19 and flu vaccines in the same appointment.

"There's no issue with timing on getting the COVID and influenza vaccines. The RSV vaccine is recommended to be given separate," Dr. Kasper says. "Most of that has to do with the fact they weren't studied together, there's not an adverse issue with it. For the population, COVID and influenza are recommended across almost all age groups. RSV is for our older population, so we recommend spacing that out by a week or two."

Dr. Kasper says for those 65 and older with respiratory conditions, it might be recommended they receive a second booster in six-month increments.

Health Highlights Video Version With Chyrons

Health Highlights Video Version Without Chyrons

The updated COVID-19 vaccine is expected to be available at pharmacies around the country in the coming weeks.

The mRNA vaccine is not a booster, says Doug Kasper, MD, an infectious disease specialist with OSF HealthCare. He says it’s recommended for a much broader portion of the population.

"The vaccine is now recommended for everybody 6 months and older as a one-time, once-a-year vaccine," Dr. Kasper says. “The vaccine has been updated. For people who are at really high risk, those 65 and older or with respiratory conditions, they may get a second shot. This would be in a six-month interval in the springtime.” 

Does the vaccine prevent me from getting COVID-19?

The quick answer? No, much like you find with the annual influenza vaccine.

"The vaccine seeks to protect severe outcomes associated with COVID-19. It doesn't protect you from getting COVID, it tries to decrease the severity of how sick you would get," Dr. Kasper says. 

While there has been an uptick in COVID-19 cases recently, Dr. Kasper says there has not been an increase in COVID hospitalizations. He attributes this to robust natural immunity in the population and adding this COVID-19 vaccine is just another way to protect yourself from severe illness.

FDA’s “What to Know” sheet

The 2024-2025 formula has been updated to protect against the Omicron variant KP.2.

• Unvaccinated individuals 6 months through 4 years of age are eligible to receive three doses of the updated, authorized Pfizer-BioNTech COVID-19 vaccine or two doses of the updated, authorized Moderna COVID-19 vaccine.
• Individuals 6 months through 4 years of age who have previously been vaccinated against COVID-19 are eligible to receive one or two doses of the updated, authorized Moderna or Pfizer-BioNTech COVID-19 vaccines (timing and number of doses to administer depends on the previous COVID-19 vaccine received).
• Individuals 5 years through 11 years of age regardless of previous vaccination are eligible to receive a single dose of the updated, authorized Moderna or Pfizer-BioNTech COVID-19 vaccines; if previously vaccinated, the dose is administered at least two months after the last dose of any COVID-19 vaccine.
• Individuals 12 years of age and older are eligible to receive a single dose of the updated, approved Comirnaty (manufactured by Pfizer BioNTech) or the updated, approved Spikevax (manufactured by Moderna); if previously vaccinated, the dose is administered at least two months since the last dose of any COVID-19 vaccine.
• Additional doses are authorized for certain immunocompromised individuals ages 6 months through 11 years of age as described in the Moderna COVID-19 vaccine and Pfizer-BioNTech COVID-19 vaccine fact sheets.

Commercial retailers are the way to go

As the vaccines from Pfizer and Moderna become available, the Centers for Disease Control & Prevention (CDC) will publish a pharmacy lookup website at https://www.vaccines.gov/en/vaccines.gov to help people find the nearest vaccine locations.

Dr. Kasper says the best bet at getting a vaccine appointment for COVID-19 or influenza, is through pharmacies at local commercial retailers like Target, Walgreens, CVS or Walmart.

Free COVID-19 home tests are coming back

“The U.S. government will make the at-home COVID testing available for free again this year. You can request up to four home tests that will be delivered to your address for free,” Dr. Kasper says. That gives people another option for testing if they think they're developing signs of COVID even after receiving a vaccine, which can be another way to avoid wait lines at urgent cares, ERs or primary care clinics, and to keep themselves isolated until symptoms have resolved.”

The U.S. Department of Health & Human Services reports that COVIDTests.gov will be the website to order from once the website is active.

Status of the Novavax vaccine

A third manufacturer, Novavax, makes a protein-based vaccine similar to influenza vaccines. While it hasn’t been approved by the FDA, Dr. Kasper suspects it will be soon.

"It likely will be approved, and Novavax has been a prior manufacturer of COVID-19 vaccines. That is a third option that will be coming that isn't mRNA based for people to consider if they had an adverse reaction with Pfizer or Moderna in the past,” Dr. Kasper says.

Can I get the COVID-19 and flu vaccine at the same time?

"There's no issue with timing on getting the COVID and influenza vaccines. The RSV vaccine is recommended to be given separate," Dr. Kasper says. “Most of that has to do with the fact they weren't studied together, there's not an adverse issue with it. For the population, COVID and influenza are recommended across almost all age groups. RSV is for our older population, so we recommend spacing that out by a week or two.”

For all vaccine questions, Dr. Kasper recommends speaking with your primary care team to go over options.

Video Interview Clips

As we get older, the chances increase for many of us to develop chronic disease. That also means the likelihood of taking daily medications for conditions such as high blood pressure, diabetes, insomnia, arthritis and high cholesterol.

In medical terms, it’s called polypharmacy.

“Polypharmacy is using or taking multiple medications,” says Jessica McCuen, manager of pharmacy operations at OSF Saint Anthony Medical Center in Rockford, Illinois. “Most healthcare professionals have agreed that the number is somewhere around five or more. Generally, we say anyone who's taking five or more medications is experiencing polypharmacy.”

Taking multiple prescription drugs can increase the risk of multi-drug interactions, in which one medication can affect another medication. Another potential concern is drug-disease interaction, where taking medication for one health issue can make another health problem worse. 

It appears to be a bigger concern for older people. It's estimated that about one-third of adults between the ages of 60 and 70 are exhibiting some form of polypharmacy.

“Once we get to that age, we tend to have chronic diseases that have been diagnosed and we take more medications to handle those chronic diseases.”

McCuen adds we don’t often think about how our age can affect how medications work. 

“That’s when your body starts to change,” she explains. “You can absorb medications differently; the way that your body works changes and then the way that you hold on to medications because of your body makeup changes too. The way that you may have absorbed or had a reaction to a medication in your 30s could be different in your 60s and 70s just because of the way that your body has changed.”

People who experience polypharmacy have a bigger risk of being tired and dizzy, which increases the risk for falls. Other symptoms are weakness, loss of appetite, gastrointestinal (GI) problems and skin rashes.

And it’s not just prescription medications pharmacists worry about. Over-the-counter medications and herbal supplements can negatively interact with daily prescription drugs.

It’s also possible to be on a medication longer than is needed. For example, some people take a proton pump inhibitor – medicines that work by reducing the amount of stomach acid – for problems like heartburn.

“They'll just continue to take it even though they probably only need to take it for a couple of weeks and then see how they do off of it,” McCuen says. “That’s one of the most common ones I see that they don't necessarily need to be on.”

That’s why it’s important to talk with your care team before starting any new medication. In fact, McCuen recommends doing a medication review with your physician or pharmacist at least once a year to make sure your medications mesh.

“Your pharmacist is really your drug and medication expert,” she says. “They know a lot about the drug interactions with all your medications.”

McCuen adds that it's also a good idea to use the same pharmacy whenever possible so that your pharmacist has a record of all the drugs that you're taking. That way if anything new is added they can intervene in the event you have an interaction with one of your other medications.

For more information on how to manage your medications, visit OSF HealthCare. 



 

Interview Clips 

B-Roll

“OSF Specialty Pharmacy is the only physical specialty pharmacy in the tri-county area to provide specialty medications for multiple complex or chronic disease states, allowing the patients the choice of picking up their prescription without having to go to a remote location by FedEx or UPS,” says Jerry Storm, Senior Vice President of Pharmacy Services at OSF HealthCare. “There is not another full-service Specialty Pharmacy in Peoria. Patients will have the ability to come on-site to pick it up. Most Specialty Pharmacies are located out of town.”

The OSF Specialty Pharmacy will supply medications across the 15-hospital OSF HealthCare Ministry. These drugs cover patients who are facing all kinds of different disease. The prescriptions could be for patients with arthritis, gastrointestinal issues, neurological disorders, and much more.

“This new service for our patients in need of specialty medications is an example of our dedication to improve specialty pharmacy care, one patient at a time, through educational, clinical, financial and service excellence,” said Sister Diane Marie McGrew, O.S.F. “We know that specialty drugs can be complicated. That’s why we have established this service to provide our patients with the highest level of custom care and to make sure they have the guidance, clarity and peace of mind to manage their condition well and live a healthier, happier life.

Additionally, specialty medications are typically expensive, but OSF is committed to minimizing costs to patients by working with insurance and maximizing manufacturer support programs.  This groundbreaking resource will enable OSF caregivers to take even better care of patients.

Storm says the impact of the OSF Specialty Pharmacy will mainly impact Illinoisans initially, but it could also benefit those across state lines.

“We can service any pharmacy in Illinois. With the wraparound pharmacies, we can service sites outside of Illinois such as Indiana. We might have Mission Partners who work in Danville, but work in Indiana. We can still service them,” Storm says. “We will make every effort to take care of manufacturer discounts and assistance programs. There’s coupons that a lot of manufacturers will offer to drive those costs down.”

That Integrated Pharmacy Distribution Center, which is adjacent to the Specialty Pharmacy, is the central distribution center for all medications used throughout the OSF HealthCare Ministry and how OSF was able to safely store and distribute COVID-19 vaccines throughout the pandemic.

Video Interview Clips

B-Roll