Assessment of Public Awareness and Attitudes Toward the Use of Over-the-Counter Analgesics and Their Potential Risks

<i>Background:</i> Over-the-counter (OTC) analgesics are among the most commonly used medications worldwide due to their accessibility, affordability, and perceived safety. However, inappropriate and unsupervised use can lead to significant health complications such as hepatotoxicity, nephrotoxicity, gastrointestinal bleeding, and drug interactions. In developing countries such as Libya, where pharmacy regulations and public health education remain under development, the tendency toward self-medication with OTC analgesics is notably high. Despite the potential public health implications, limited empirical evidence exists regarding public awareness, attitudes, and patterns of OTC analgesic use in Libyan communities. <i>Objective:</i> This study aimed to evaluate public awareness, attitudes, and practices related to the use of OTC analgesics and to identify potential knowledge gaps and behavioral risk factors associated with their misuse. The investigation focused on three Libyan cities Zawiya, Surman, and Sabratha and included participants from the general population, university students, and practicing pharmacists to ensure a comprehensive understanding across different educational and professional backgrounds. <i>Methods:</i> A descriptive cross-sectional design was adopted between March and July 2025, enrolling a total of 200 participants selected through convenience sampling. Data were gathered via a validated and pre-tested self-administered questionnaire comprising five sections: demographic characteristics, types and frequency of OTC analgesic use, sources of information, awareness of potential adverse effects, and attitudes toward self-medication. <i>Results:</i> Out of the 200 participants, 54% were female and 46% male, with a mean age of 27.3 ± 8.6 years. Approximately 68% reported using OTC analgesics without medical consultation, most commonly paracetamol (acetaminophen) and ibuprofen. Pharmacists exhibited the highest awareness of potential risks (mean score = 82.4%), followed by university students (63.1%) and the general public (49.6%). Statistical analysis indicated significant differences in awareness across groups (p < 0.001). Awareness levels showed a positive correlation with educational attainment (r = 0.46, p < 0.01) and a negative correlation with frequency of unsupervised use (r = -0.38, p < 0.05). Despite this, only 37% of respondents could correctly identify the risks of excessive paracetamol use or potential gastrointestinal complications related to NSAIDs. <i>Conclusion:</i> The findings underscore a substantial gap in public knowledge regarding the safe use of OTC analgesics in the studied Libyan regions. Misconceptions about the safety of common painkillers, combined with insufficient pharmacist counseling, contribute to high rates of unsupervised medication use. Strengthening public health education, integrating rational drug use modules into university curricula, and enhancing community pharmacy engagement are strongly recommended.