Over‑the‑counter (OTC) medication use has expanded globally as a result of increased accessibility, escalating healthcare costs, and a growing emphasis on patient autonomy. In Bulgaria, community pharmacies frequently serve as the primary point of entry into the healthcare system for adult patients, thereby assigning pharmacists a central role in promoting rational self‑medication practices. This study investigated patterns of OTC drug utilization among adult pharmacy clients and examined the extent to which pharmacist counseling influences purchasing decisions and medication safety. A cross‑sectional survey was conducted in several Bulgarian cities among adults acquiring non‑prescription medicines, using a structured questionnaire to gather data on demographic characteristics, commonly used OTC medication categories, motivations for purchase, sources of drug‑related information, and perceptions of pharmacist‑provided advice. The results indicated that analgesics, cold and cough preparations, and gastrointestinal agents were the most frequently purchased OTC products. A substantial proportion of respondents reported that pharmacist counseling significantly affected their final product selection, especially with regard to appropriate dosing, therapeutic suitability, and awareness of potential drug interactions. These findings underscore the indispensable role of pharmacists in ensuring the rational and safe use of OTC medications. Enhancing pharmacist–patient communication and strengthening public health education initiatives may further improve self‑medication practices and medication safety within the primary healthcare context.
