Profile of drugs used by university students for self-medication in times of the COVID-19 pandemic: A scoping review

Fernandes, Natielle Alves; Fernandes, Larissa Torres; Macieira, Welerson Gregório; Maduro, Lauro César da Silva; Santos, Sabrina Cerqueira; Bonomo, Larissa de Freitas

doi:10.1590/s2175-97902025e231009

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Review • Braz. J. Pharm. Sci. 61 • 2025 • https://doi.org/10.1590/s2175-97902025e231009 linkcopy

Profile of drugs used by university students for self-medication in times of the COVID-19 pandemic: A scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

A significant increase in self-medication was observed during the SARS-CoV-2 pandemic, especially among university students due to their higher level of knowledge and awareness, making them more prone to self-medication. Therefore, in this scoping review we aimed to understand the profile of medications used for self-medication among university students during the pandemic, both for COVID-19 prevention and other reasons. We followed the PRISMA-ScR guidelines in conducting the review. The PICo guiding question was, “What is the profile of medications used for self-medication during the COVID-19 pandemic among university students?” Searches were conducted in the Scielo, PubMed, Embase, EBSCOhost, Web of Science, Scopus, BVS, Google Scholar, and CAPES databases based on MESH and DeCS descriptors. A total of 35 studies were selected, with eight (22.8%) reporting self-medication for COVID-19 prevention/treatment ranging from 14-83%, four (11.4%) reporting self-medication for specific symptoms ranging from 11-95%, 19 (54.4%) reporting several reasons for students self-medicating with a range of 50-100%, and four (11.4%) studies not specifying the reason for medication use in self-medication varying from 3-93%. The included studies revealed that the irrational use of medications is a common practice among university students, with varied prevalence of self-medication observed in this population during the COVID-19 pandemic.

Keywords:
Review; Students; Self-Medication; COVID-19; Drug Utilization

AUTHOR(S), YEAR	COUNTRY	STUDY DESIGN	Nº	SF* (%)	MEDICATIONS	COURSE OF UNIVERSITY STUDENTS	MAIN CONCLUSIONS OF THE STUDIES	REASONS FOR SELF-MEDICATION
Alves, 2022	Brazil	Descriptive and quantitative research	33	27%	Vitamin C (60.6%) Dipyrone (48.5%) Paracetamol (48.5%)	Public Health	During the pandemic, 72.7% of public health undergraduates participated in this study, and they used medications for flu-like syndromes or COVID-19, with 27.3% using them without a prescription. The majority of students reported having knowledge about self-medication	Simple symptoms, difficulty accessing hospitals, ease of purchase, and seeking prevention for COVID-19
					Ivermectin (36.4%)
					Zinc (36.4%) Azithromycin (30.3%)
Andrade, Moreno, Ortiz, 2021	Brazil	Observational	59	52%	Ivermectin (35.59%) Vitamin D (23.73%) Vitamin C (18.64%) Azithromycin (8.47%) Dexamethasone (3.39%)	Pharmacy, Biomedicine, and Medicine	The students engaged in self- medication during the pandemic and reported having this practice outside of this context with: analgesics, anti-inflammatories, antipyretics, and antibiotics	Seeking prevention for COVID-19
Faria et al., 2020	Brazil	Cross-sectional study	226	93%	Analgesics/ antiemetics (72.1%)	Medicine	There is a high prevalence of students who self-medicate. When compared to the student’s academic year, it was observed that all third, fourth, and seventh-semester students self-medicate, followed by fifth and first-semester students	NI
Faria et al., 2020	Brazil	Cross-sectional study	226	93%	NSAIDs (49.1%) Antiallergics and antihistamines (40.3%) Corticosteroids (12%)	Medicine		NI
Mauricio, 2022	Brazil	Cross-sectional study	160	63%	Vitamin C (32.6%) Medicinal plants and herbal medicines (21.2%)	Physics, Mathematics, Chemistry, Biology, Nursing, Pharmacy, and Nutrition	Among the medications listed in the questionnaire, vitamin C was the most commonly described. Those not included in the questionnaire were analgesics and antipyretics, anti-inflammatories, systemic antihistamines, and muscle relaxants. Headache was the most reported symptom that prompted the use of medications (14.9%). According to the respondents, the medications were already being used before the pandemic (80.4%)	Prior knowledge, family recommendations, the health issue does not require a visit to the doctor
					Mineral and vitamin supplements (16.5%)
					Ivermectin (9.8%) Azithromycin (8.9%)
					Vitamin D (8.5%) Analgesics and antipyretics (30.6%) Anti-inflammatories (16.6%) Antihistamines (12%)
Santos et al., 2022	Brazil	Cross-sectional study	193	53%	Analgesics/ Antipyretics (62.1%)	Biomedicine, Biological Sciences (Bachelor’s), Pharmacy, Nutrition, Dentistry, and Psychology	A self-medication prevalence of 53.0% was observed among the respondents. The main symptoms reported for practicing self-medication were: cold/flu (89.1%), followed by menstrual cramps (69.9%), stomachache/indigestion (62.1%), and headache/fever (61.1%)	Previous experience with the medication used, mild symptoms, considered it unnecessary to see a doctor, the need for immediate improvement, and the ease of going to the pharmacy and purchasing the medication
					Cold remedies (87.0%) Anti- inflammatories (15.5%)
					Antiallergic (12.9%) Vitamins (4.1%) Antacids/
					Digestives (59.5%) Antibiotics (4.1%)
Silva et al., 2021a	Brazil	Cross-sectional study	83	95%	Analgesic (72.1%)	Nursing, Physiotherapy, Biomedicine, Physical Education, Esthetics and Cosmetics, Pharmacy, Nutrition, Psychology, and Social Work	It was observed that the relationships between the level of knowledge and self-medication are interconnected	Influence of the media, knowledge of the drug, recommendations from neighbors, family, colleagues, and difficulty accessing health services
Silva et al., 2021a	Brazil	Cross-sectional study	83	95%	Antibiotic (13.9%)
Souza, 2022	Brazil	Cross-sectional study	1553	14%	Ivermectin (4.24%) Vitamin C (1.60%) Vitamin D (1.48%) Azithromycin (0.3%)	Medicine, Dentistry, Pharmacy, Nursing, Nutrition, Public Health, Speech Therapy, Physiotherapy, Occupational Therapy, and Physical Education	The study shows that 14.9% of health area students practice self-medication with the aim of preventing or treating COVID-19 infection. Medication consumption has changed during the pandemic, with several drugs gaining focus, such as ivermectin, azithromycin, and vitamin C/D	Prevent or treat a coronavirus infection
Souza, 2022	Brazil	Cross-sectional study	1553	14%	Zinc (0.25%)			Prevent or treat a coronavirus infection
Cienfuegos et al., 2022	Peru	Observational	2401	88%	Paracetamol, NSAIDs (anti- inflammatory drugs), amoxicillin, and antihistamines	Medicine	Fourth-year students are the most likely to self-medicate, with 85.8%. The main complaints were pain, cold/ flu, and allergies. It was observed that students believe that advertising influences self-medication (71.31%) and that they had relatives or friends who sometimes bought these medications (73.77%)	Reasons include economic factors, over-the-counter availability, and considering having sufficient knowledge about the use of medications
Tapia et al., 2020	Peru	Cross-sectional study	718	51%	Paracetamol (41.4%)	Health Science	The study shows that students often self-medicate in the context of COVID-19, largely motivated by respiratory symptoms, and experience side effects. One in ten students who self-medicated reported having side effects, occurring frequently in those who self-medicated with macrolides (clarithromycin) and ivermectin, both medications used and recommended in the health protocols of Peru in the context of the COVID-19 pandemic	Believing that the symptoms were not severe enough to warrant a doctor’s visit, reporting having relatives/friends who are healthcare professionals, and economic reasons
					Ibuprofen (21.1%) Azithromycin (4.9%) Clarithromycin (1.1%) Erythromycin (1.4%)
					Prednisone (4.2%) Dexamethasone (10.7%) Methylprednisolone (0.7%)
					Warfarin (0.4%) Enoxaparin (0.6%) Hydroxychloroquine (1.1%)
					Chloroquine (0.9%)
					Ivermectin (0.9%)
Rojas-Miliano et al., 2022	Peru	Cross-sectional study	166	14%	Paracetamol (70.8%)	Health Sciences, Architecture and Engineering, Administrative Sciences, Accounting and Economics, Social Sciences and Education, and Agricultural Sciences	A self-medication for COVID-19 among students in the health field and those not in the health field in this study is low. The most commonly used medications were paracetamol, aspirin, and cold remedies. Those who self-medicated with aspirin, ivermectin, dexamethasone, and chlorine dioxide reported experiencing side effects after consumption. The perception that self-medication is harmful to health and having doctors as a source of information about medications is associated with lower self-medication due to COVID-19	Sore throat, fever, and prevention of COVID-19
					Aspirin (62.3%)
					Cold remedies (62.5%)
					Naproxen (41.7%) Ivermectin (37.5%)
					Ibuprofen (37.5%) Dexamethasone (25%)
					Cetirizine (16.7%) Azithromycin (16.4%)
					Penicillin (12.5%)
					Chlorine dioxide (8.3%) Hydroxychloroquine (4.2%)
Escobar et al., 2022	Peru	Cross-sectional study	388	77%	Cold remedies (33.77%)	Nursing, Pharmacy and Biochemistry, Obstetrics, Dental Medicine, and Psychology	We found that self-medication is a common practice among university students in the health field. Among the characteristics of self-medication, the majority of students who self- medicate (75.50%) do so for 2 to 4 months; 50.67% self-medicate for pain, with headache being the most frequent (33.77%). Additionally, according to our findings, 53.97% of those who self-medicated indicated some improvement	Did not have time to see a doctor
					Analgesics (37.79%)
					NSAIDs (24.17%) Antimicrobials (4.30%)
					Antacids (2.65%) Antidiarrheal (1.66%) Antihistamines (0.99%) Antidepressants (0.66%)
Sapana et al., 2021	Peru	Cross-sectional study	168	89%	Analgesics/ anti-inflammatories (76.3%)	Medicine	An associated factor evaluated in the study is the increase in self-medication according to the academic year, ranging from 86.2% in the first year to 100% in the sixth year, except for the fourth year, which showed a self-medication rate of 75.9%. The symptoms that most led to self- medication were fever, abdominal pain, and headache	Lack of time for a medical appointment, adequate knowledge of medications, and difficulty accessing a medical consultation
					Analgesics/ antipyretics (54.5%)
					Vitamins (38.5%) Antihistamines (30.7%)
Sallem, Butt, Ahmad, 2021	Pakistan	Cross-sectional study	520	58%	Analgesics (55.96%) Antipyretic (34.44%) Antibiotic (38.74%) Antihistamine (20.86%)	Medical and non-medical	The practice of self-medication is relatively higher among undergraduate medical students compared to non- medical university students during the COVID-19 pandemic. However, the prevalence of self-medication was high in both groups	The symptoms are minor, past experience, saving time, pharmacist advice, and saving money
Sallem, Butt, Ahmad, 2021	Pakistan	Cross-sectional study	520	58%	Antidiarrheal (8.28%) Antiemetic (9.27%) Antacids (5.96%) Vitamins (17.55%)	Medical and non-medical
Yasmin et al., 2022	Pakistan	Cross-sectional study	489	83%	Paracetamol (65.2%), Multivitamins (56.0%), Ibuprofen (29.0%), Cetirizine (27.8%), Azithromycin (25.6%)	Medicine	The incidence of self-medication revealed is around 83%. The study showed that being in the 3rd year of the medical course or having already been infected with COVID-19 were the factors associated with respondents who were more likely to self-medicate	Preventive measures for COVID-19 or self-medication for COVID-19 symptoms
Zeb et al., 2022	Pakistan	NI	1250	NI	Antimicrobials (50.4%), Anti-inflammatories (26.4%),	Health Science	Antibiotics were more commonly used to treat sore throat, prolonged fever, lung infections, and other upper respiratory infections. High antibiotic consumption was found in the majority of students enrolled in the healthcare field, as they had affiliations with healthcare professionals. They had good knowledge about antibiotics and other medications	Exemption from medical fees, a convenient and inexpensive source of medications, and the lack of pharmacy availability
					Multivitamins (11.3%), Gynecological purposes (4.7%), Analgesics (5.7%),
					Herbal medicines (1.2%)
Yousaf et al., 2021	Pakistan	Cross-sectional study	826	28%	Antibiotics	Biological Sciences	This study indicates a moderate level of knowledge regarding the use and resistance to antibiotics. Regarding the effectiveness of antibiotics against antiviral infections, the majority of participants in the current study knew that antibiotics are effective only against bacterial infections	NI
Palikhey et al., 2021	Nepal	Cross-sectional study	519	69%	Paracetamol (45.7%) Ibuprofen (26.6%) Chlorpheniramine (25%)	Medical and non-medical	This study revealed that one of the main benefits of self-medication in students is the quick relief of symptoms. Headache was the most common symptom that led to self- medication, followed by cough and cold	Quick relief, ease and convenience, previous experience, and the mildness of the illness
Palikhey et al., 2021	Nepal	Cross-sectional study	519	69%	Pantoprazole (14.3%) Vitamin C (3.5%)	Medical and non-medical
Shrestha, Kushwaha, Tiwari, 2021	Nepal	Cross-sectional study	199	50%	Analgesics (62%) Antipyretics (52%) Antihistamines (28%)	Medicine and Dentistry	The study revealed that the most common indication for self-medication was headache (47%). However, 16.6% of students encouraged and 23.6% considered self-medication to be safe	Pharmacology knowledge, mild illness, previous exposure to the disease, immediate relief, and familiarity with pharmacology education
					Cough suppressants (28%)
					Antacids (24%) Vitamins (16%)
Subedi, 2021	Nepal	Cross-sectional study	206	100%	Analgesics (33.4%)	Fields of Science and Technology, Management, Humanities, Law, and Education	All students reported self-medication practices. The diseases included in this study that led to self-medication were headache (62.9%), fever (32.7%), gastric acidity (23.9%), cough (27.3%), and common cold	Previous experience, mild illnesses, timesaving, seeking quick relief, ease, and personal convenience
					Cold remedies (27%)
					Antiulcer agents (14.1%)
					Antipyretics (38.6%) Antibiotics (17.7%) Antihistamines/ sedatives (5.5%)
Alduraibi, Altowayan, 2022	Saudi Arabia	Cross-sectional study	316	63%	Analgesics (88.29%) Antipyretics (49.68%) Antihistamines (36.71%) Cough syrups (13.9%) Antacids (9.49%) Antiemetics (3.8%)	Pharmacy and Medicine	With regard to knowledge, 94.6% of students showed a good level of knowledge about self-medication. The proportion of pharmacy students with good knowledge on the subject was significantly higher than that of medical students. Regarding the practice of self-medication, the results showed that 63.9% of pharmacy and medical students had at least one occurrence of self-medication in the last 6 months	Due to the non- severity of the illness and quick relief
Qahtani et al., 2022	Saudi Arabia	Cross-sectional study	205	60%	Antibiotics (25%)	Medicine	About a quarter of the students (25.36%) used antibiotics for self- care. Students mentioned headaches, colds and flu, fever, gastric acidity, and ulcers as common illnesses for which self-medication is practiced	Less severe nature of the illness, quick relief, good pharmacological knowledge, prior information about medications, privacy, greater distance to a healthcare unit, and learning opportunities
					Analgesics (25%) NSAIDs (52.7%) Antipyretics (13.7%)
					Antacids (12.7%) Paracetamol (20%)
					Diclofenac (1%) Ibuprofen (1%) Pantoprazole (5.4%) Amoxicillin (3.9%)
					Hyoscine (2.9%) Vitamin C (2%) Domperidone (1.5%)
Mannasaheb et al., 2021	Saudi Arabia	Cross- sectional study	371	55%	Antipyretics (37.7%) Multivitamins (36.4%) Sedatives (20.2%) Antihistamines (18.6%) Anti-inflammatories (17.3%)	Pharmacy, Medicine, and Applied Sciences	The overall adequacy of students’ knowledge and attitude towards self- medication was satisfactory. The study shows that 78.7% of students are aware of responsible self-medication	Mild illnesses, previous experience, and lack of time to go to the health service
González et al., 2022	Mexico	Pesquisa anônima	284	23%	Vitamins C and D (53.9%) Paracetamol/NSAIDs (17.1%) Herbal remedies (10.5%)	NI	A significant percentage of students self-medicated with the intention of preventing COVID-19. Considering that the studied population has a high level of education, the use of chlorine dioxide (3.9%) as a preventive product for COVID-19 was concerning	Intention to prevent COVID-19
González et al., 2022	Mexico	Pesquisa anônima	284	23%	Chlorine dioxide (3.9%)	NI		Intention to prevent COVID-19
Roblero et al., 2022	Mexico	Cross-sectional study	310	74%	Analgesics (Paracetamol and Ibuprofen)	Medicine	Students who conducted all academic activities virtually in the last semester experienced muscle pain and use medications to alleviate the pain. In general, they spend more than 10 hours a day on class, work, or study schedules. During the vacation period, the symptoms of muscle pain and the consumption of analgesics significantly decreased	Muscle pain
Alahendra et al., 2021	Sri Lanka	Cross-sectional study	138	87%	Analgesics (83.2%)	Biotechnology, Law, Psychology, Physical Sciences, Biological Sciences, English, and Nursing	Analgesics, vitamins, and minerals were the most commonly used types of medications for self-medication. Headache and cold were the main health conditions that led participants to engage in self-medication	The restrictions of Covid-19, the belief that it is unnecessary to consult a doctor for minor illnesses, and prior relief
					Vitamins and minerals (47.8%)
					Antiallergics (39.8%)
Bello et al., 2022	Nigeria	Cross-sectional study	356	65%	Paracetamol (43%)	NI	Self-medication was significantly associated with the occurrence of COVID-19 symptoms. The study further reveals that the experience of COVID-19 symptoms significantly influences self-medication among Nigerian university students	Perceived symptoms of COVID-19
					Tramadol (2%)
					Cough syrup (8.1%)
					Vitamin C (52%)
					Herbal remedies (28.7%)
					Antimalarial (24.7%)
					Antidiarrheal (2.2%)
					Antiallergic (3.4%)
					Hydroxychloroquine (2%)
Johora et al., 2021	Bangladesh	Cross-sectional study	916	51%	Paracetamol (88.9%)	Medicine	The most common illnesses that led to the practice of self-medication among students from 14 medical colleges were fever, headache, and dry cough. The rate of self-medication with anti- infective agents such as azithromycin (22.6%) was high among future doctors during the pandemic	8.5% engaged in self-medication as a prophylactic measure against COVID-19, driven by perceived symptoms
					Antihistamine (48.5%)
					Vitamin C (40.2%)
					Zinc (31.3%)
					Azithromycin (22.6%)
					Doxycycline (7.2%)
					Ivermectin (6.8%)
Sarango et al., 2020	Chile	Cross-sectional study	62	85%	Paracetamol (40.31%)	Nursing	85% of fourth-cycle nursing students engaged in self-medication, which is a significantly high percentage. A large proportion of the surveyed students self-medicate primarily for headaches, with 31% choosing this option as their most common reason, followed by the flu at 16%	They don’t have time to go to the doctor and don’t believe it’s always necessary to consult a doctor
					Ibuprofen (9.67%)
					Amoxicillin (6.45%)
					Azithromycin (6.45%)
					Loratadine (6.45%)
					Cetirizine (3.22%)
					Acetylsalicylic acid (Aspirin) (3.22%)
					Omeprazole (3.22%)
					Cold remedies (3.22%)
Alhaj et al., 2021	Sudan	Cross-sectional study	725	79%	Antibiotics	Medical and non-medical	The study revealed that many participants did not exhibit appropriate behavior regarding the use of antibiotics, possibly due to decreased awareness of the adverse effects of unnecessary antibiotic use. Moreover, 37% of participants stop taking the medication when they feel better, while 79% use antibiotics as prophylaxis, and this is common among non-medical students. Additionally, 21% take antibiotics when they experience symptoms of the common cold	Prophylaxis of diseases and the common cold
Misli et al., 2021	Malaysia	Cross-sectional study	214	70 %	Antipyretics (35%), Vitamins (14.5%), Antibiotics (13.1%), Antiallergics (2.8%)	Nursing	The overall prevalence of self- medication reported in this study was (70.1%). The majority of respondents (92.5%) had good knowledge of self-medication. Most (40.7%) of the undergraduates in this study choose to practice self-medication as soon as they fall ill, followed by seeking medical consultation (39.3%)	Previous experience, emergency use, quick relief, lack of time for a doctor consultation, and costs
Armillo et al., 2022	Philippines	Descriptive and quantitative research	327	NI	Analgesic/Antipyretic (78.9%)	Medical and non-medical	The students reported that they only self-medicate two to four times a year to manage a mild illness because they believe it helps them improve. Researchers demonstrated that the internet could influence the self- medication habits of the interviewees. There is no significant relationship between the extent of internet use and the level of self-medication	Managing mild illnesses
					NSAIDs (11.62%)
					Antibiotics (36.70%) Antacid (12.2%)
					Eye drops (12.8%) Cough suppressant/
					expectorant (20.18%) Antihistamine (21.10%)
					Nasal decongestant (23.85%)
Silva et al., 2021b	Portugal	NI	2029	4%	Valerian (62.1%) and (Stilnoite^®) (12.1%)	Social Sciences and Humanities, Sciences and Engineering, and Arts	Approximately 31% of students report suffering from insomnia. Regarding the frequency of consumption, 35.5% of individuals in the sample indicated consuming “every day or almost every day,” 32.9% reported consuming “when they are stressed,” and 10.5% reported consuming “two or three times a week”	Difficulty sleeping
Witteveen, 2021	United States	NI	45	11 %	(Adderall), (Ritalin), (Vyvanse), and Dexedrine	Nursing	20% of students have an official diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD) and are prescribed medication to help with their symptoms. When asked if they have ever taken (Adderall), (Ritalin), (Vyvanse), or Dexedrine without a prescription, 11.1% of students admitted to doing so.	Students resort to medication to stay awake longer and enhance their focus capacity. They believe that using these medications will improve academic performance
Cvitkovic, 2021	Croatia	Cross-sectional studyl	213	3%	Diazepam (2.34%) Alprazolam (0.46%).	Pharmacy and Biochemistry	During the COVID-19 pandemic, almost half of the students experienced a deterioration in mental health. The majority of students in this study sought professional help for mental health issues. The frequency of antidepressant use was 11.7%. Five of these individuals use diazepam, and one person uses alprazolam without a professional prescription.	NI
Sljivo et al., 2022	Bosnia and Herzegovina	Cross-sectional study	827	19%	Lorazepam, diazepam, bromazepam, phenobarbital, and zolpidem	NI	Students reported anxiety symptoms due to COVID-19. Individuals who reported depressive symptoms associated with COVID-19 were more likely to be female, exhibit anxiety symptoms, be unemployed, and use sedatives or alcohol	NI

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[TFN1] Legend: NI - Not informed; SF - Self-medication; NSAIDS - Non-steroidal anti-inflammatory drugs.