Background In Saudi Arabia, the non-prescription sale of drugs has threatened patient safety for at least a decade. It has been reported that community pharmacists often dispense medicines based solely on consumer request. The current study investigated consumers' non-prescription requests for prescription medicines, community pharmacists' efforts to ensure the correct dispensing of medicines and pharmacists' views on the incidence and reporting of adverse events in their practice.

Method A qualitative study using a structured interview format with pre-defined themes was conducted among 10 hospital-affiliated and 10 non-hospital-affiliated community pharmacies in Al-Hofuf, Eastern Province, Kingdom of Saudi Arabia.

Results Consumer requests were highest for analgesics (eg, Panadol and Voltaren) followed by cough preparations and antibiotics. Augmentin and ciprofloxacin were the antibiotics most frequently requested over the counter. In hospital-affiliated pharmacies, non-prescription dispensing was mostly carried out for regular customers. Nearly 30% of consumers were familiar with the names of the medicine they requested, while 30–35% normally brought empty bottles or boxes. However, pharmacists sometimes guessed (eg, based on shape, colour and/or price) the correct medicine. Stomach pain, urticaria, nasal bleeding, indigestion and mouth dryness were recently observed adverse events. However, due to lack of awareness of suitable websites or contact numbers for regulatory authorities, no pharmacist had ever reported an adverse event.

Conclusions Analgesics and antibiotics were frequently dispensed without prescription with pharmacists often using their personal judgment to ensure the right medicine was dispensed. Adverse events in community pharmacy settings in the eastern region of Saudi Arabia were under-reported.