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In recent years, the Australian Therapeutic Goods Administration (TGA) has proposed implementing a standardized over-the-counter (OTC) medicine label. However, there were mixed consumer opinions regarding a label proposed in 2012 and limited evidence demonstrating the usability of the revised (2014) format.To develop and examine the usability of alternative OTC medicine label formats for standardization, and explore consumer perspectives on the labels.Four alternative labels were developed for the exemplar medicine diclofenac. One was based on the Medicine Information label proposed by the TGA (‘Medicine Information’), one was based on the U.S. Drug Facts label (‘Drug Facts’), and two were based on suggestions proposed by consumers in the earlier needs analysis phase of this research (referred to as the ‘Medicine Facts’ and ‘Consumer Desires’ label formats). Five cohorts of 10 participants were recruited. Each cohort was assigned to user test one of the alternative labels or an existing label for a proprietary diclofenac product (which acted as a comparator) for diagnostic purposes. Each participant then provided feedback on all 5 labels. Each interview consisted of the administration of a user testing questionnaire, measuring consumers' ability to find and understand key points of information, and a semi-structured interview exploring consumer perspectives.Overall, all 4 alternative label formats supported consumers' ability to find and understand key points. The existing comparator label was the poorer label with respect to participants' ability to find and understand key points. Factors such as perceived usability, color, design, content, and/or content ordering impacted consumer preferences. The ‘Consumer Desires’ or ‘Drug Facts’ label formats were most often preferred by consumers for use as the standardized OTC label over the TGA proposed format.All alternative label formats demonstrated satisfactory usability and could be considered for use in OTC label standardization. User testing of OTC labels and consumer feedback received as part of the testing process can assist in the refinement of OTC labeling to ensure that implemented policies are evidence-based.Four label formats for diclofenac were developed in light of proposed Australian over-the-counter medicine labeling changes.All 4 label formats demonstrated good usability, superior to that for an existing over-the-counter diclofenac label.Consumers expressed diverse opinions on the label formats' design and content.Only 4/50 consumers “most preferred” the Therapeutic Goods Administration's (TGA) proposed standardized label format.User testing data and consumer perspectives reinforced the need to optimize the TGA proposed standardized label format.