Codeine drug use to face checks by pharmacists

Siobhain Ryan | April 09, 2009

CONSUMERS of the popular painkillers Nurofen Plus and Panadeine Plus face counselling by a pharmacist before they can buy the products under new proposals aimed at limiting addiction to, and side-effects from, the drugs.

The number of tablets per pack would be limited to five days' supply, more than halving the largest current pack size, under recommendations published yesterday by a government committee.

The Pharmacy Guild of Australia and the Australian Self-Medication Industry warned that thousands of people could be inconvenienced, without curbing the abuse problem, if the changes were adopted by the nation's drug watchdog.

Many of the analgesics and cold/flu medicines that combine codeine and ibuprofen, paracetamol or aspirin have long been sold from pharmacy shelves without the need to refer to a pharmacist or doctor.

Larger doses and pack sizes are already subject to the "pharmacist-only" dispensing rule.

The Therapeutic Goods Administration committee will call for public comment on the proposed changes later this month, for review at a June meeting.

The TGA was prompted to review access to the medicines after hearing of 77 side-effects where people became addicted to codeine-ibuprofen painkillers, taking an average of 50 tablets a day.

One death, seven renal failures, 39 gastrointestinal haemorrhages or perforations and 38 cases of opioid dependence and withdrawal were reported.

The Pharmacy Guild's national president, Kos Sclavos, said reducing the pack size did little to stop patients moving from pharmacy to pharmacy to buy the products and thwart the pack-size rule.

"If anything, this is a green light to such activity, which is difficult to fathom," he said.

ASMI scientific director Deon Schoombie said he feared the Government could overreact to abuses of the medicines by a minority of users.

"These medicines play an important role in relieving strong pain and addressing the symptoms of cold and flu, and any move to restrict their availability would be an enormous inconvenience to thousands of responsible users," he said.

But the Australian Medical Association's John Gullotta said "pharmacist-only" restrictions on Nurofen Plus and similar painkillers would be far less stringent than some of the alternatives floated last year, which could have seen the drugs subject to the same controls as medicinal cannabis or heroin.

"It'd probably be good to get a bit of counselling, and they'd get that in (pharmacist-only scheduling), in theory," Dr Gullotta said.