Pseudoephedrine: National Pharmacy Association Not Persuaded By Arguments To Switch To Prescription Only, UK

Main Category: Ear, Nose and Throat
Also Included In: Respiratory / Asthma;  Flu / Cold / SARS;  Pharmacy / Pharmacist
Article Date: 25 Apr 2007 - 10:00 PDT

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Proposals issued by the MHRA to reclassify pseudoephedrine as a POM (prescription only medicine) have been rejected by the association. The NPA advocate a more measured reaction to the possibility that purchases could be used to manufacture the illicit drug Methylamphetamine.

NPA director of Practice Colette McCreedy comments:

"Pseudoephedrine is widely used as a decongestant and there are currently many over the counter (OTC) products which would be affected by this reclassification including commonly used cough and cold remedies that are highly valued by the public. Is a GP's time best spent supplying medicines for self limiting minor ailments?"

"We fundamentally disagree with the implication that the only way of controlling the supply of pseudoephedrine is through prescription only status. P sales could be limited to one pack per patient and the pack size it self could be reduced - similar to the restrictions imposed on paracetamol sales. We know that changes of this type do stop inappropriate use - the use of paracetamol in suicide reduced significantly since these restrictions were imposed. If even more stringent restriction is required we feel strongly that this incorporated into pharmacy supply."

"The Government are keen for pharmacists to take a greater role in healthcare, officials can give a clear signal of faith in the profession by allowing pharmacists to continue to manage of the supply of pseudoephedrine."

Colette adds:

"We also know that by increasing awareness of the potential for illicit use of pseudoephedrine, pharmacists and their support staff will appropriate steps to restrict the supply those with clinical need."

The NPA is also concerned by the reduction in choice available to manufacturers in formulating OTC products if pseudoephedrine is removed.

The NPA will be making a full response to MHRA highlighting our concerns and suggesting alternative approaches to those suggested in the consultation.

Our initial recommendations would include:

-- Pack sizes could be reduced to contain a maximum of 720mg (this is sufficient for short-term treatment of symptoms)

-- Pharmacists could limit sales to one pack per patient The NPA would support additional professional guidance for pharmacists and their staff to ensure the sale of these products is closely monitored and controlled.

In the interim the NPA have issued the following advice to members:

-- At the moment there is no need for you to take these products off the shelf or cease supplying them as P medicines

-- However, all pharmacy staff should be made aware of the RPSGB guidance and the potential for misuse associated with these products

-- All staff should be alert to unusual requests such as repeated requests for these products or requests for large quantities

-- You should monitor sales of these products and alert the police if you notice an increase in sales

-- Ensure your self care SOP or sale of medicines protocol includes appropriate guidance on the sale of these products such as referral to the pharmacist for unusual requests.

www.npa.co.uk

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