Tighter regulations on pain relievers

Australian consumers to face new tighter regulations on pain relievers from May 1

From 1st May, in just over three weeks time, a significant number of pain relievers containing codeine, such as Nurofen Plus and Panadeine, will be available to Australians only after consultation with a pharmacist, rather than consumers being able to choose themselves ('self-select') in the pharmacy. Larger packs containing more than five days' worth of tablets will now require a prescription from a GP. The change conforms to new 'scheduling' regulations set by the Therapeutic Goods Administration 1.

Pain relievers combining codeine with ibuprofen or paracetamol have been shown to be effective in treating moderate to strong pain. "Many Australians benefit from the extra pain relief provided by the non-prescription codeine-based pain relievers," says John Bell, a community pharmacist in Sydney and Principal Advisor to the Pharmaceutical Society of Australia Self Care health information program. "When taken appropriately they are especially useful for short term use in conditions such as acute back pain, dental pain, period pain and sports injuries."

Margot Harley, 26, an ex-elite rower from Sydney, has been taking the most commonly used of these medicines - Nurofen Plus - for some time for pain relief after sports injuries. She says "I started taking Nurofen Plus when I was rowing. I found that it worked fast and that it gave me better pain relief than other products available. I still take Nurofen Plus for back pain today."

The revised scheduling of codeine combination analgesics was considered necessary to reduce the risk of misuse of these types of medicines, which in some cases has led to addiction. The decision to upschedule was ratified by the TGA's own National Drugs and Poisons Scheduling Committee in October 2009. 1

However, experts have reassured consumers that these medicines are safe if used in accordance with directions on the pack. "The vast majority of consumers use these medicines responsibly and benefit from the convenience of being able to obtain them in consultation with a pharmacist rather than having to visit their GP for a prescription", says Geraldine Moses, Senior Drug Information Pharmacist at the Mater Hospital, Brisbane.

The new regulation will mean that combination analgesics containing codeine will be stored behind the counter. These medicines will be provided in pack sizes up to 30 tablets for people with moderate to severe pain. Patients can discuss their symptoms with their pharmacist, who will advise them on the most appropriate medication. People who have previously used Nurofen Plus or other codeine combinations can ask for the medicine of their choice. Ultimately, the pharmacist has decides whether to provide the medicine.

Margot Harley takes the tablets in accordance with the label and is not put off by the changes, adding "I will keep taking Nurofen Plus regardless of the changes to how it is purchased."

Information for consumers
A website, www.managepain.com.au, was launched in 2009 to help Australians understand when to take codeine based pain relievers, what to take them for and any side effects they may have. The website was developed by the Pharmaceutical Society of Australia and the Pharmacy Guild of Australia, in partnership with Reckitt Benckiser, the makers of Nurofen Plus, who funded the site.2

Further information is available to consumers directly from their pharmacist.