Patients who visit their community pharmacies to purchase analgesic and cough and cold medicines containing codeine will first need to visit their doctor and obtain a prescription for the medicines from 1 February 2018.
The decision to upschedule medicines containing codeine has been taken by the Therapeutic Goods Administration on the basis it believes these medicines can be addictive and are being used inappropriately by some patients with chronic pain.
The medicines that will be affected are:
- Paracetamol + codeine 500 mg + < 15 mg (eg Panadeine ®, Panadeine Extra ®, Mersyndol ®)
- Ibuprofen + codeine 200 mg + < 15 mg (eg Nurofen Plus ®, Panafen Plus ®)
- Aspirin + codeine 300 mg + < 15 mg(Aspalgin ®, Codis Disprin Forte ®)
- Cough and Cold medicines (eg Codral Original Cold & Flu ®, Demazin Day & Night Cold & Flu ®)
At present these medicines are available over-the-counter after speaking to a pharmacist.
From 1 February 2018 all patients will need a prescription to purchase these medicines.
This is expected to have an impact on local GPs, with a consumer survey showing 51 per cent of respondents will visit their doctor for a prescription when the new system comes into effect, increasing the pressure on an already strained system.
Community pharmacists will be helping patients make the transition to the new system.
It is in the interests of patients, the pharmacist profession and the wider health system that community pharmacies lead the effective management of this transition for the nearly one million Australians who currently use codeine containing over-the-counter analgesics.
As accessible medicine experts, community pharmacists can advise on medicines available to relieve mild to moderate pain, whether these are available over-the-counter or whether a doctor should be consulted.
Under Australia’s medicine schedules, certain medicines, including pain relief medicines, are available from community pharmacies, sometimes requiring direct pharmacist advice.
Pharmacists are trained to assess the pain relief needs of patients and can advise on the most clinically appropriate therapy to manage pain.
This will be of particular importance for people who use medicines containing codeine to manage pain.
A recent consumer survey showed people use pain killers containing codeine primarily for relief of migraines (28 per cent), followed by back pain (23 per cent) muscular pain (9 per cent), period pain (7 per cent) and dental pain (6 per cent).
If you suffer from persistent or chronic pain, medicines alone may not be helpful. Patients are encouraged to consult their doctors for a thorough assessment of pain and where necessary, a referral to an appropriate allied health professional or pain specialist.
Before the change occurs, most pharmacies will continue to seek patient information through a real time recording system called MedsASSIST when supplying medicines containing codeine.
This is a voluntary system designed to assist pharmacists to assess the appropriateness of supplying the medicines to individual patients.
The Pharmacy Guild of Australia is developing a model that would enable patients to access medicines containing codeine from a community pharmacy under certain strict conditions which include that the pharmacy must use MedsASSSIT.
The conditions would include that the pharmacist has undergone additional training and that the patient is suffering acute pain.
The use of MedsASSIST with this exception model would ensure all sales are monitored and recorded to help identify vulnerable patients and reduce misuse of these medicines.
