New Codeine Guidance Now in Force
August 01, 2010
The PSI (Pharmaceutical Society of Ireland), the pharmacy regulator, has stated that from today all pharmacists and retail pharmacy businesses (pharmacies) must comply in full with its guidance on the safe supply of codeine medicines.
PSI Head of Communications, Kate O’Flaherty, said it was important that members of the public receive the professional expertise and advice of a pharmacist in order to use these medicines safely and properly.
“Members of the public who need advice about pain management or who feel they may be experiencing side-effects or other problems from their use of painkillers containing codeine should seek the advice and assistance of their pharmacist. It is the clear expectation of the regulator that it will be a pharmacist who personally conducts the consultation with any patient seeking advice about codeine medicines, and who makes the professional judgement and decision as to what is the most appropriate treatment or advice for the patient. This may be what painkiller or other medicine is most suitable - which will in some cases be a codeine medicine. Or it may be whether the patient needs referral to a GP or other healthcare professional or if there is any other specific advice or information that they require.”
The guidance is to ensure compliance with new regulations under the Pharmacy Act 2007 and with the Code of Conduct for pharmacists which places the patient as the primary concern of a pharmacist. From August 1, all pharmacists and pharmacies must be consistent in their approach and practice to this important patient safety issue.
Non-prescription medicines containing codeine are available in Ireland in pharmacies only. The guidance states that superintendent pharmacists must ensure that policies and procedures in the pharmacy or pharmacies under their control adhere to this guidance. The guidance also outlines that the regulations under the Pharmacy Act 2007 mean these medicines must not be accessible to the public for self-selection and therefore they must be stored in an area of the pharmacy under the pharmacist’s direct management and supervision, out of sight of the public; the dispensary is the recommended location.
The guidance also states that patients should be facilitated and encouraged in obtaining medical assistance for any health problems related to misuse.
Codeine medicines should only be used when considered necessary and for the shortest period necessary. Patients should be advised of the importance of adhering to the recommended dose and duration of use and should be informed of risks of developing tolerance and dependence. Patients should also be advised of added risks from excessive consumption of ‘combination products’ - painkillers containing codeine and another drug such as paracetamol or ibuprofen - and should be counselled about other potential side effects, such as drowsiness, which might affect their ability to drive safely.
The advertising of these medicines to the public is prohibited (as codeine is a controlled drug) – this includes window displays, in-pharmacy displays, shelf stickers and promotional leaflets.
Read the Guidance for Pharmacists on the Safe Supply to Patients of Non-Prescription Medicinal Products containing Codeine.
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