Added: Dennise Maldanado - Date: 11.02.2022 11:57 - Views: 45592 - Clicks: 4405
The range of analgesics available over-the-counter OTC in pharmacies will be reduced when all codeine-containing products are reclassified as prescription-only medicines from 5 November, Pharmacists will need to recommend other methods to manage pain and people who are accustomed to buying codeine-containing products from pharmacies will need to be informed about the change.
From 5 November,all codeine-containing products ly available over-the-counter OTC will become prescription-only medicines. Pharmacies are permitted to dispense, on prescription, medicines containing codeine that are not labelled as prescription-only medicines until 5 May,in order to use up existing stock.
The details of the codeine-containing products that will become prescription-only medicines from November 5,are provided in Table 1. The Codral range of cold and flu preparations has already been reformulated without codeine; the original products are listed in Table 1 as some pharmacies may still have stock of these formulations.
It is likely that some codeine-containing products that are currently available OTC may be withdrawn from the New Zealand market due to a lack of demand once a prescription is required. These products were included in the table as some pharmacies may have remaining stock of codeine-containing formulations. People often visit pharmacies to request medicines for the relief of mild to moderate acute pain associated with headache and migraine, dental issues, back injuries, menstruation and musculoskeletal conditions.
The reclassification of codeine will limit the of products pharmacists are able to sell to people with pain, and other treatments will need to be recommended. People who are accustomed to purchasing analgesics containing codeine OTC will need to be informed of the change and advised to purchase a different medicine or to consult with their general practitioner.
The initial goal in the pharmacy is to distinguish between acute, self-limiting pain that the person can manage themselves with guidance, and long-term or more serious conditions that require consultation with a general practitioner or another health professional, e. Pain-related questions that may help in forming treatment recommendations include:.
Additional factors that may influence pain management strategies include co-morbidities, any medicines or complementary and alternative treatments the person may be taking, and potential contraindications to medicines, e. If self-management is appropriate, people should be advised to consult their general practitioner if their pain has not improved ificantly in an agreed time frame or if their pain is increasing. It may be appropriate to consider the possibility of codeine misuse if a person becomes belligerent or distressed when informed that codeine is no longer available without prescription.
Paracetamol and a NSAID can also be taken concurrently or in a staggered dosing regimen if pain is not controlled with one medicine alone. It is important that people are made aware that paracetamol and NSAIDs may have different recommended dosing intervals, e. Topical NSAIDs may be appropriate for people with mild musculoskeletal pain that does not involve deep tissue.
A range of rubefacients are also available that increase blood circulation near the skin which may reduce discomfort, however, there is limited evidence supporting their use. People may also apply heat or cooling packs to painful areas to either increase blood circulation or attempt to reduce inflammation. In general, people with musculoskeletal pain benefit from staying active, assuming this does not exacerbate an injury or the underlying condition.
A consultation with a physiotherapist may be beneficial for patients with injuries or reduced mobility. Strapping tape, support bandages or braces for ts may also provide limited benefit, where appropriate. Paracetamol is less effective but may be preferable for some patients.
People with frequent or debilitating migraine should be advised to consult with their general practitioner about prophylactic medicines. There is little evidence that one NSAID provides superior pain relief to another; 6 commonly used options are naproxen mg tablets, mefenamic acid mg capsules Ponstan or ibuprofen.
Dental pain can be treated with a NSAID, usually ibuprofen, as the first-line choice and paracetamol can be recommended if a NSAID is contraindicated; 7 consultation with a dentist should be advised, or if this is not possible, a general practitioner. Table 2 : Analgesic medicines available Codeine pills over the counter in community pharmacies in New Zealand, displayed by suggested use in adults. Codeine was ly present in a small of cough and cold preparations, however these products have now been reformulated to be codeine-free, therefore the management of winter illnesses will not be greatly affected by the reclassification of codeine.
It is unclear what the intended purpose of codeine was in these products; it may have been to provide analgesia for sore throat and general aches and pains, or to act as a cough suppressant which codeine is indicated for. There are multiple other products that can be recommended to treat the symptoms of cold and flu, including analgesia such as paracetamol or ibuprofen. There is limited evidence supporting the use of cough syrups for the relief of acute cough.
After a treatment decision has been made, confirm the person understands any recommended medicine regimen, e. In general, people should be advised to return to the pharmacy if their symptoms have not resolved in an agreed timeframe or to consult their general practitioner, particularly if their symptoms worsen. Expert reviewers do not write the articles and are not responsible for the final content. We have now added the ability to add replies to a comment. Codeine pills over the counter click the "Reply to comment" button and complete the form.
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Log in. Codeine: all formulations prescription-only. Codeine reclassified as a prescription-only medicine: a community pharmacy perspective You are reading this. Published: 9 October References Medsafe. Reclassification of codeine. Classification of codeine: Information paper for the Medicines Classification Committee. NZF v Chronotherapy of non-steroidal anti-inflammatory drugs may enhance postoperative recovery. Sci Rep Codeine pills over the counter Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension-type headache, cluster headache, medication-overuse headache.
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