From Mr D. J. Savage, MRPharmS
SIR,—I write as a gesture of support (or do I mean sympathy?) with Noel Stow of Bury St Edmonds (PJ, December 11, 1999, p947). Challenged by a customer about a warning he did not understand on a familiar traditional medicine, he wrote for clarification to the Society's information department.
Miss Khan clearly went to great lengths to help him discover what the risks are to customers with heart or kidney disease when taking glycerin, honey and lemon mixture. Miss Khan came to no significant conclusion.
The PJ, very logically, invited Mr Edwards, as a director of Thornton & Ross, the manufacturer of the product Mr Stow stocks, to comment. His reply, published in full, is a classic example of passing the buck and is totally unhelpful.
Perhaps the Medicines Control Agency should comment, if it is the agency that placed the legal requirement on Thornton & Ross to include this warning on the label. Maybe it could quantify the "risk" to help us all appreciate the need for the warning.
I would also appreciate a comment from the Society. Perhaps it would give us a model set of questions to ask a potential customer for glycerin, honey and lemon before we stick our necks out and risk harming our customers or risk litigation arising from another sale of this well established traditional cocktail.
Martindale makes interesting reading but hardly justifies reclassification of this medicine to "black triangle" status. Now that we have been invited to join the select ranks of "yellow card reporters" may we know if any adverse drug reactions are already on the database for glycerin, lemon and honey? Something must be known to justify the MCA's requirement for the warning to appear on the label. I do not understand what it is. Noel Stow does not understand either. The MCA could share its greater wisdom and give us an indication to dispel my suspicion that Pat Clarke has not hit the nail squarely on the head when she speculates that "this is surely labelling gone mad" (PJ, October 30, 1999, p708).
What would be the model answer to Mr Stow's anxious husband or does the MCA just want to undermine public confidence in pharmacy?
John Savage
York