The Pharmaceutical Journal Vol 266 No 7152 p815-820
June 16, 2001

  RPM
  In-store pharmacies
  Pharmacy medicines
  Patient packs
  The Profession
  Future of pharmacy
  Coronary heart disease
  Influenza
  Checking technicians
  Dianette
  Paracetamol
  Monitored dosage systems
  Disillusioned youth
  Code of Ethics
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Paracetamol

Sales restrictions flouted

From Ms K. A. Liddell, MRPharmS

A veritable stockpile of analgesics was handed to a local hospital pharmacist by an inpatient who had been admitted following an overdose of 16 paracetamol 500mg tablets, 16 ibuprofen 200mg tablets and 10 co-proxamol tablets. The man had managed to collect 96 boxes of paracetamol 500mg tablets (16s), four boxes of ibuprofen 200mg (12s) and six boxes of cold relief powders (5s), purchased from his local supermarket over about a year. He also had two boxes of 100 co-proxamol tablets which had been prescribed by his general practitioner.

The restrictions on paracetamol sales introduced by the Medicines Control Agency in September, 1998, were intended to reduce the severity of impulse overdoses taken in the home, by making it much more difficult for people to stockpile tablets in this way. The quantity of paracetamol allowed to be purchased in one transaction was restricted to 16 500mg tablets from a non-pharmacy retail outlet, and 32 tablets from a pharmacy. The pharmacist has discretion to exceed this amount, but is charged with a responsibility to check that customers are not intending to build up large stocks at home.

Despite all of this, my husband brought home two packs of 16 paracetamol 500mg when I asked him to get some at the supermarket recently. Our local shop does not have an instore pharmacy, and he was not challenged at the till.

One of our pharmacists decided to try to purchase four packs of 16 from her local Asda store. The check-out assistant advised her that she could only purchase two packs of 16 at the till. However, she helpfully informed her that if she really wanted the other two packs, she could purchase them at the cigarette kiosk.

Research has shown that since the introduction of the sales restrictions both the number and severity of paracetamol overdoses have reduced.¹ A further reduction could perhaps be achieved by reinforcing the legal status of paracetamol containing products in non-pharmacy outlets, as it seems that sales are not being adequately controlled.

Reference

1. Turvill JL, Burroughs AK, Moore KP. Change in occurrence of paracetamol overdose in UK after introduction of blister packs. Lancet 2000;355:2048–9.

Karen Liddell
Senior Pharmacist, Ailsa Hospital, Ayr

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