Sale of paracetamol
In the light of a recent study of individuals admitted to hospital
for acute paracetamol overdose (Postgraduate Medical Journal 2006;82:520),
pharmacists
are reminded of the need to exercise their professional judgement when they
meet requests for large quantities of paracetamol.
Restrictions on the pack sizes of non-effervescent tablets or capsules of paracetamol
available from both pharmacy and non-pharmacy premises were introduced in 1998
following changes to legislation. The changes were designed to improve the safety
of over-the-counter painkillers because of concern about the number of deaths
and serious morbidity connected with overdosing and evidence that many people
who intentionally overdose use products that are readily available in the home.
The Medicines (Sale or Supply) (Miscellaneous Provisions) Regulations 1980, as
amended, limits the pack size of non-effervescent paracetamol products. Pharmacies
may not sell packs containing more than 32 non-effervescent tablets or capsules
and may not lawfully supply more than 100 non-effervescent tablets or capsules,
or a combination of both, to any one person at any one time.
Pharmacists are advised to use their professional judgement when meeting a request
for large quantities of paracetamol. The appropriateness of supplying more than
one pack of 32 paracetamol tablets or capsules should be assessed on a case-by-case
basis and pharmacists must be satisfied that a decision to supply, or indeed
refusal to supply, large quantities of paracetamol is in the individual’s
best interests. Pharmacy staff must be appropriately trained to deal with requests
for large quantities of paracetamol and able to recognise when referral to the
pharmacist may be necessary.
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Products containing citronella oil or eucalyptus oil
UPDATE (14 October 2006)
Clarification: products
containing citronella oil or eucalyptus oil
Citronella oil and eucalyptus oil (among other active substances)
have been “identified” under
the Biocidal Products Directive (BPD)(98/8/EC), which means that biocidal products
containing those active substances had to be removed from the EU market by 1
September and cannot be stored for any purpose (except for export and disposal).
The Health
and Safety Executive
website provides further information and has a list of biocidal products
currently approved under the Control of Pesticides Regulations that are affected.
Pharmacists are
advised to check the list and remove from sale biocidal products containing citronella
oil or eucalyptus oil (PDF 2.1MB).
There will be no phased withdrawal as it was the industry’s responsibility
to ensure that no biocidal products containing such active substances remained
on the EU market after 1 September. Pharmacists should contact the suppliers
of biocidal products affected by this for further advice.
For further advice, the HSE can be contacted(tel 0151 951 3535;
e-mail biocides@hse.gsi.gov.uk).
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Strychnine no longer approved for mole control
Pharmacists are reminded that since 1 September 2006, strychnine is
no longer approved for purchase or use for mole control. Therefore no
supplies for this intended use should be made.
Strychnine is classified as “Special Waste” and to dispose
of unwanted stock appropriately, the local Environmental Agency should
be contacted. Consignment notes will have to be completed before it can
be removed and there may be a charge for the removal. If stock is accepted
back from authorised users for destruction, the pharmacist would be responsible
for ensuring it was disposed of as special waste and would incur the
costs.
Pharmacists, however, are not required to take strychnine back from authorised
users. It is the user’s responsibility to arrange the safe disposal
through a licensed
waste collector. (PJ 2005:275:360.)
Further information is available from the Pesticides
Directorate website.
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Pharmaceutical Journal