BMJ  2008;336:694-696 (29 March), doi:10.1136/bmj.39504.389676.AD

Analysis

Over the counter medicines: proceed with caution

¹ West Midlands Centre for Adverse Drug Reactions, City Hospital, Birmingham B18 7QH , ² Mansionhouse Unit, Victoria Infirmary, Glasgow G41 3DX

Robin Ferner and Keith Beard caution that the risks of increasing people’s access to over the counter medicines may outweigh the benefits

The first 150 words of the full text of this article appear below.

An all party parliamentary group in England is currently assessing whether there is a case for banning over the counter access to analgesics containing weak opioids.¹ Recent coroner’s inquests found that a 41 year old man died from respiratory depression after taking an over the counter analgesic containing paracetamol and dihydrocodeine² and attributed the death of a 49 year old woman to renal failure from addiction to an over the counter preparation containing ibuprofen and codeine.³ Here we consider what determines whether a medicine is available over the counter and whether changes are needed.

Current legislation

UK legislation to regulate the supply of medicines dates back 40 years. It stems from the disastrous consequences of prescribing the teratogenic drug thalidomide to pregnant women after inadequate safety checks.⁴ The ensuing inquiries led to the UK Medicines Act 1968⁵ and European Economic Community Directive 65/65/EEC.⁶ Broadly, these divide medicines into classes that do or . . . [Full text of this article]

Balance between benefit and harm

In favour of wider availability

Concerns about wider availability

Steps to increase safety

Summary points

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