Observations THE WEEK IN MEDICINE

Is killing the pain worth the risk?

BMJ 2007; 334 doi: http://dx.doi.org/10.1136/bmj.39104.415961.68 (Published 25 January 2007) Cite this as: BMJ 2007;334:186
  1. Rebecca Coombes, journalist, London ([email protected])

    MPs argue that the regulators went too far when it banned co-proxamol

    The story so far

    MPs staged a last ditch attempt to get an effective ban on the painkiller co-proxamol overturned last week. The bid was ultimately thwarted but it gave a valuable insight into how patients and doctors are handling the phased withdrawal of the once popular analgesic two years after the uncompromising decision was made.

    Co-proxamol is a prescription only analgesic that combines paracetamol (325 mg) and dextropropoxyphene (32.5 mg). It has low side effects and is popular with patients with chronic pain. But it is also the second most frequent means of suicide with prescribed drugs in England and Wales, second only to tricyclic antidepressants. Concern about the number of such deaths was expressed in the BMJ as long ago as 1980.

    In 2004 the Medicines and Healthcare products Regulatory Agency announced a phased withdrawal of the painkiller. A review by the agency found that around 300-400 people a year die as a result of taking too many tablets either deliberately or by mistake. That co-proxamol is potentially very toxic was highlighted in a 2005 study in the British Journal of Clinical Pharmacology. It found that an overdose of co-proxamol was more than 10 times more likely to be …

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