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I was interested to read about Anne Begg's experience with co-
proxamol versus 'full strength paracetamol'. It is what I would expect
given the pharmaology of the respective drugs. Unfortunately, most
pharmacologists, doctors and regulators have failed to distinguish between
single-dose studies and regular administration in real life. The
difference is emphasised in the revised monograph on dextropropoxyphene
for the forthcoming 3rd edition of the Palliative Care Formulary.
Of course, the question as to whether the regulators are right to
proscribe a product because of an adverse effect on a third party is
distinct from the matter of faulty knowledge about a drug's performance.
However, it is possible that a different conclusion might have been
reached had the regulators not been misled by incorrect information.
It is over 5 years since I retired as a palliative care clinician,
and I don't think I should campaign to retain specific drugs or drug
products any more. However, I was surprised by the silence which came from
my younger fellow professionals. In my opinion, co-proxamol should remain
available on a named patient basis.
Dr Robert Twycross
Emeritus Clinical Reader in Palliative Medicine, Oxford University;
Director and Joint Editor-in-chief, palliativedrugs.com Ltd.
1. Will the ban on co-proxamol actually prevent suicidal patients
from achieving their aim or is it more likely that they will seek other
drugs to do so?
2. What cheap alternative will offered to the thousands of patients
whose pain was well-controlled by co-proxamol but will now be denied this
treatment so that 300-400 other patients will not be able to use it as a
means to suicide?
Is killing pain worth the risk?
I was interested to read about Anne Begg's experience with co-
proxamol versus 'full strength paracetamol'. It is what I would expect
given the pharmaology of the respective drugs. Unfortunately, most
pharmacologists, doctors and regulators have failed to distinguish between
single-dose studies and regular administration in real life. The
difference is emphasised in the revised monograph on dextropropoxyphene
for the forthcoming 3rd edition of the Palliative Care Formulary.
Of course, the question as to whether the regulators are right to
proscribe a product because of an adverse effect on a third party is
distinct from the matter of faulty knowledge about a drug's performance.
However, it is possible that a different conclusion might have been
reached had the regulators not been misled by incorrect information.
It is over 5 years since I retired as a palliative care clinician,
and I don't think I should campaign to retain specific drugs or drug
products any more. However, I was surprised by the silence which came from
my younger fellow professionals. In my opinion, co-proxamol should remain
available on a named patient basis.
Dr Robert Twycross
Emeritus Clinical Reader in Palliative Medicine, Oxford University;
Director and Joint Editor-in-chief, palliativedrugs.com Ltd.
Competing interests:
None declared
Competing interests: No competing interests