Popular painkiller Nurofen Plus in danger of becoming a prescription only drug

Apr 15 2008

Australia's National Drugs and Poisons Scheduling Committee (NDPSC) is apparently considering making one of the most commonly used over-the-counter (OTC) drugs available only with a prescription.

The popular Nurofen Plus, which contains 200 milligrams of ibuprofen and 12.8 milligrams of codeine, could soon become a Schedule 8 drug on a par with morphine and methadone.

Nurofen Plus is one of the strongest OTC painkillers available in Australia and is used by many to treat toothache, period pains and a plethora of other common painful conditions; it can be bought OTC in packs of up to 72 tablets but double that amount is available on the internet.

If the NDPSC succeeds in making Nurofen Plus a Schedule 8 drug it will place it in the same category as some of the most addictive medications currently on the market.

It appears that the committee, which is made up of experts, has been inundated with reports the drug is being abused by addicts and drug dealers resulting in a large number of admissions to hospital.

Reports have been received that some codeine addicts have taken up to 24 tablets a day, apparently unaware that the medication's other active ingredient, ibuprofen, a non-steroidal anti-inflammatory, can cause ulcers in the stomach and duodenum.

There have also been reports that the codeine in the tablets is being extracted by manufacturers of illicit drugs and these reports are currently being investigated.

The committee will hear from drug and alcohol experts before reaching a decision which is expected in June.

Pharmacists have voiced concern over increasing numbers of requests for codeine-combined painkillers and they say the public appears to believe because such products that are widely promoted, they are not harmful.

Should Nurofen Plus become a Schedule 8 drug, patients will need a complex prescription that must be copied, registered and locked in a safe by the pharmacist and many in the industry regard the move to place the drug in this category as extreme.

According to the Pharmacy Guild of Australia the move would cost the nation millions of dollars and inconvenience thousands of legitimate patients.

John Gullotta, the chairman of the Australian Medical Association's federal therapeutic committee, says the Schedule 8 category is as a rule reserved for medications that have been abused while they are on prescription and making the drug prescription-only would be extreme and unprecedented.

Recent research revealed that following three months of regular use, up to 20 per cent of patients developed stomach ulcers and 10 per cent developed duodenal ulcers; when patients took the drug for a 12 month period, bleeding, perforation or obstruction of the intestines occurred in around 4 per cent of patients.

Many pharmacists believe that codeine abuse is not that serious an issue and does not justify the products becoming unavailable to the public, who they say need easily accessible pain relief and use such drugs in a responsible manner.