People who are about to undergo major surgery are seeing cold and flu remedies removed from the shelves.
Products containing pholcodine, an opioid cough suppressant, are being withdrawn. This includes some Day & Night Nurse capsules and own-label cough syrups sold at Boots and Superdrug.
According to the Medicines and Healthcare products Regulatory Agency, (MHRA), the medicines were being withdrawn as a precautionary measure following a review.
Reviewers concluded that the benefits of pholcodine were not worth the risk of anaphylaxis in general anaesthesia surgery.
The MHRA stated in a statement that pholcodine usage, especially during the twelve months prior to general anaesthesia with Neuromuscular Blocking Agents, was a risk factor for anaphylactic reactions.
Anaphylaxis, according to the NHS, is a potentially fatal allergic reaction which can quickly develop. Anaphylactic shock is another name for it.
Anaphylaxis can be described as swelling of the throat, tongue, and mouth. This can lead to breathing difficulties and difficulty swallowing, severe abdominal pain, nausea, vomiting, and even unconsciousness.
Day and Night Nurse are among the flu treatments that have been withdrawn due to concerns they could prove harmful
All healthcare professionals and pharmacists have been instructed to “halt supplying the above products immediately” as well as “quarantine any remaining stock.” This is in accordance with the advice of the Commission on Human Medicines that advises the government on safety of medicines. The Commission on Human Medicines stated that there was “sufficient overall evidence” to support a link between pholcodine injections and anaphylaxis in surgery.
It also stated that the “absolute risk of anaphylaxis is very low”. It is estimated that it affects approximately 1 in 10,000 general anaesthesia procedures.
The MHRA stated that patients who use pholcodine in general do not have an increased risk of developing allergic reactions. This problem is only for those who are undergoing surgery.
The European Medicines Agency (EMA), also recommended that the medicine be withdrawn from EU markets in December due to similar concerns.
Concerned users of cough medicine should consult a pharmacist to get alternative suggestions. If you have used a cough medicine within the last 12 months, it is a good idea to inform your anaesthetist before going to surgery.
The MHRA stated in a statement that: “If you take a cough medicine (including syrups and tablets), please check the package, label, or Patient Information Leaflet to determine if pholcodine has been listed. If it is, you can ask your pharmacist for a recommendation on a suitable medicine.
If you suspect you have taken pholcodine in the last 12 months, tell your anaesthetist. Anesthetists manage allergic reactions in surgery routinely. The Association of Independent Multiple Pharmacies stated that pharmacies take patient safety very seriously. They will follow the MHRA guidelines and recall all pholcodine products.
The pharmacists are able to offer advice and help with symptoms such as a cold or a cough.