Cough medicines containing pholcodine removed from UK pharmacy shelves over safety risks

Some cough medicines are being pulled from UK pharmacy shelves over safety fears. Credit: PA

Some cough medicines are being removed from UK pharmacy shelves due to safety risks.

All products which contain pholcodine, a cough suppressant, are being recalled and withdrawn from the UK as a precaution.

Experts have found the medicines, which include some cough syrups and Night Nurse, can have an increased risk of sudden, severe and life-threatening allergic reaction.

The rare side effect has been identified among some people who take the medicines up to a year before going under general anaesthetic involving neuromuscular blocking agents (NMBA).

NMBAs are used to relax the muscles during general anaesthesia for some surgical procedures.

The Medicine’s and Healthcare products Regulatory Agency (MHRA) said that, based on advice from the Commission on Human Medicines (CHM) - the advisory body that provides expert advice on drug safety - it was recalling the products “as a precaution”.

Geraint Vincent explains why the decision has been made to remove some cough medicines from pharmacy shelves

The following products are affected:

  • Boots Night Cough Relief Oral Solution

  • Boots Dry Cough Syrup 6 Years+

  • Boots Day Cold & Flu Relief Oral Solution

  • Cofsed Linctus

  • Care Pholcodine 5mg/5ml Oral Solution Sugar Free,

  • Galenphol Linctus,

  • Galenphol Paediatric Linctus,

  • Galenphol Strong Linctus

  • Covonia Dry Cough Sugar Free Formula

  • Pholcodine Linctus Bells Healthcare 5mg Per 5ml Oral Solution,

  • Numark Pholcodine 5mg per 5ml Oral Solution

  • Well Pharmaceuticals Pholcodine 5mg per 5ml Oral Solution

  • Superdrug Pholcodine Linctus BP

  • Strong Pholcodine Linctus BP

  • Pholcodine Linctus BP

  • Strong Pholcodine Linctus BP

  • Pholcodine Linctus, PL

  • Glaxosmithkline Day & Night Nurse Capsules

  • Glaxosmithkline Day Nurse Capsules

  • Glaxosmithkline Day Nurse

All pharmacies should stop the supply of the above products immediately.

They are advised to quarantine all remaining stock and return it to the supplier.

This recall applies to all batches currently within shelf-life for the products listed. 

Healthcare professionals are advised to recommend appropriate treatment alternatives when counselling patients who may present with symptoms of cough, cold and flu.  

Professor Claire Anderson, president of the Royal Pharmaceutical Society, said: “All products containing the cough suppressant pholcodine have been withdrawn due to concerns of its potential to cause a severe allergic reaction in some people having general anaesthesia for surgery.

“The risk to patients who have used pholcodine is very small. If you are due to have surgery, please speak to your pharmacist or medical team for advice," she added.

“This withdrawal is needed as safety of patients is paramount and we support efforts to ensure that all medicines on the market are safe and effective."

How do I know if I've taken pholcodine and what can I have instead?People taking a cough medicine (including tablets and syrups), should check the packaging, label or Patient Information Leaflet to see if pholcodine is a listed ingredient.

"If it is, and you have any questions, you can talk to your pharmacist who can suggest a different medicine suitable for you," suggests Professor Anderson.

“A cough usually clears up within three to four weeks. You can treat it with other cough medicines or hot lemon and honey (not suitable for babies under one year old)," she added.

“Rest up if possible and you can try paracetamol or ibuprofen, if suitable, to treat any pain. If your cough persists for longer than three to four weeks seek advice from a healthcare professional."

What should I do if I've taken this medicine and am due to have surgery?

Surgical patients are being advised to tell their anaesthetist before an operation if they think they have taken pholcodine in the past 12 months, or if they think they have taken one of the withdrawn medicines.

There is no increased risk of allergic reactions, including anaphylaxis, with other allergens following pholcodine use and the absolute risk in patients who have used pholcodine is "very small", according to the MHRA.

Any suspected adverse reactions should be reported via the MHRA Yellow Card scheme. 

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