Changes to Codeine Prescribing – Effective 1st February 2018

Changes to Codeine Prescribing – Effective 1st February 2018

Effective from February 1st 2018, the Therapeutic Good Administration (TGA) have ruled that all medications containing codeine will no longer be available without a prescription. This includes medicines that contain codeine in combination with other analgesics such as Panadeine, Nurofen Plus and Mersyndol as well as various generic pharmacy brands of pain relief and/or cough and cold medication.

Why have these changes occurred?

Until now, medications containing low dose codeine have been available over the counter. The TGA ruling has now made products containing codeine a Schedule 4 medication, meaning they can only be obtained with a Doctor’s prescription.

Codeine is an opioid product belonging to the same family of analgesics as morphine. Its use in the long term can lead to codeine tolerance, meaning a person becomes ‘tolerant’ to it effects, requiring higher and higher doses to obtain relief. It also induces withdrawal effects such as headaches, muscle aches, nausea, insomnia and mood affects.

Another reason for this change is that codeine is often combined with another analgesic such as paracetamol or ibuprofen. When people become tolerant and use high doses of these combination products, it is easy to exceed the recommended daily dose of paracetamol or ibuprofen and this can lead to liver damage, internal bleeding and kidney failure.

Hospitalisations linked to codeine misuse (either suspected or confirmed) are on the rise and cost the healthcare system an estimated $10,000 per admission. Patients often do not disclose use of codeine and extensive and expensive tests are often required to connect a patient’s symptoms with misuse of codeine.

Research has demonstrated that combination low dose codeine products provide very little additional pain relief when compared to products that do not contain any codeine.

What do I do if I cannot get my medication?

If you use products that contain codeine, you should discuss your ongoing needs with your Doctor. Your medication may be continued on prescription, or an alternative treatment regime may be discussed that could benefit you better that your existing regime. If you have any questions, you should speak to your Doctor or pharmacist or visit the National Prescribing Service Website at:

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