Sale of popular cough syrups without doctor’s note banned

The Pharmacy and Poisons Board has banned the sale of medicines that contain an opioid pain reliever known as codeine without a doctor’s chit.

By clamping the sale of these drugs without proper prescription, the board wants to tame abuse of and addiction to codeine.

Among the drugs that will need a doctor’s prescription before purchase are three common cold medicines and a painkiller.

Prescription will be restricted to three days.

The board also gave manufacturers six months to change packages of drugs that contain codeine to include clear and prominently positioned warnings on labels, summary product characteristics and patient information leaflets about the risk of addiction and the importance of not taking them for more than three days.

SEVERE PAIN

The agency said codeine was a controlled substance that could no longer be sold over the counter.

Though he did not give a list of drugs that would require prescription before being dispensed, board registrar Fred Siyoi said the medicines were being abused and used for recreational purposes.

“We have received many complaints about the abuse of these drugs. Anything that the government feels is becoming risky to the public has to be restricted,” said Dr Siyoi.

Codeine, used to treat mild to moderately severe pain, is an opioid medication which is sometimes called a narcotic. Pure codeine is mostly prescribed as a painkiller and falls under controlled substances.

Because of the restriction, users look for codeine elsewhere, with cough syrup being the easiest. Almost all these syrups contain only 10mg of codeine and five per cent alcohol.

ACCESSIBLE

Some of the most common and easily accessible codeine-containing cough syrups are Benylin with Codeine, Coscof C and a cough suppressant known as Actifed with codeine syrup.

Betapyn tablets, used to treat headaches, toothache and joint pain also contain codeine and are often sold without prescription.

The board warned pharmacists against refilling the drugs if buyers failed to present prescription notes.

“Please note that no refill will be allowed for prescriptions with medicines that contain codeine,” Dr Siyoi said.

It has become a trend to abuse codeine cough syrup by mixing it with soda or alcohol.

The problem is now global. A recent study shows nearly four million Americans older than 12 abuse prescription pain relievers, including codeine.

ADDICTION

Whereas the number in Kenya may be marginal, health data estimates that about 90 people die from opioid overdose annually in Kenya.

Last year, for instance, a Nairobi-based accountant confessed to weaning off a crippling two-year substance dependence on a codeine-based cough syrup.

A few years ago, a magazine published a story on former TV anchor Cynthia Nyamai who traced her addiction to the cough medicine, saying the syrup helped her deal with the pain of her divorce.

Ms Nyamai said she realised one bottle was not enough and as her life spiralled south, she began taking an extra bottle.

SIGNATURE

To minimise the risk of overuse and addiction, the board has converted medicines that contain codeine as one of the active pharmaceutical ingredient from pharmacy-only medicines to prescription-only.

“Prescribers and dispensers should not offer for sale medicine that contains codeine without a valid prescription from a duly registered medical practitioner,” Dr Siyoi said.

Prescription will only be considered if it contains the patient’s as well as the medical practitioner’s details, including their registration number and signature made in indelible ink.

City pharmacies have begun implementing the directive as a number of them are hesitant to sell the drugs without a doctor’s note.

“We cannot sell you these drugs if you do not have a prescription,” said one during a spot check by the Nation on Wednesday.