Hospital pharmacists support pholcodine recall
The Society of Hospital Pharmacists of Australia (SHPA) has supported yesterday’s announcement by the Therapeutic Goods Administration (TGA) to recall pholcodine-containing medicines and remove them from the Australian Register of Therapeutic Goods (ARTG), as a regulatory decision that will improve patient safety and reduce medication-related harm.
SHPA Chief Executive Kristin Michaels says, ‘Our specialist pharmacist members working in surgical wards and medication safety services have been keenly aware of the link between pholcodine-containing medicines and an increased risk of anaphylactic reactions to neuromuscular blocking agents (NMBA) which are essential to safely performing surgery.
‘This specific issue has been known among clinicians for a number of years, with various journal articles publishing and discussing evidence, including in the Australian Prescriber.
‘Ahead of the TGA’s decision, discussion by specialist pharmacists in SHPA’s Medication Safety and Surgery and Perioperative Medicine streams demonstrated that hospitals across Australia were already enacting their own measures to limit the use of pholcodine.’
The newly-established state-wide NSW Medicines Formulary published a communique late last year citing the risk of NMBA anaphylaxis from prior use of pholcodine-containing medicines as well as the limited evidence of pholcodine as an effective treatment for dry coughs.
Around the same time, the European Medicines Agency (EMA) also recommended the withdrawal of all pholcodine-containing medicines from Europe.
Ms Michaels says, ‘There are various alternatives to treat dry coughs and we support calls from the TGA and the Pharmacy Guild of Australia for patients to discuss these alternatives with their pharmacist.
‘We also echo the TGA’s calls for patients to advise their doctors and pharmacists of any prior pholcodine use ahead of undergoing any anaesthesia, which surgery and perioperative hospital pharmacists aim to establish with patient’s medication histories in preparation for surgery.’