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Table 1 Codeine Regulations in Ireland, South Africa and the UK

From: A comparative analysis of pharmacists’ perspectives on codeine use and misuse – a three country survey

Ireland

Irish medicine board.

Guided under the misuse of drugs act 1977.

Over the counter sales permissible in regulated pharmacies under supervision of the pharmacists without prescription Usually in 8 mg/500 and 12.8 mg/500 combination drugs containing analgesics such as paracetamol and aspirin.

Cannot be visually displayed or advertised to the consumer.

Patient must be advised on its use at point of sale

Must contain warning of addiction on pack.

Higher strength codeine formulations 15/300, 30/500 of codeine phosphate/paracetamol combinations- are prescription only medicines. Codeine is also available combined with Ibuprofen; a common formulation is 12.8 mg Codeine alongside 200 mg Ibuprofen.

Preparations containing pure codeine (e.g., codeine phosphate tablets is considered controlled drug (CD) (Controlled Drug (Possession without authority is illegal).

South Africa

South African medicines agency.

Over the counter preparations in combination with one or more therapeutically active substances, and containing 20 mg or less of codeine (calculated as base) per dosage unit, .

Pack sizes sold can contain up to 100 doses.

Sold under supervision of the pharmacists.

Sales of codeine containing products must be recorded in the pharmacy.

Prescription Only Medication (POM) medicine in doses up to 20 mg of codeine per dosage unit and are only available on medical prescription.

United Kingdom

Medicine and healthcare products regulatory authority Controlled under the Medicine of Drugs Act 1971.

Over the counter sales permissible in regulated pharmacies under supervision of the pharmacists without prescription. Usually in 8/500 and 12.8/500 combination drugs containing analgesics such as paracetamol and aspirin.

1 over the counter Dihydrocodeine product containing 7.46 mg of active ingredient.

Only 1 pack × 32 tablets allowed per customer transaction unless sanctioned by the pharmacist.

Can be visually displayed and advertised to the consumer at the point of sale, under pharmacist supervision.

Must contain warning of addiction on pack.

Higher strength codeine formulations 15/300, 30/500 of codeine phosphate/paracetamol combinations are prescription only medicines (POM). Codeine is also available combined with Ibuprofen; a common formulation is 12.8 mg Codeine alongside 200 mg Ibuprofen.

Preparations containing pure codeine (e.g., codeine phosphate tablets is considered a controlled drug (CD). (Possession without authority is illegal).

No longer permitted for use under the age of 18 years (codeine containing linctus for cough).