Pseudoephedrine and ephedrine: update on managing risk of misuse in the UK

Implementation of measures to regulate sales, together with the additional voluntary actions overseen by the pharmacy profession, has made an important contribution to managing the risk of misuse of pseudoephedrine and ephedrine in the UK.

Pseudoephedrine and ephedrine are medicines used as nasal decongestants, which are available from pharmacies. Between 2007 and 2008, we introduced restrictions on their use because of concern that medicines containing these active substances could be used in the illicit manufacture of the class A controlled drug methylamphetamine.

Sales restrictions

Since April 2008, after public consultation and following advice from the Commission on Human Medicines (CHM), the following sales restrictions have been in place to manage the risk of misuse of pseudoephedrine and ephedrine:

  • it is illegal to sell or supply any product that contains more than 720 mg pseudoephedrine or 180 mg ephedrine without a prescription
  • it is illegal to sell or supply a combination of products that between them add up to more than 720 mg pseudoephedrine or 180 mg ephedrine without a prescription
  • it is illegal to sell or supply a product that contains pseudoephedrine and a product that contains ephedrine in one transaction

Furthermore, the Royal Pharmaceutical Society advises that the sale and supply of these products must be made by a pharmacist or suitably trained pharmacy staff under the supervision of a pharmacist

Continual monitoring

CHM has continually reviewed these measures and their effect on containing the potential problem of misuse (see Drug Safety Update October 2012 and a Public Assessment Report October 2012).

Impact of restrictions: 2015 review

Between June 2013 and March 2015 there have been a few reports from pharmacies of suspicious behaviour, which have been addressed according to established procedures. There has been no evidence of methylamphetamine manufacture from medicines. The evidence suggests that the restrictions are continuing to help manage the risk of misuse. Further information is available in our report: Pseudoephedrine and ephedrine: managing the risk of medicines misuse – September 2015.

Implementation of measures to regulate sales, together with the additional voluntary actions overseen by the profession, has made an important contribution to managing the risk of misuse of pseudoephedrine and ephedrine. The recommendation is that existing levels of monitoring, education and awareness measures by pharmacists should be maintained. The success of these measures depends on the pharmacy profession, which makes a substantial contribution to managing the risk of misuse of these products.

Further information

Pseudoephedrine and ephedrine: quick reference guide from the Royal Pharmaceutical Society

Article citation: Drug Safety Update vol 9 issue 2 September 2015: 3

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