Co-proxamol and suicide: Co-proxamol should be restricted, not banned

Marples, Ivan

doi:10.1136/bmj.327.7409.287-a

Cited by 1 publication

(2 citation statements)

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“…It has also been noted previously that in the hospital setting, this drug combination continued to be prescribed out of habit [1]. The use of personal formularies has been noted with other medicines [9] and some workers have reported the efficacy of co‐proxamol in clinical practice [10]. However our results may also suggest that prescribers are not aware of the ongoing controversy with its use [2, 3, 5, 11–13] and may point to the need for better communication of the risks and benefits of use of co‐proxamol to prescribers in primary care.…”

Section: Discussionmentioning

confidence: 90%

“…Calls to have the use of co‐proxamol restricted or even removed from the marketplace were recorded when it was first licensed [2, 11] and were renewed more recently [10, 26, 27], because of concerns over its safety. However, the usage remained relatively high in the UK [1, 26] until recently and this study shows usage of this combination is also significant in Ireland.…”

Section: Discussionmentioning

confidence: 99%

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Usage of paracetamol‐containing combination analgesics remains high in primary care

Usher

Teeling

Bennett

et al. 2005

Brit J Clinical Pharma

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AimsParacetamol-containing combination analgesics are widely prescribed but the use of paracetamol/dextropropoxyphene (co-proxamol) is particularly controversial. We aim to examine the prescribing patterns of the paracetamol-containing analgesics in Ireland. MethodsA national primary care prescribing database was used to investigate patterns of usage. Twenty-six thousand three hundred and eighteen patients who were new to therapy with paracetamol and paracetamol-containing analgesics between January and June 2002 were identified as follows: no previous analgesic medication in the 6 months prior to enrolment into the study, and followed up for at least 12 months from the time of enrolment. Duration of therapy and the number of prescriptions received post enrolment were analyzed according to age. Odds ratios for receiving long-term ( > 1 month) compared with short-term (1 month) prescriptions for co-proxamol, paracetamol only or a paracetamol combination-type analgesic were calculated for women vs. men, and in those aged over 65 vs. those aged under 65 years. ResultsCo-proxamol was the most commonly prescribed analgesic, accounting for 42% of all prescriptions dispensed during 2003. Long-term use of paracetamol-containing analgesic preparations was uncommon, with 56.7% receiving only 1 month's prescription during the study period. However, women (OR = 1.18, 95% CI 1.07, 1.28, P < 0.0001) and those over 65 years (OR = 1.71, 95% CI 1.57, 1.86, P < 0.0001) were more likely to receive a follow-up prescription for co-proxamol, but also for paracetamol (women, OR = 1.28, 95% CI 1.16, 1.39; over 65 year olds, OR = 2.67, 95%CI 2.44, 2.93) and the paracetamol combinations (women, OR = 1.33, 95% CI 1.20, 1.47; over 65 year olds, OR = 1.69, 95% CI 1.53, 1.87). ConclusionsCo-proxamol was the most commonly prescribed paracetamol-containing analgesic preparation in Ireland. The results may indicate inappropriate use in primary care.

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