Minister backs medicine downscheduling

More work needs to be done on downscheduling medicines in Australia, the Minister for Health believes.

Meanwhile a final decision on the scheduling of codiene could be delivered before the end of the year

Speaking at the Australian Self Medication Industry (ASMI) Conference in Sydney yesterday, Minister Sussan Ley said there are strong arguments supporting the downscheduling of some prescription medicines to the pharmacist-only (S3) category.   

Looking across the Tasman for examples, the Minister said influenza, urinary tract infection and migraine medicines were among those that were non-prescription in New Zealand, but remained S4 in Australia.

As with calls for S3 consumer advertising, she said any changes would need to balance choice with consumer protection, but she welcomed the “stronger role” that consumers and pharmacists would play expansion of S3 medicine options, as well as the impact it would have on freeing up GP waiting lists.

Ms Ley also updated ASMI delegates on the current status of proposals to up-schedule codeine-containing medications.

Currently the Department of Health was completing a regulatory impact statement on the proposals and a decision would be made public before the next round of scheduling decisions was announced.

With more than 260 submissions made during the public consultation process on these proposals, she said a range of options had been highlighted include smaller pack sizes, strengthened label warnings and separating scheduling for analgesic and cough/cold medicines containing codeine.  

During his presentation to the conference, Pharmacy Guild of Australia national president George Tambassis reiterated the success of the MedsAssist program in reducing harmful dispensing of codeine-containing medicines.

“Real time monitoring, as provided by MedsAssist, helps us identify those who may be addicted to codeine, and lets us talk to patients about their pain management.  This is facilitating pharmacists playing a consultative and patient educative role.”

To date, 3.5 million sales had been recorded around Australia, and he highlighted the work done across the sector to have this program developed and operational in a short period following the announcement of the rescheduling proposals in late 2015.

Click here to see why pharmacist Samantha Kourtis thinks its important for pharmacy to use MedsAssist.

Around 90% of pharmacies in osem states are currently using MedsAssist Tambassis said, although NSW was dragging the chain with 70-75% of pharmacies currently registered. 

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1 Comment

  1. Ron Batagol

    Pharmacists are obviously doing a great job, in helping to monitor
    codeine abuse, with the Meds Assist program.

    However, this is only part of the problem, and what concerns me
    is that, when we look at the overall issue of the effectiveness of pharmacists
    assisting patients with effective pain management, our available options of OTC
    medications do have severe limitations, and in many cases, have limited efficacy!

    In summary, we know that non-prescription codeine products are
    far too low-strength to have significant analgesic effects, whilst still
    creating toxicity risks for ultra-fast metabolisers.(1).

    (So maybe use of codeine at its effective dosage range of 30mg-60mg,
    should be on medical advice, on prescription only??)

    As for the other available OTC analgesic options, whilst they
    may provide some relief, there are some obvious cautions applicable to the use
    of NSAIDs. Apart from G-I irritation,and the perennial vexed issue of exacerbation
    of underlying risks of cardiotoxicity, (2)we have known for some time about the
    renal risks including , albeit temporary, renal failure of using NSAIDs with fluid
    depletion of any sort, especially in the very young, elderly or renally compromised,
    exacerbated when “triple whammy” interactions come into play(3)(4)

    Whilst it’s certainly not the complete answer, perhaps it is not surprising that many patients will turn to
    paracetamol, for whatever degree of moderate pain relief it provides, (and btw,
    it’s safe to use during pregnancy as well!)


    1.Iedema.J.Cautions with codeine Aust Prescr 2011;34:133-5 | 1 October 2011 |

    2. All NSAIDs have cardiovascular risks.2011:

    3. Anon: Beware, the triple whammy. Australian Adverse Drug Reactions
    Bulletin, 2006;Vol 25: No 5

    4. Misurac JM Anti-Inflammatory Drugs Are and
    Important Cause of Acute Kidney Injury in Children. J Pediatr 2013; 162
    1153-1159 e1

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