coproxamol

[tengreenbottles]

Have you already looked at

Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis -- Hawton et al. 338: b2270 -- BMJ

Suicides haven't transferred successfully to other analgesics - though they might be throwing themselves off cliffs or under trains.

I'm with you about replacements for co-proxamol not always being as effective

Co-proxamol: where have all the patients gone? -- Ottewell and Walker 47 (3): 375 -- Rheumatology

But the political decision was made that a target was a reduction in suicides - to this end the means of suicide have been curtailed. (It's cheaper and easier than looking at the reasons which drive a person to suicide)

To add insult to injury -
The European Medicines Agency (EMEA) has announced their
recommendation to withdraw the marketing authorisations for
dextropropoxyphene-containing medicines (including co-proxamol) across
the European Union (EU). This recommendation was made after the
Committee on Medicinal Products for Human Use (CHMP) concluded that
the risks, particularly of potentially fatal overdose, were greater
than the medicine’s benefits. The EMEA’s recommendation has been
forwarded to the European Commission (EC) for a decision which will be
legally binding across the EU. In the UK, the only medicine affected
by the EMEA's announcement is co-proxamol.

News Centre : MHRA

Jeff

So the people responsible for the situation have commissioned a survey to prove they are correct? Look, its still just opinion. Maybe those suicides havnt been counted amongst other drugs because the people concerned have used a different method than drugs to kill themselves? I do not deny that SOME people have either OD'd or taken their own lives on Co-prox but still I have not seen any INDEPENDENT evidence to suggest that the mortality rate for CP is any higher than it is for any other strong pain killer.

Paracetamol, for example, is lethal if overdosed on. People with colds do it all the time when taking cough remedies (powder etc) and tablets together - and you can buy that c*ap over the counter for a few pence. People alsop use it to top themselves. A problem thats been known about for DECADES .

Theres even sites dedicated to it!!! HERE for example

- and googling will give you many more examples

So given that paracetamol is just as much of a risk - if not MORE of a risk and widely used in suicides and O/D's why the hell isn't it restricted and why can it be bought, over the counter, for a few pence? Its a killer.

The facts here are that ANY drug can be a killer if OD'd and if a person is determined to kill themselves they will - period, with whatever they can get their hands on.

Co-Prox got the treatment it got because the powers that be needed a scape goat for the death of David Kelly. The time line couldn't be clearer. Thousands of people are suffering - and for what?

I repeat, SHOW ME PROOF that Co-Prox is more dangerous than any other pain killer.

[Jeff]

So the people responsible for the situation have commissioned a survey to prove they are correct?

Not true - all declarations of interest have been declared at the end of the paper

"Funding: This work was funded by a National Institute of Health Research (NIHR) Programme Grant for Applied Research (RP-PG-0606-1247). The views and opinions expressed in this paper do not necessarily reflect those of the Department of Health/NIHR or NHS. The funders played no role in the analysis or write up of this paper. KH is also supported by Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust and HB by the Department of Health.

Competing interests: KH and SS presented evidence to the MHRA committee that evaluated co-proxamol.

Ethical approval: None required.

Provenance and peer review: Not commissioned; externally peer reviewed."

Look, its still just opinion.

No it's more than that.

I have not seen any INDEPENDENT evidence to suggest that the mortality rate for CP is any higher than it is for any other strong pain killer.

Look at the results below. And what do you mean by INDEPENDENT ? It's not the sort of work someone who wasn't interested and working in the field could do.
"Results A steep reduction in prescribing of co-proxamol occurred in the post-intervention period 2005-7, such that number of prescriptions fell by an average of 859 (95% confidence interval 653 to 1065) thousand per quarter, equating to an overall decrease of about 59%. Prescribing of some other analgesics (co-codamol, paracetamol, co-dydramol, and codeine) increased significantly during this time. These changes were associated with a major reduction in deaths involving co-proxamol compared with the expected number of deaths (an estimated 295 fewer suicides and 349 fewer deaths including accidental poisonings), but no statistical evidence for an increase in deaths involving either other analgesics or other drugs."

Maybe not proof - but pretty good evidence.

Paracetamol, for example, is lethal if overdosed on.

But a paracetamol overdose is easier to treat and less likely to result in death. See results quoted above.

SHOW ME PROOF that Co-Prox is more dangerous than any other pain killer.

I'm not sure that you would find any proof acceptable.

Co-proxamol IS more dangerous than other analgesics - but it is also sometimes more effective than other analgesics.

Arguments for its use should be based on its effectiveness - not on a denial of its dangers or on conspiracy theories.

Jeff

[Geoff Powers]

I have chronic back-pain following an injury 17 years ago. The Co-proxamol that my GP prescribed was withdrawn for me quite suddenly in Aug. 2007, just as I was about to go on holiday. Instead I was given co-dydramol.

I have never been so miserable in any two weeks in my life, with chronic constipation sitting on a hotel loo and passing pellets each day. How I longed for a decent crap! Other drugs I trialled over the next 3 months included co-codamol, with similar effect. Apart from this I was getting ineffective pain-relief, as compared with co-proxamol. Paracetamol alone simply does not work.

I saw my GP again just after Christmas 2007, and learned that I am probably one of the 8% or whatever who cannot tolerate codeine. He put me straight back onto co-proxamol.

Going through the hoop again this week: re-ordered my monthly prescription medicines - can't prescribe co-proxamol, says the surgery. Yes, you can have it, says GP, when I made a fuss. Go to pick up prescription at local pharmacy - no co-proxamol!! Today (Saturday - surgery closed for weekend!) am in great discomfort, and no, paracetamol definitely does not work for me!!

If there was another analgesic that might be efficatious I would gladly take it, but the only one that works is co-proxamol. I stick rigidly to the dosage, do not drink and follow what it says on the tin: why should I be penalised because there are idiots who do not have the good sense to read the labels and information contained with their medication?

'Oh, let's drink-a-drink-a-drink to Lily the Pink-thePink-the Pink - the saviour of the human ra-a-ace.....(etc.)'

[Poppy]

Because my own NHS GP can't prescribe Coproxamol because she was overrulled by the other 8 docs in the practice I have just been to a Private GP yesterday and it cost me £110 for a consultation (£85 for 15 mins plus £25 for the extra 5 mins after, 20 mins in all) and given a prescription for a year no problem............hooray.......wait a minute......still trying to find a Pharmacist who will supply them now. Found one yesterday who quoted me £32 per 100 tabs after a different woman in the same shop quoted £25 a couple of days ago!!!!!!!!.........the nightmare goes on!!!!!!!!!!!

[johnep]

Official opinion seems to think that anyone still wanting co-proxamol must be addicted, and yet anecdotal evidence is that there is variation in pts.
However, WHO has decided that the active ingredient in co-proxamol is dangerous and it is likely manufacture will cease anyway.
johnep

[Chirpy]

hooray.......wait a minute......still trying to find a Pharmacist who will supply them now. Found one yesterday who quoted me £32 per 100 tabs after a different woman in the same shop quoted £25 a couple of days ago!!!!!!!!.........the nightmare goes on!!!!!!!!!!!

Go to pick up prescription at local pharmacy - no co-proxamol!!

I am pleased that you both have found some pain relief. I admire your perseverance and hope that you manage to sort out the problems with supply.

Are you struggling to find a pharmacy that will supply or just one that has stock physically sitting on the shelves? As you have found one of the difficulties of the loss of product licence is that the price has rocketted because it is only available via a couple of places. Also less pharmacies will have it sitting on the shelves due to a reduction in demand (or maybe not demand, just scripts actually issued!). Ordering the tablets should only take a couple of days.

Thank you for contributing your stories.

[Poppy]

Chirpy.....one pharmacist I phoned today tried to find supplies and had no luck but I've to phone back Monday as some people weren't available on a Saturday.......this pharmacist only had one box @£6 left........I've more phone calls to make on Monday to some others. Wish me luck

[Geoff Powers]

Hi!

Unfortunately I have one of those GPs who is absolutely brilliant.....if you happen to have diabetes (his specialism), but is dozy, communicates in monosyllables, and runs, as senior partner, a large practice of 10 other GPs, with a dispensary staff who seem to follow their own private agendas, and pretty much tell the GP what to do! I think,.... sorry, I KNOW, there are lots of crossed wires there. I plan to go down to the surgery on Monday morning, with my wife as a very interested party, as she is having to put up with my complaints this weekend, and between us we plan to ask some awkward questions, like 'Why am I being messed around like this?

[Geoff Powers]

PS.

I know that my pharmacist has no problem obtaining co-proxamol; he has been supplying co-prox for the entire period since my original injury in 1991, apart from my autumn 2007 'trial' period (see orig. message) when my co-proxamo; was temporarily withdrawn. He is totally reliable, and the advice he gives to the local folk and general public is like gold-dust: it is almost like having a third GP practice in the town. Many go to him in the first instance to save themselves the bother of booking a surgery appointment. As one might expect, though v. sympathetic to my plight, he won't issue the tabs. unless it's on the prescription form. Spoke to him on the phone this lunchtime; as has been stated already, there is every indication that this time the Department of Health, WHO, etc. mean business and will come down like a ton of bricks on GPs who continue to prescribe, and pharmacists who hold stocks of co-proxamol

The danger then is that people like Poppy with severe pain issues, and those living on small disability pensions or benefits will, in order to find relief, be driven to indulge in expenditure they can ill-afford, or else go to (very) dodgy online suppliers, where there is no quality control and no come-back!

I am thinking of writing to my MP; he was very helpful when I had difficulties with British Gas back in the winter, though it was not a quick process.

Might there be a way of challenging the decision to withdraw co-proxamol through some kind of patient ombudsman service if such exists? Earlier, in 2007, I sought advice from the Arthritis Care web-site, but I do not know whether a charity would also act as a pressure group to put pressure on government.

It seems that a number of academic studies do concur that a minority of patients may still require to be prescribed co-proxamol where other analgesics are inedffective or considered inappropriate.

I'd be interested to get some feedback on these points fairly quickly.

Will keep you posted!

[Poppy]

Geoff.......I wrote to my MSP a while back and it was him who suggested going to a private GP and that it would be expensive but he didn't say he was doing any more about it. Check out this website CO-PROXAMOL ; time for a sensible debate - Home there's a guy fighting to get Coproxamol back.