Selling OTC off-label?

[philly]

Can a pharmacist sell an OTC product off-label, e.g. hydrocortisone cream for use on the face? When a GP prescribes something off-label or even off-licence, it is acceptable. On the other hand, is it really justified in legal terms? Which act(s) discuss this issue?

[johnep]

Often have pts saying Dr said get some 0.5% HC cream for putting on eyelids/face etc. Some get shirty when told cannot have.
If pt buys to put on arm and then puts on face, that is not our responsibility as long as we have refused sale for use on face.
johnep

[Defblade]

I get really shirty with customers who ask for use on face then say, well I've have some for my arm, or maybe their other half says they'll buy some instead.

It's one of the very few times you might hear me swear to a customer as they are taking the ****. Tho sometimes I'll say "mick" instead.

Saying it's no longer our responsibility when we know they are simply trying to get around the rules (which are there for their protection, not convenience) means we may as well put everything on self-selection and head down the Job Centre.

If they chose to go to another pharmacy and lie from the outset, that is a level of behaviour we don't have the ability to protect against. If we did, I would use it. (Have been known to phone other local pharmacies with super-dodgy people, but that's usually things like trying to get scripts early).

[Pharmanaut]

It seems one of the aims of a consultation by the GPhC is to sound us out about the [P] category.
I've got a feeling that it will go in the next few years.

[pharmacrat]

I don't see that happening. Or if it does then all "questionable medicines" would almost certainly go POM- the codeine, dihydrocodeine, morphine and pholcodine preps would require a change in other law (misuse of drugs act) to be sold in non-pharmacy retail markets as they are schedule 5, and I don't see this happening. This is why there is no OTC domperidone, sumatriptan, prochloperazine etc. in the States- imagine people who failed their GCSEs or equivalent selling 10 packs with no questions asked in a corner shop! Which would be possible if they made them OTC due to their lack of a middle category. ("EHC" and codeine cough syrup in some states are de facto P medicines there and pseudoephedrine/ephedrine restrictions are tight enough that only pharmacies are willing to follow them and thus legally sell the product.)

Few medicines for systemic use have been fully reclassified to GSL, so why would they do it to ALL of them in one go? Pack sizes for general sale are often smaller- for example, would 32 packs of ibuprofen, 24 packs of ranitidine and 30 packs of cetirizine and loratadine become GSL or POM? And the most commonly used P medicines (diphenhydramine- in at least a dozen products in several categories; DXM; pseudoephedrine; travel sickness pills; headlice products) would not sit too comfortably in either from a pharmacist's perspective.