Australians who suffer from osteoarthritis are being told to rethink their current medical treatments following a decision on Thursday to up-schedule modified-release paracetamol products. Many people with osteoarthritis currently manage pain with modified-release dosages of painkillers such as Panadol Osteo, which delivers a drug with a delayed effect for a prolonged period of time.
The changes mean that from June 1 next year, all modified-release paracetamol products will only be available from behind pharmacy counters. At present, people are able to self-select medication from shelves at pharmacies across the country.
The Therapeutic Goods Administration (TGA) made their final decision about the medication on Thursday and found that people are at increased risk of serious health issues if they overdose on modified-release paracetamol. Paracetamol is currently the single most commonly-taken pharmaceutical medication in overdoses that leads to hospital presentation and admission.
There were 8,341 cases of paracetamol overdose reported to the NSW Poisons Information Centre in 2016 alone, and 818 of these involving modified-release paracetamol products. The decision to move these drugs behind-the-counter follows similar changes in other countries around the world including New Zealand and the European Union.
The decision has been welcomed by many health professionals, with pharmacist Alex Page, who has been specialising in pain management for more than 10 years, saying: “This is a positive change that will allow Australians who suffer from many types of pain, like osteoarthritis, to benefit from pharmacist counselling on the potential risks associated with excessive use of this type of medication.”
He explained that people who currently rely on these types of medications should be starting to talk with their pharmacist about their current treatment plan and its effectiveness, as well as asking what other options are available to manage pain. Current Australian guidelines encourage those with osteoarthritis to utilise a variety of interventions to manage their pain.
For example, the Royal Australian College of General Practitioners updated their treatment guidelines for hip and knee osteoarthritis just last year, which now recommends the use of non-steroidal anti-inflammatory medication (NSAIDs) taken for short periods to manage pain. This may help people manage flare-ups and reduce inflammation that is often the underlying cause of pain.
“Health professionals should now be focusing on current evidence-based recommendations whilst considering the safety for the patient,” Page said. “NSAIDs such as ibuprofen have good evidence for many pain types when used intermittently, so there may be an alternative worth discussing.”
Meanwhile, other health professionals are also encouraging Australians to discuss their pain management, with GP Anchita Karmakar, who also specialises in pain, saying: “If you’re an Australian suffering from osteoarthritis pain, the up-schedule of modified-release paracetamol is a good opportunity for you to speak to your doctor about what has and hasn’t been working for you and how you can better proactively manage your condition.”
Karmakar added: “It’s important to ask your health professionals about the latest science for managing osteoarthritis pain, to make sure you are approaching your pain management in the best way and that you are up to date on the latest recommendations and guidelines.”
The latest painkiller policy comes after Australian pharmacists were banned from selling over-the-counter codeine medication to people without a prescription in February last year, meaning patients now require a note from the doctor to obtain pain-relief medication including Codral, Mersyndol, Panadeine and Nurofen Plus.
At the time, the TGA claimed alternative over-the-counter painkillers were just as effective for short-term pain as low-dose codeine products, but without the codeine-related health risks.
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