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Co-proxamol ban is reducing pain control, evidence shows

By Nigel Praities

GPs are being forced to switch patients from co-proxamol to controlled drugs and other potentially risky analgesics in an often vain attempt to maintain pain control, a new audit reveals.

The study revealed that the majority of switched patients wanted to return to co-proxamol, and comes as new figures reveal that over 43,000 people remained on the drug in January, even after withdrawal of its license.

Patients in the audit said their satisfaction and pain relief had been significantly higher before being switched from co-proxamol than afterwards.

Of 56 people who had been taking the drug, 69% wanted to be returned to go back to it, while only 31% were happy with their new treatment.

Most of the patients switched had been moved to co-codamol, but some were taking tramadol, co-drydamol, DF118 or MST 1 continuous.

The Medicines and Healthcare Products Regulatory Agency withdrew co-proxamol at the end of December because of fears over the risk of overdose. But Pulse revealed in December that there remained a hard-core of patients who GPs struggled to take off the drug.

Figures from Cegedim Strategic Data shows GPs are continuing to prescribe the drug on a named-patient basis. Some 43,000 patients remained on the treatment in January, with 630 new patients started on the drug in primary care during the course of the month.

Study leader Dr Lesley Ottewell, musculoskeletal specialist registrar at the Freeman Hospital in Newcastle, said taking patients off co-proxamol was often difficult as they found it a retrograde step. ‘Many of them have been around the houses with chronic pain relief. The MHRA guidance made no provision for those who really genuinely cannot find an alternative,' she said.

The research, published in the latest issue of Rheumatology, also found patients on co-proxamol had few of the risk factors associated with overdose on the drug, such as depression or a history of alcohol misuse.

But Dr Louise Warburton, a musculoskeletal GPSI who works in a hospital rheumatology department in Shropshire, warned it may not be the patient who overdoses on the drug. ‘I agree the ones who are taking it are the least likely to take an over dose, but the problem was that if you have a granny who has it in her cupboard, then it is still available,' she said.

Dr Louise Warburton: it may not be the patient who overdoses on the drug. Dr Louise Warburton Co-proxamol

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