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Co-proxamol withdrawal to prevent 300 deaths per year

By Emma Wilkinson

The withdrawal of co-proxamol will save as many as 300 lives a year across the UK, the first research to examine the impact on suicide suggests.

An analysis of poisoning mortality data from coroners in Scotland found the proportion of deaths attributable to co-proxamol fell dramatically – with no compensatory rise in deaths from other drugs.

Co-proxamol was responsible for 21.8% of deaths between 2000 and 2004, but only 7.8% in 2006. The drop was associated with a 60% fall in co-proxamol prescriptions in the six months after the decision by the Medicines and Healthcare Products Regulatory Agency to withdraw its license.

The most pronounced fall was in male ‘out of hospital' deaths attributable to co-proxamol, which fell from an average of 17 a year to just two.

Deaths from other common analgesics did not increase over the time period, concluded the researchers, writing online in the British Journal of Clinical Pharmacology.

Study leader Professor Nicolas Bateman, professor of clinical toxicology at the National Poisons Information Service in Edinburgh, said the research suggested the withdrawal of co-proxamol – which lost its license at the end of 2007 after a three-year phase-out – was likely to be saving lives across the UK.

‘We have shown we've saved 30 lives in Scotland and if the same effect is observed in England you would expect to save 300 a year. It's a really encouraging finding but we have to make sure it continues.'

He said he had wanted to see co-proxamol phased out decades ago: ‘I don't want to minimise the problem of controlling pain in general practice but the drug was never that good – addictive but never that good.'

Dr Brian Crichton, a GP in Solihull and honorary senior lecturer in clinical pharmacology at Warwick University Medical School, it was an important piece of research given the ‘unpopularity' in primary care of the withdrawal.

But he added he would want to see a broader UK study and research on longer-term trends. ‘I think most of us felt there needed to be something done but complete withdrawal was further than we expected. It's good to see something positive has come out of it and this will probably harden the MHRA's line.

‘But it's recognised there's a core of people struggling with the withdrawal and we're finding it very difficult to find analgesics to control their pain. It's difficult to draw any firm conclusions yet.'

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