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GPs buried under trusts' workload dump

Is it time for a rethink on the co-proxamol ban?

The 2007 crunch time for the co-proxamol ban is approaching. Problems are emerging. Codeine allergy intolerance, constipation in both young and old addicts, ex-addicts and those on naltrexone, methadone and brupromorphine – and a great deal of

evidence of patients' preferences over analgesic

effectiveness.

Co-proxamol is so accessible because it is the most useful analgesic in general practice and so a lot has been prescribed.

The academics who recommended banning it have made a kneejerk reaction without

listening to those of us facing the realities at the coalface of medicine. All the alternatives, including paracetemol itself, are more toxic than co-

proxamol. Tablet for tablet, they all have more paracetemol than co-proxamol. Dextropropoxyphene is not toxic to the liver. Paracetemol, co-

codamol and co-dydramol

are all readily available, more toxic and more expensive than co-proxamol, tramadol and

so on.

Prescriptions will increase. More bleeds, more deaths and more drug interactions will occur. There will be more prescriptions for laxatives, more bowel obstructions, more hospitalisations. Drug costs will go up substantially and more successful suicides will occur.

I plead – think again. What do other GPs think?

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