The National Agency for Drug Safety wants aspirin, ibuprofen and paracetamol to be placed behind the counter of the pharmacist.
Soon finished free access to aspirin, ibuprofen and paracetamol at the pharmacy? This is what the National Agency for Drug Safety (ANSM) wants in an information point broadcast on October 3rd, 2019.
The ANSM explains that it wants to “strengthen the pharmacist’s advisory role for the use of medicines containing paracetamol and certain nonsteroidal anti-inflammatory drugs (ibuprofen and aspirin)”.
The agency wants these drugs, available without a prescription, and for some free access in pharmacies, are no longer placed on the shelves, but behind the counters of pharmacies and distributed by pharmacists, from January 2020.
Pour favoriser le bon usage des médicaments les plus utilisés en automédication (#paracétamol #ibuprofène #aspirine) nous souhaitons que l’ensemble de ces médicaments ne soit plus présenté en libre accès dans les pharmacies à compter de janvier 2020
— ANSM (@ansm) October 3, 2019
“Risk” drugs misused
If these drugs remain “safe and effective when properly used”, the ANSM warns about the risks they can present in case of “inadequate” use.
Paracetamol (Doliprane) and nonsteroidal anti-inflammatory drugs (NSAIDs) (such as Advil, Nurofen …) are “the most used drugs in self-medication and self-medication as analgesics (anti-pain) or antipyretic (anti-fever) ) in adults and children, “says the agency. It recalls that these NSAIDs can be the cause of kidney complications, serious infectious complications and are “toxic to the fetus in case of exposure from the beginning of the 6th month of pregnancy (beyond 24 weeks of amenorrhea ) “.
Paracetamol can also pose health risks if misused.
“Paracetamol can cause severe liver damage in some cases of overdose, which can lead to grafting (the leading cause of liver transplantation drug-induced in France).”
“A course of care and no consumption”
Gilles Bonnefond, President of the Union of Community Pharmacists (USPO), sees in this proposal an excellent signal sent: “No one can compromise with the safety of patients, especially when there is a risk of overdose. ”
The professional, who notes “the high efficiency of these molecules, with few side effects, if properly used”, is pleased that the recommendations of the ANSM go in the right direction, in a context where “the supermarket tries to recover this market, by favoring the free access of certain medicines “.
“We came back from this pattern of mass distribution, and all the better because drugs are not trend products. It is important to remember that they are part of a journey of care, not consumption.”
Last April, the Competition Authority gave the go-ahead for the sale of drugs in large and medium-sized supermarkets, as well as para-pharmacies, before the measure was reluctant by the government, because of a risk of weakening of small pharmacies in rural areas.
Promote the pharmacist’s advice
By recommending that these drugs are all placed behind the counter of the pharmacist, while remaining on sale without prescription, the ASNM strengthens the role of advising the professional, a vital role for Gilles Bonnefond.
“Being able to provide personalized advice, on the right dosages, for a child, an adult, a senior … It’s the job of the pharmacist! And it’s more effective than warning messages or logos on medicine boxes, that you end up not noticing.”
A reference to the message soon visible on the boxes of medicines containing paracetamol, to alert on the risk for the liver in case of overdose.
ANSM stresses that a “contradictory phase” is in progress with the laboratories concerned. At the end of this phase, a final decision will be made.
And in case of pain or fever, especially in case of angina or coughing, the ANSM invites to privilege the use of paracetamol by respecting the rules of good use, in particular the maximum duration of recommended treatment (3 days in case fever, 5 days in case of pain, in the absence of prescription).
Nonsteroidal anti-inflammatory drugs should be avoided in cases of chickenpox and should not be prolonged beyond 3 days in case of fever and beyond 5 days in case of pain.
We remember the emotion following the death of Naomi Musenga, in Strasbourg, in December 2017, who died of a paracetamol intoxication absorbed by self-medication over several days.