Items which should not routinely be prescribed in primary care - co-proxamol by all Sub-ICB Locations
Why it matters:
The Medicines and Healthcare products Regulatory Agency (MHRA) fully withdrew the painkiller co-proxamol from the UK market in 2007 due to safety concerns. All use in the UK is now on an unlicensed basis. Prescribing an unlicensed medicine should be in line with General Medical Council (GMC) guidance, which states suitably licensed alternatives need to be considered and the prescriber must be satisfied that there is sufficient evidence or experience of using the medicine to demonstrate its safety and efficacy.
Since 1985 advice aimed at the reduction of co-proxamol toxicity and fatal overdose has been provided, but this was not effective and resulted in withdrawal of co-proxamol by the MHRA. In 2011 MHRA reported that the withdrawal of co-proxamol from the UK had saved an estimated 300 to 400 lives each year from self-poisoning, around a fifth of which would have been accidental. Since the withdrawal, further safety concerns have been raised, resulting in co-proxamol being withdrawn in other countries.
Due to the significant safety concerns, the joint clinical working group considered co-proxamol suitable for inclusion in this guidance. Co-proxamol is no longer manufactured or supplied in the UK and any use on an unlicensed basis requires it to be imported for individual use, at an increasing cost to the NHS and the environment. The average cost per item is £265 (January 2022), which is an increase of £44 since 2021.
NHS England recommend that GPs:
- Do not initiate.
- Deprescribe in patients currently prescribed this medicine.
Description: Cost of co-proxamol per 1000 patients
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Tagged as: Cost Saving, NHS England - items which should not routinely be prescribed in primary care, Pain, Safety (or browse all measures)
Sub-ICB Locations are ordered by mean percentile over the past six months. Each chart shows the results for the individual Sub-ICB Location, plus deciles across all Sub-ICB Locations in the NHS in England.
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