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Pholcodine

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Pholcodine is an antitussive, given to treat dry or painful cough.

Pholcodine is an opioid medicine approved in adults and children older than 6 years of age to treat non-productive (dry) cough and, in combination with other active substances, for the treatment of symptoms of cold and influenza:

  • reviews have examined the link between prior use of pholcodine and an increased risk of anaphylaxis during general anaesthesia involving neuromuscular blocking agents (NMBAs)
  • has been a decision for the withdrawal of pholcodine from UK market as a precautionary measure (1)

Advice for healthcare professionals (1):

  • pholcodine-containing cough and cold medicines are being withdrawn from the UK market as a precaution following a review which found that their benefits do not outweigh the increased risk of the very rare event of anaphylaxis to neuromuscular blocking agents (NMBAs) used in general anaesthesia
  • ask patients scheduled to undergo general anaesthesia involving NMBAs whether they have used pholcodine-containing medicines, particularly in the past 12 months, and maintain awareness about the potential for perianaesthetic anaphylaxis related to NMBAs
  • do not dispense or sell pholcodine-containing medicines
    • consider recommending appropriate treatment alternatives for patients who present with a new dry cough or who are currently taking pholcodine
  • pharmacies should follow the MHRA Class 2 Medicines Recall Notice to quarantine stock of pholcodine-containing medicines and return it to the manufacturer
  • report suspected adverse drug reactions to the Yellow Card scheme

Reference:

  • Drug Safety Update volume 16, issue 8: March 2023: 1

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