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MHRA introduces measures to slash abuse of stimulant laxatives

MHRA: Pharmacists can give advice on “treatment of short-term constipation in children over 12”

The MHRA has introduced new restrictions on over the counter sales of stimulant laxatives in a bid to reduce misuse of the products, including for weight loss purposes.

Stimulant laxatives will be sold in smaller packs from this summer to help “reduce abuse and overuse”, the Medicines and Healthcare products Regulatory Agency (MHRA) said in a statement today (August 18).

The MHRA also mandated that the products display additional on-pack warnings about the risks associated with overuse and to make it clear to patients that they do not help with weight loss.

Retail outlets will now only be allowed to sell stimulant laxatives to customers over the age of 18 but “pharmacists will be able to sell [them] for use in children aged 12 and over,” the MHRA said.

The new measures apply to pharmacy medicine and general sale list stimulant laxatives of senna and sennosides, bisacodyl and sodium picosulfate.

Guidance for pharmacy teams

The Royal Pharmaceutical Society (RPS) has collaborated with the MHRA on new guidance for pharmacists and their teams to help them advise patients on the “safe and correct use” of stimulant laxatives.

“Our new guidance and work with the MHRA will help to improve patient safety and support community pharmacists and their teams in giving the best possible care for those wanting to purchase these products,” RPS president Sandra Gidley said in a statement today.

Ms Gidley encouraged patients to seek the advice of community pharmacy teams “if they are unsure or concerned about the laxative products they are taking” as “pharmacists have the best expertise on medicines of any health professionals”.

The MHRA also advised parents and carers to speak to a pharmacist “about treatment of short-term constipation in children over 12”, but said they should approach their GP if the child is younger than 12, or if they are concerned about the health of the child.

Evidence of abuse

Stimulant laxatives can be abused by people with eating disorders, adopted for long-term use by the elderly and inappropriately used in children, according to director of the MHRA vigilance and risk management of medicines division Dr Sarah Branch.

“We believe these new measures are necessary to address the risks associated with misuse while continuing to allow safe and appropriate access to these medicines without prescription to treat short-term constipation,” she said.

What do you make of the MHRA's announcement?

C A, Community pharmacist

I can't say that I sell a huge amount of laxatives over the counter.

On the other hand "adopted for long-term use by the elderly," I think you'll find they get it on script...

N O, Pharmaceutical Adviser

If smaller packs can still be sold by corner shops, then what is the need for all this? Ever heard of BOGOF offers in these places? If someone is abusing something then will continue to do it by buying multiple packs from these outlets where there is no control. Paracetamol (before the pandemic) reminds me of something.

PARESH shah, Community pharmacist

Aren't these the same people who approved these lines GSL. It was obvious to most what the consequence would be. But not the MHRA.I rest my case.



Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I've actually noticed a massive increase in requests during lockdown - probably because of lack of exercise and rubbish diets I suppose, but an unforeseen consequence, certainly. I get the feeling there will be a lot of those when this has played out in it's entirety.

Freelance Chemist, Pre-reg Pharmacist

All meds regardless of class should only be sold through pharmacies FULL STOP!

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Agreed. It's a nonsense when people can buy these things from Wilkos and B+M with minimal controls.

Freelance Chemist, Pre-reg Pharmacist

Have you noticed we are starting to agree more and more now?

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Getting a bit scary, mate!

David Stead, Hospital pharmacist

Am I alone to be shocked by the use of the term "slash"in this excretory context?

I would get out more but my local council closed our "conveniences" years ago.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Now, if it was a headline about Furosemide abuse, 'slash' would be accurate. I think in THIS context, the word 'block' would be more appropriate....

N O, Pharmaceutical Adviser

Few questions, RPS, since you already jumped the queue

1. What is the new pack size?

2. What do we do with existing packs?

3. Do we ask people if they are using for Weight loss? ( as if they will give honest answer)

Why not just make them POM??

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Because then the mythical 'professional judgement' couldn't be applied and they couldn't blame us when things when wrong.

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