In October, the Home Office announced that from today (April 1) the drugs – used to treat anxiety, nerve pain and epilepsy – would be placed in schedule 3 under the Misuse of Drugs Regulations 2001, but would be excluded from the requirement to be stored in a safe.

Speaking ahead of the reclassification last week, Leyla Hannbeck, the NPA’s director of pharmacy, said that pharmacists need to be aware of how to comply with the change in the law; for example "that [pregabalin and gabapentin] can’t be given under an emergency supply”.

Even though the medicines do not need to be in a safe, pharmacists still need to comply with the safe standards of storage, Ms Hannbeck advised (see more below).

“Pharmacy communicates changes to patients”

Vikesh Patel, the clinical lead for north-east London local pharmaceutical committee, claimed that his local surgeries had stopped prescribing the medicines electronically three weeks ago, but it was left to pharmacy teams to communicate to patients why they were having to pick their prescriptions up from GP practices.

“That burden fell on the pharmacy, which was not fair,” claimed Mr Patel, who is also superintendent pharmacist of several branches.

However, staff have had no trouble implementing the changes in handling pregabalin and gabapentin because they had previous experience of the switch with tramadol, from schedule 4 to 3 in 2014, he said.

Mr Patel has no concerns about the reclassifications, as he appreciates they aim to improve medicines safety, he said.

“Adding another layer to the control shows the importance of the drug and [highlights] how easy it is to abuse.”

Additional workload

Sadik Al-Hassan, the manager of a Well branch in Bristol, said the switch “has created quite a bit of additional workload”.

The changes “meant we had to look at the effect on some of the services we offer, but Well provided some great support to help our team at the beginning of March”, he told C+D.

He oversaw a campaign in his pharmacy, which dispenses gabapentin and pregabalin daily, to educate patients on the changes.

His team had been talking to patients about how the changes would affect them since February, he said.

“Without the work we have done as a pharmacy team, I don't believe patients would be aware until the switch occurred.”

The reclassification may reflect the “growing problem of abuse” with these medicines, he said.

NPA recommendations

Under the reclassification, prescriptions for pregabalin and gabapentin must be signed by the prescriber, and include a clearly defined dose, correct formulation and strength where appropriate, the NPA said in guidance outlining the changes.

Prescriptions will only be valid for 28 days, the NPA continued, and although not a legal requirement, the “strong recommendation” from the Department of Health and Social Care and Scottish government is for a maximum of 30-days supply unless the prescriber has provided justification for a longer supply, the NPA said.

A national rollout of schedule 2 and 3 controlled drugs via the electronic prescription service (EPS) is currently underway. The Pharmaceutical Services Negotiating Committee has advised pharmacy teams to refer to NHS Digital’s schedule to identify when their local GP practices are due to go live.