Published: February 2010

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Medicines classification update

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Prescriber Update 31(1): 5
February 2010

Healthcare professionals are advised of a number of medicine classification changes recommended at the 42^nd meeting of the Medicines Classification Committee (MCC) in November 2009.

The MCC has recommended that medicines containing codeine should be reclassified to pharmacist-only medicines when:

• Each dose unit contains not more than 15mg of codeine base.
• The maximum daily dose is limited to 100mg of codeine base.
• The pack size is not more than five days supply.

The MCC has also recommended all codeine containing medicines contain warnings on the labels, including that codeine is an addictive substance and should not be used for more than three days.

The MCC recommendations follow concerns about increasing rates of addiction to codeine in New Zealand and are similar to the controls recently introduced in the United Kingdom and Australia.

Medsafe is currently considering the MCC's recommendations and any submissions made by the sector in response to the Committee’s decision. Medsafe is also reviewing whether implementation of the MCC’s recommendations needs to be delayed so manufacturers can repack products into smaller packs. In the meantime, Medsafe supports the advice of the Pharmaceutical Society of New Zealand and the Pharmacy Guild to encourage all pharmacists to move these medicines behind the counter so they are not available for self selection.

Famciclovir has been reclassified from a prescription medicine to a pharmacist-only medicine, when supplied in packs specifically labelled for pharmacist-only sale. The MCC has recommended that a warning be included on the label that treatment should not be repeated within seven days.

Zolmitriptan nasal spray (Zomig) is a prefilled nasal spray containing 5 mg of zolmitriptan per dose and is now a pharmacist-only medicine. Zomig nasal spray can only be supplied as a pharmacist-only medicine for the acute relief of migraine attacks in patients who have a well established pattern of symptoms.

Fexofenadine has been reclassified to a general sales medicine, but only for capsules containing 60mg or less, or tablets containing 120mg or less. Fexofenadine can only be sold as a general sales medicine for short term treatment (maximum five days) of seasonal allergic rhinitis in adults and children over 12 years of age.

Lansoprazole tablets and capsules containing 15mg or less are now pharmacist-only medicines when supplied in packs specifically labelled for pharmacist-only sale. This change follows the reclassification of other proton pump inhibitors to pharmacist-only, such as omeprazole in 2009.

Further information on the classification process and the minutes of the Medicines Classification Committee meetings are available at:
www.medsafe.govt.nz/profs/class/clascon.asp