MCAZ withdraws pholcodine cough syrups

Trust Freddy

Herald Correspondent

ALL cough syrups containing pholcodine, an opiate, now have to be quarantined by pharmaceutical wholesalers, retailers, public and private hospitals as these are being withdrawn from the Zimbabwean market by the Medicines Control Authority of Zimbabwe (MCAZ).

In a statement on Friday, MCAZ general-director Mr Richard Rukwata said due to the seriousness of the safety risk, all pholcodine-containing products were being withdrawn from the Zimbabwean market.

Pholcodine is an opioid medicine that is used for the treatment of non-productive or dry cough in children and adults.

“Available data indicated that the use of pholcodine in the 12 months before general anaesthesia with neuromuscular blocking agents (NMBA) such as suxamethonium, and atracurium is a risk factor for developing an anaphylactic reaction upon administration of the NMBA,” Mr Rukwata said.

“The hypothesis that pholcodine use could trigger anaphylactic reactions to NMBAs is based on the body producing antibodies against pholcodine, which eventually trigger reactions to NMBAs.”

Further, he said, authorities had noted there was no immediate solution to the risk.

“The authority noted that there are no effective measures to minimise this risk, nor is there an identified patient population for whom the benefits of pholcodine outweigh its risks.” “The hypothesis that pholcodine use could trigger anaphylactic reactions to NMBAs is based on the body producing antibodies against pholcodine, which eventually trigger reactions to NMBAs.”

For health care professionals, Mr Rukwata said, they should advise patients to stop taking pholcodine-containing medicines and consider appropriate alternatives to treat their symptoms.

“Check whether patients scheduled to undergo general anaesthesia with NMBAs have used pholcodine in the previous 12 months and remain aware of the risk of anaphylactic reactions in those patients.”

For consumers, the MCAZ director general said: “If you need general anaesthesia and have taken a pholcodine-containing medicine in the past 12 months, advise your healthcare professional prior to undergoing the procedure.”