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What changed and what medicines were affected?

On 1 February 2018, there was change to how codeine medicines were scheduled. The change means codeine medicines have stopped being available over-the-counter at a pharmacy. 

The following codeine-containing medicines are no longer available without a prescription.

  • Codeine-containing combination analgesics (painkillers) (available under brand names such as Panadeine, Nurofen Plus, Mersyndol and pharmacy generic pain relief products).
  • Codeine-containing cough, cold and flu products (available under brand ranges such as Codral, Demazin and pharmacy generic cough, cold and flu medicines).
Find a full list of codeine-containing medicines in our Medicine Finder.

Find out more about medicines with codeine.

What if I can’t afford the money or time to see a doctor?

For short-term pain such as a headache or a sports injury, your pharmacist can advise about a suitable over-the-counter treatment that is just as effective as low-dose codeine. 

If your pain is more severe or longer-lasting, a doctor’s examination can help you get to the bottom of the cause. Your doctor may then be able to prescribe or recommend a more suitable treatment than codeine, saving you money and time in the long run.

What about the cost to the system? Surely this is costing the taxpayer more money?

Most people with short-term pain, such as headaches or sports injuries, won’t need to see a doctor for pain relief. Your pharmacist can advise about over-the-counter treatments that are just as effective as low-dose codeine but lack many of the side effects. 

Your doctor is best placed to manage more serious or longer-lasting pain and will be able to recommend treatments, including non-drug treatments, which have the best chance of relieving your pain. Ultimately, better pain management should lead to cost savings for the taxpayer.

Why are we all being penalised for a small minority who abuse these drugs?

Codeine is an unusual medicine that can affect people quite differently. Many people who have become dependent on codeine are just ordinary men and women who started taking it for pain relief, but then their bodies became tolerant to the effects and they required higher and higher doses to get relief. 

By making codeine prescription-only, we can reduce the chance of people self-medicating with codeine and protect others from future harm. 

If codeine is dangerous, why is it still available on prescription? 

Codeine belongs to the group of opiate pain-relievers and is related to morphine. When used at the higher doses found in prescription-only medicines, it can provide effective relief for short-term pain. 

If codeine is restricted to prescription-only, and requires a visit to the doctor, patients and doctors can agree on pain management plans and follow-up. This will reduce the chance of people developing problems with the medicine, including problems of dependence and other side effects. 

I can’t take NSAIDs because of stomach issues, so my only non-prescription option is paracetamol. Are there any other alternatives?

Paracetamol (Panadol) is an effective pain reliever for mild to moderate pain. In fact, studies have found that the low dose of codeine in formerly available over-the-counter pain relievers may not offer any benefit over paracetamol alone. 

Sometimes, the best way to manage your pain may not be a tablet at all. 

Your pharmacist will be able to advise about other treatments, such as heat or cold packs or, when appropriate, NSAID ointments, which may be used as an alternative or in addition to paracetamol, to help you manage your pain. 

I sometimes used codeine-containing medicines to treat acute or intermittent pain. What should I do?

Talk to your doctor or healthcare provider about alternative treatment options that may be available for you.

Most individuals will be able to manage acute pain with safer, non-codeine based medicines.

Your pharmacist will be able to advise on the most appropriate options for you.

I sometimes used codeine-containing medicines to treat the symptoms of cough, cold or flu. What should I do?

All cough, cold and flu medicines available over the counter became codeine free after 1 February 2018. 

Talk to your doctor or healthcare provider about the alternative treatment options that may be available for you.

Most individuals will be able to manage the symptoms of cough, cold or flu with safer, non-codeine based medicines. 

Your pharmacist will be able to advise on the most appropriate options for you.

I suffer from chronic pain. What should I do?

People with chronic pain should talk to their doctor or healthcare provider to determine better treatment options. This may include: 

  • alternative over-the-counter (OTC) or prescription medicines
  • non-drug therapies from an allied health professional such as a physiotherapist or psychologist
  • self-management tools such as exercise or relaxation
  • referral to a pain specialist or pain management clinic.
Ask your doctor about a Medicare-funded care plan, which will allow you access to a rebate for treatment from an allied health professional. 

Medicare provides a rebate for the preparation of a Chronic Disease Management Plan and a Team Care Arrangement. For more information see the Chronic Disease Management Patient Information: Planning your health care, Patient Information Sheet (Department of Health).

If your doctor does not bulk bill for these services, you may be required to pay a gap payment.

3 min read

Date published: 13 September 2017
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