I don't know about you, but I find it difficult when reading news and updates these days not to see COVID-19 everywhere I look! But a few non-COVID things have caught my eye this month, and one started quite a debate amongst myself, colleagues and students at prescribing and pre-registration nursing level. What was this heated issue? Well, it was about over the counter medication. With the recent news that the Medicines and Healthcare products Regulatory Agency (MHRA) have approved some forms of oral contraceptives for sale without prescription, it led to the question of safety and why some drugs can (and should) be over the counter and why some healthcare professionals worry about monitoring and safety of others that they feel warrant closer medical supervision.
The progestogen only (or mini pill) contraceptives Hana and Lovima, which contain 75 micrograms of desogestrel will soon be able to be bought, after a consultation with a pharmacist as well as still being available free on prescription (gov.uk, 2021). Many welcome this advance as freeing and empowering women around their access to contraceptives.
Dr June Raine CBE, Chief Executive of the MHRA said: ‘This is good news for women and families. Pharmacists have the expertise to advise women on whether desogestrel is an appropriate and safe oral contraceptive pill for them to use and to give women the information they need, to make informed choices.’
This is supported by the Royal College of Obstetricians and Gynaecologists (RCOG) and the idea of over-the-counter hormonal contraception has been something that has floated in and out of our attention for many years now. This time period tells us it is not a simple, straightforward procedure to reclassify a drug but something that requires careful consultation and consideration. It reminded me of a statement I saw at the end of last year regarding the move from prescription only to pharmacy and general sales list supply for fexofenadine, an antihistamine medication (gov.uk, 2020).
This confirmation of the reclassification is now over 6 months old, but the drug is not yet available to buy and the British National Formulary does not allude to the change in status. This has been a source of frustration for some of my hay fever suffering colleagues this year as the hope of this (in their opinion) more effective over the counter option has not yet materialised, as this update from the Chemist and Druggist outlines (Callachand, 2021).
It is important as prescribers we are always asking about non prescribed medicines and as the list available without prescription grows, I know many of my colleagues are mindful of their responsibilities in this area, with some incorporating specific medications to ask about due to their impact on the drugs in their area of practice. To me this is good, and safe, practice, something I have come to expect from non-medical prescribing professionals.
Stay safe and well everyone.