Popular cold and flu medicines have been banned in the UK over fears they could trigger deadly allergic reactions, leaving many Brits wondering how to treat their symptoms.
But Dr Hilary Jones has shared how people can manage their coughs without turning to pholcodine, which the UK’s medicines regulator says raises the risk of life-threatening anaphylaxis among patients put under general anaesthetic.
Twenty products are being urgently withdrawn, including ones made by Day & Night Nurse and Covonia — as well as own-brand versions on sale in Boots and Superdrug.
But the GP and Good Morning Britain expert said hot lemon and honey, steam inhalations and lozenges are among ‘plenty’ of alternative remedies to treat a cough, while noting that the risk from the medications being pulled from shelves is ‘tiny’.
Twenty cold and flu products are being withdrawn in the UK, including some of those made by Day & Night Nurse and Covonia — as well as own-brand versions sold in Boots (pictured)
Dr Hilary Jones (pictured) has shared how people can manage their coughs without turning to pholcodine, which the UK’s medicines regulator says raises the risk of life-threatening anaphylaxis among patients put under general anaesthetic
Asked on Good Morning Britain what people should do if they have the banned medications in their cupboard, he said: ‘It’s an effective antitussive, it’s good for a dry cough, isn’t it.
‘But the advice people are being given is to go and talk to your pharmacist or your doctor and say “what are the alternatives to this”, and the pharmacist will say “give me that back, I’ll dispose of that for you, there are plenty of alternatives”.
‘Hot lemon and honey, steam inhalations, lozenges, simple linctus, which don’t contain pholcodine, which is, after all, a dilute opioid.’
Hot lemon and honey eases cold-like symptoms, because the citrus fruit contains vitamin C and helps break down mucus, while honey has antibacterial properties.
Consuming them together in a hot drink can soothe inflammation and boost hydration.
Meanwhile, steam inhalation — hovering over a bowl of hot water and covering your head with a towel — helps cold and flu symptoms.
The warm, moist air helps to soothe and open up inflamed nasal passages and the NHS says it is also thought to loosen mucus in the throat and lungs.
Another remedy, throat lozenges, can ease a sore throat by keeping it lubricated.
Options such as Strepsils and Soothers may also be packed with ingredients such as lemon, honey, antiseptics and pain relievers.
And simple linctus, a cough syrup that can be used by adults and children over the age of 12, contains citric acid, which helps reduce inflammation.
The medicine can also help make it easier to cough up phlegm — mucus from the lungs and lower airways that protects against germs and foreign contaminants.
There are plenty of other cough medicines on the high street that don’t contain the now-banned ingredient, meaning some versions of Night Nurse, Covonia and own-brand options can still be used.
It comes after the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA), which polices the safety of drugs used in Britain, yesterday confirmed that it is recalling any medicines that contain pholcodine as a precaution.
The opioid suppresses cough reflexes by reducing the nerve signals sent from the brain to the muscles involved.
But the Commission on Human Medicine (CHM) — which advises the MHRA on the safety of medicines — flagged concerns among patients who took the drug ahead of being put under general anaesthetic with neuromuscular blocking agents (NMBAs).
NMBAs are used in around half of general anaesthetics administered in the UK to relax the muscles before some operations.
One use is when a patient needs to be intubated, with the NMBA paralysing or relaxing the jaw and the vocal cords.
Those who took pholcodine in the 12 months before being exposed to NMBAs were at increased risk of having a life-threatening allergic reaction, called anaphylaxis.
This causes a patient’s blood pressure to drop and their airways to narrow, blocking breathing. It can be life-threatening without immediate treatment.
The CHM admitted that ‘the absolute risk of anaphylaxis remains very small in patients who have taken pholcodine’.
Currently the risk it is thought to affect only around one in 10,000 procedures, with many doctors never encountering the reaction in their entire career.
Explaining the move, Dr Jones said: ‘Pholcodine has been around for 70 years. It’s a very common ingredient and I have to say that this is a precaution. The risk of this anaphylactic reaction is very, very small.
‘However, safety is paramount and that’s why the MHRA have decided to withdraw these things from the shelves.’
He said the move will not stop anyone having an operation and that he ‘has not seen this reaction in 45 years of medical practice, most doctors won’t either’.
Bosses at the European Medicines Agency also recommended that pholcodine products should be withdrawn from the EU market last December following similar concerns.
And two weeks ago, Australia issued a national recall for 55 medicines containing pholcodine on the same grounds. Health chiefs said it was aware of 50 cases of this anaphylactic shock during general anaesthesia that were linked with pholcodine, including one death.
Dr Hilary Jones said hot lemon and honey (left) and lozenges (right) are among the alternatives people can use to can manage their coughs without turning to pholcodine
Dr Hilary Jones said steam inhalation (left) and simple linctus (right) are among the alternatives people can use to can manage their coughs without turning to pholcodine
Ben Jephcott, from Shrewsbury, said that the decision to ban pholcodine, which he says is ‘safe and actually works’, is a ‘ludicrous over-reaction’
Another Twitter user, Sandy Karenso, said pholcodine is ‘absolutely the best cough remedy’. She urged health chiefs to ‘leave us alone’ and ‘let us make our own decisions’
No comparable figures have been released for the UK.
In Britain, the affected products, which include Day & Night Nurse Capsules, Boots Night Cough Relief Oral Solution and Superdrug Pholcodine Linctus, will no longer be available in pharmacies.
Brits taking tablets or syrups for a cough have been told to check the packaging, label or information leaflet to see if pholcodine is a listed ingredient.
If it is, they can talk to their pharmacists who can suggest a different medicine.
They have also been advised to tell an anaesthetist before surgery if they have taken a medicine containing pholcodine in the previous 12 months.
Despite the MHRA warning that the potential risk of taking medicines containing pholcodine outweighs the benefits, desperate Brits have hit out at the move.
Ben Jephcott, from Shrewsbury, said that the decision to ban pholcodine, which he says ‘actually works’, is a ‘ludicrous over-reaction’.
He called for a national ‘Save our Cough Mixture campaign’ in a bid to reverse the decision.
Another Twitter user, Sandy Karenso, said pholcodine is ‘absolutely the best cough remedy’. She urged health chiefs to ‘leave us alone’ and ‘let us make our own decisions’.
Online pharmacies have displayed ‘out of stock’ messages, while others including Boots, reported ‘stock coming soon’.
Patients took to social media to complain of issues getting hold of depleted stocks of medication.
One woman reacting to the news tweeted: ‘This is outrageous. I’ve had trouble getting Day Nurse and Night Nurse for months so it isn’t new.’
Meanwhile, another wrote: ‘Day and Night Nurse being withdrawn from the UK market is actually quite sad, it’s the only medicine that has been touching the sides with this never ending cold I currently have. It’s been so hard to get hold of recently too.’
Another wrote: ‘What, always take night nurse! Never had a problem! Need to stock up!!’, one tweeted.
One said: ‘Utterly ridiculous. Been available for years, works like a charm too. Day and night nurse are great. Hope they’re back on the shelves soon.’