Citation

Sandilands EA, Bateman DN. Br. J. Clin. Pharmacol. 2008; 66(2): 290-293.

Affiliation

NPIS Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.

Copyright

(Copyright © 2008, John Wiley and Sons)

DOI

10.1111/j.1365-2125.2008.03206.x

PMID

18489609

PMCID

PMC2492929

Abstract

Co-proxamol is associated with excess mortality in overdose. Legislative change in 2005 has led to a phased withdrawal of co-proxamol from the UK market. Co-proxamol legislation resulted in a marked reduction in the number of prescriptions for co-proxamol within 6 months. This was followed by a major reduction in mortality associated with co-proxamol poisoning. Overall mortality from drug poisoning in Scotland has also fallen over the same period, suggesting an effect on total overdose mortality AIM To determine what effect the withdrawal of co-proxamol from the UK market has had on mortality from poisoning in Scotland. METHODS This was a retrospective, observational study of mortality relating to poisoning by single agents in Scotland for the period 2000-2006. Mortality data were obtained from the General Register Office Scotland, and primary care prescribing data from the Information and Statistics Division of the Scottish Executive Health Department. RESULTS A significant reduction in the proportion of poisoning deaths due to co-proxamol was observed following legislation [mean 2000-2004, 37 deaths (21.8% of total poisoning deaths); 2006, 10 (7.8%); P < 0.0001]. The most significant reduction was seen in male out-of-hospital deaths [mean 2000-2004, 17 (21.8%); 2006, two (2.9%); P < 0.0001]. This was associated with a decline in prescriptions by 60% within 6 months of legislation. The total number of poisoning deaths also fell, slightly earlier than the full impact on co-proxamol deaths (mean 2000-2004, 171.2; mean 2005-2006, 129.5; P = 0.005). CONCLUSIONS Legislation has resulted in a major reduction in the number of deaths associated with co-proxamol poisoning in Scotland, with no compensatory rise in mortality from poisonings from other common analgesics. We estimate from this study that a minimum of 300 lives across the UK will have been saved by the withdrawal of co-proxamol.

Language: en