Painkillers to be prescription only in Denmark

08 April 2013

In Denmark, it will soon only be possible to buy large packs of mild painkillers when prescribed by a doctor. The aim is to reduce poisoning incidents and the need for liver transplants. The decision was made on the basis of new data and after having consulted the Licensing Committee.

The effect of restricting access to large packs could reduce the number of suicides as well as the need for liver transplants. So shows an assessment of a recent major study published in the British Medical Journal 2013, which investigated the link between reduced pack sizes and sales outlets and the number of deaths and need for liver transplants. The study points to significant reductions in paracetamol-related deaths, registrations for transplantation at liver units and actual liver transplants. The number of poisoning incidents is expected to fall by restricting access to large packs.

In recent years, it has become increasingly acknowledged that NSAIDs, which cover acetylsalicylic acid, ibuprofen and phenazone, etc. have far more and serious side effects than assumed earlier. Even when taken in recommended doses, NSAIDs could give gastrointestinal side effects, which could be serious in elderly patients among others. Furthermore, when NSAIDs are used in high doses and for long-term treatment, there may be a small increased risk of blood clots in heart and brain as well as adverse impacts on the renal function. NSAID poisoning is difficult to treat.

The restrictions in access to large packs will affect all mild painkillers that contain the below active substances:

  • paracetamol
  • acetylsalicylic acid
  • ibuprofen
  • acetylsalicylic acid in combination with codeine or caffeine
  • phenazone in combination with caffeine or containing phenazone salicylate in combination with caffeine and salicylamide.

The decision to make these substances subscription only will cover tablets, mixtures, suppositories, but not medicines that are applied on the skin.

The formal processes of consulting the companies have been initiated, and we expect the decision to take effect in June.

Article: Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. Hawton K, Bergen H, Simkin S, Dodd S, Pocock P, Bernal W, Gunnell D, Kapur N. BMJ 2013; 346:f403)