In the world of pain killers, the real alternative to Syndol is Syndol. If there has been any unchanging reality in the world of pain killers for the past century, it has been the unique formulation of Syndol headache tablets.
Well, that's been the case for a long time but things have changed now. Adco - dol paracetamol-doxylamine-codeine-caffeine is used for the symptomatic relief of mild to moderate pain, pain associated with tension, and fever. It has a ntipyretic, analgesic and antihistaminic properties. Now, if you look very carefully ladies and gentlemen, those are the same ingredients in Syndol except that Adco-dol has slightly more Caffeine 45mg whereas Syndol as 30mg. We get a lot of questions from our clients and guests relating to Syndol and Adco-dol headache tablets, such as:.
So, we thought why not take a look at it. Today we are going to put the two headache tablets head to head and point out the differences from a neutral standpoint. Syndol is medication commonly used in the United Kingdom for the relief of pain and the reduction of fevers.
Syndol contains paracetamol, codeine phosphate, doxylamine succinate, and caffeine. Paracetamol is used in the treatment of mild to moderate pain. It is also useful for reducing fever. It is not fully understood how paracetamol produces these effects. Codeine belongs to group of medicines called opioids. Opioids mimic the effects of naturally occurring pain reducing chemicals endorphins that are found in the brain and spinal cord.
They act on the opioid receptors in the brain and block the transmission of pain signals. Therefore, even though the cause of the pain may remain, less pain is actually felt. Caffeine is a weak stimulant. It is thought that the addition of caffeine may enhance the analgesic effects of paracetamol and codeine. Doxylamine is a sedating anti-histamine. It acts by blocking the action of histamine which is a chemical released when an allergic response occurs. Histamine is the chemical in the body that causes the symptoms of an allergic reaction.
These can include inflammation of the skin, airways or tissues, rashes, itching of the skin, eyes or nose, nasal congestion and narrowing of the airways. By blocking the actions of histamine, doxylamine prevents and relieves the typical symptoms of an allergic reaction. Sedation is a common effect of doxylamine. As a result it is commonly used in pain relief preparations to encourage sleep.
This medicine is used for the treatment of mild to moderate pain and to reduce a high temperature. So far the two products look almost exactly the same. Again the only discernible difference lies in the amount of Caffeine.
But is that a fundamental difference? Perhaps not, given the role of caffeine in the composition. But why such a huge difference in prices, how can the price of Syndol be justified, you may want to ask. This was because people wanting codeine would need to see their doctor, so they might request the stronger products that had always been prescription-only. There was also concern the change would push people towards even stronger painkillers, like oxycodone and morphine.
What happened next? So we were keen to evaluate whether the change in codeine availability affected the number of overdoses. We, like others, were also worried there might also be unintended consequences of the change in its availability. There was no increase in poisonings with high-strength codeine or other opioids. Again, there was no increase in use of high-strength codeine.
Genetics are also important Concerns over misuse and addiction were not the sole reason behind the change in codeine availability. This enzyme activates codeine by converting it to morphine in the body. The latter is the most dangerous scenario and has resulted in several deaths. This has included a newborn baby who died after their mother had a normal dose of codeine for pain after childbirth. The mother was later found to have the gene that results in excessive codeine activation, and a lethal dose of morphine was transmitted to her baby in her breast milk.
Even if the misuse problems disappeared overnight, people who advocated codeine be available only by prescription argued that a medicine with such a variable effect should only be available after seeing a doctor. Unintended consequences of the codeine switch Future research needs to look into possible unintended consequences of the change in codeine availability. For instance, people may have switched to simple analgesics, like paracetamol and ibuprofen.
Yet they can still be toxic when overdosed. Limiting availability works Prescription drug misuse and overdoses are problems that are very much driven by drug availability. This has happened with the opioid painkillets tramadol , hydrocodone and dextropropoxyphene , and the benzodiazepine aplrazolam.
Our study shows a good example of how effective simple strategies can be in tackling opioid misuse. In , Fingleton et al. Usage is not recorded at a national level and those who become dependent are often unaware they are addicted.
This addiction is, therefore, often missed by healthcare professionals, leaving people at risk [8]. In , tighter controls were introduced on OTC painkillers containing codeine or dihydrocodeine in order to minimise the risk of overuse or addiction [9]. Pharmacists were asked to support the measures by giving important safety messages about short-term use and avoiding addiction.
Scotland has been making significant in-roads in defining OTC opioid dependency and what pharmacists can do to help prevent and manage it. In , the Royal Pharmaceutical Society RPS in Scotland ran a series of opioid dependency workshops across health boards in response to feedback from pharmacists that this is a difficult area of practice. The aim of the workshops, which were led by specialist pharmacists in substance misuse, was to help pharmacist attendees to identify, manage and reduce OTC- and prescription-opioid dependency and to provide advice on how to engage in conversations with customers suspected of opioid dependency see Box 1.
But this could be just the tip of the iceberg. In the study, which was based on a cross-sectional survey posted to all community pharmacists in Scotland, codeine-containing products were mentioned in This was the first time that codeine topped the list for 20 years: in previous surveys, carried out in , and , the sleep aid diphenhydramine Nytol had been the most cited see Figure. Figure: Over-the-counter codeine overtakes Nytol as the product community pharmacists most suspect of being misused.
Catriona Matheson, a substance use expert at the University of Stirling, convener of the Drugs Research Network Scotland and one of the authors of the study, says the most noticeable difference found when analysing more than 20 years of survey data is the increasing number of OTC codeine-containing products on the market. In terms of self-reported misuse, another survey by Matheson et al. Of those respondents who said they had developed dependence on an OTC medicine, most said they were rarely or never questioned by pharmacy staff about their medicine needs or health condition.
The research revealed that there is public awareness that OTC medicines are associated with risks but it highlighted the need for improved pharmacovigilance of OTC medicines and for healthcare providers to be aware of the potential for misuse, abuse and dependence, particularly in patients with long-term illnesses.
A further study by the same group, published in , found that analgesics containing codeine were the most common OTC medicine of dependence seen by doctors in specialist substance misuse treatment services [7]. The study identified a clear need for specific clinical guidelines for the treatment of OTC drug dependence. Despite their addictive potential, it is unclear whether the OTC opioid products available are strong enough to have any therapeutic value.
Stannard agrees that patients will probably not get much benefit from 8mg of codeine and that the best thing for acute pain management is ibuprofen and paracetamol. If we are going to continue to have OTC codeine-based products they need to be the right ones, for the right reasons, and we need to have the appropriate mechanisms to manage them.
Soni says that if products are sub-therapeutic and causing addiction, there would be an argument for removing them from OTC sales. But, he adds, if the products do have therapeutic value, they are useful for pharmacists to have in their armoury, provided use is properly recorded, which is not currently the case. Ash Soni, president of the Royal Pharmaceutical Society, says that if OTC codeine-based products are sub-therapeutic and causing addiction, there would be an argument for removing them from OTC sales.
Before the ban in Australia, pharmacies introduced a real-time monitoring system for OTC sales of codeine-containing products, which required customers to show identification in order for their recent codeine purchases to be monitored [1]. Matheson stresses that early intervention in the pharmacy would be preferable to a total ban on OTC codeine. She says that pharmacists would need training to do this properly, but adds that they could also link in with specialist addiction services to make sure people get the support they need.
Unfortunately, getting the money to develop ideas is quite challenging. Emma Davies, an advanced pharmacy practitioner in pain management at Abertawe Bro Morgannwy University Health Board, concurs, saying that removing codeine from OTC sales would be counterproductive.
People will always get hold of things from somewhere … removing things from sale is too simplistic. But David Juurlink, a pharmacologist and drug safety researcher based in Canada, where it is still possible to get codeine in low-dose tablets without a prescription in most provinces, disagrees. When it comes to treating dependency, McGregor highlights that there are no services available to help people stop taking OTC opioids.
She believes that this is where pharmacists and professional pharmacy organisations, such as the RPS, have a role to play. Stannard argues that there is a lot of shame and stigma around people who get stuck on OTC opioids. That stigma needs to be dealt with in order to move forward, she explains. She adds that it is easy to slip into OTC opioid addiction, but that people who are supported to stop taking these medicines do very well.
Individuals may also require support in other areas, for example, for psychological and emotional factors that may be playing a part. Community initiatives, such as social prescribing, and commissioning from arts and cultural organisations, can help patients to deal with the parts of their lives that may have been overshadowed by pain.
0コメント