Headaches, aches and pains can affect us all, the following triggers may give special cause for Pharmacists to experience more in February 2019. Like all health care professionals’ pharmacists need to excel at plate spinning: balancing care for customers, obtain stock of medicines, navigate fluctuating drug prices, be Brexit aware, the Falsified Medicines Directive (FMD) and fee pressures may be contributing factors this month, as they reach for Over the Counter (OTC) analgesic remedies.

Therefore, it’s a welcome relief to see the return of an old OTC medicine back into the Pharmacy armoury. Yes, Syndol is back, with its original four ingredient formulation. Original Syndol disappeared in 2014, and in its place came Syndol Headache Relief Tablets – a  triple action formula of caffeine, paracetamol and codeine phosphate. The missing ingredient was doxylamine succinate.

In 2014, a spokeswoman for Sanofi, which makes Syndol, said: ‘It is the manufacture of doxylamine specifically that we are having difficulty with, which is why we have had to remove it from our Syndol formulation.”

Syndol relaunch 2019

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Many customers for months after the disappearance of Syndol sought out the old formula, as they believed it was more effective. At the time Sultan Dajani, a community pharmacist and a spokesperson for the Royal Pharmaceutical Society said .’Doxylamine is an antihistamine with sedating effects, but it also enhances the effects of codeine.’

Five years on and the relaunch of Syndol tablets is being supported through a nine-month 360 bespoke Pharmacy education and training campaign. This programme will help pharmacy teams to readily identify between tension and migraine-type headache and provide detailed information on Syndol tablets.

Simultaneously the Syndol launch arrives at the same time as an editorial campaign to support pharmacy with the aim to help patients manage acute pain, organised by the Pharmaceutical Journal with the support of Reckitt Benckiser. The campaign originated with a pharmacy consultation and acute pain survey, 35% of respondents (n>1000) stated that they spoke about acute adult pain 2-5x a day. Some results suggest there is confusion around the guidance and treatment recommendations for different acute pain indications, hence the identified need for further education.

There will be three learning articles that will be published in the coming months. The first of these will explain how to understand the efficacy and safety of oral OTC analgesics in the context of acute pain relief; the second will run alongside this and explain how to correctly interpret the relevant clinical data, including the different types of studies used to assess pain. The final learning article will provide practical information on how to consult with patients, implement clinical guidance and apply the evidence base.

Through this, pharmacists will undoubtedly be able to put patients at the centre of the care pathway and promote self-care for acute pain.

Pharmaceutical Journal Article

Given the potential turbulence in the weeks ahead, its good to know that pharmacists as the first line professionals in helping customers manage acute pain have the products and tools to support themselves and others to be comfortable and pain free.

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2017 Cochrane Review

Read this a 2017 Cochrane review of non prescription (OTC) oral analgesics for acute pain – an overview of Cochrane reviews.

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The starting point for any independent review of OTC analgesia, will often begin at the Cochrane Library (Trusted evidence. Informed decisions. Better health). A 2017 OTC analgesics Cochrane review concluded that a ‘combination of ibuprofen plus paracetamol worked in 7 out of 10 (70%) people, and fast acting ibuprofen formulations 200 mg and 400 mg, ibuprofen 200 mg plus caffeine 100 mg, and diclofenac potassium 50 mg worked in over 5 out of 10 (50%) people. Paracetamol plus aspirin at various doses worked in 1 out of 10 (11%) to 4 out of 10 (43%) people. An important finding was that low doses of some medicines in fast acting formulations were among the best’.

Plenty of change and advice around for Pharmacists this spring, meaning we as customers and consumers have access to more choice and better informed decisions for our self-care managed health and wellbeing.