Brian

@brianmackenna.bsky.social

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Pharmacist | MPH | Data

Picture of full letter text. Dear Editor, we read your editorial on co-proxamol with great interest.1 This is not just a legacy prescribing issue; it is a patient safety issue that continues today. Co-proxamol deserves renewed attention, not just as a footnote in pharmacovigilance history, but as a current and addressable safety risk. Despite the formal withdrawal of its marketing authorisation nearly two decades ago, co-proxamol prescribing persists, with tragic results. Since its withdrawal, over 200 people have died due to co-proxamol poisoning2 and new initiations of co-proxamol are occurring.3 In the last year alone, NHS spending on co-proxamol was approximately £2 million,4 roughly half of the cost in the last year before regulatory action.5 Our group delivers OpenPrescribing.net, which provides online dashboards of measures of prescribing quality and safety for every general practice in England. We have a dedicated measure of co-proxamol and we encourage all practices to review their co-proxamol prescribing, which is also called for in this year’s NHS planning guidance6 Co-proxamol’s ongoing use, despite robust regulatory action and sustained reductions in prescribing, presents an opportunity to revisit how such withdrawals are implemented. General practice has made major progress, but prescribing levels suggest further system-level attention is needed to complete the job.
percentile chart showing uptake of phesgo across english hospital. it is very steep uptake starting in 2021