Check Your Cough Syrups & Lozenges Now!

To Our Customers,

You may have heard the news about the concern on all products containing pholcodine, a common cough-suppressing agent used in numerous products. The following points are aimed at helping you understand more about the nature of this situation.

1. Pholcodine itself does not pose any threat to our health. It has been used for many years and is even safe for pregnant women. Children have also been prescribed this medicine without much issue.

2. The problem arises when individuals who have used pholcodine undergo surgery requiring general anesthesia within roughly a year after pholcodine exposure.

In this type of surgery, doctors need to administer neuromuscular blocking agents (NMBA) to ensure your muscles do not tense up during the procedure.

3. When NMBA’s are given to patients who have taken pholcodine within a year, there is an increased risk of anaphylactic reactions.

4. Anaphylactic reactions are severe, life-threatening allergic responses that are rare but deadly. Usually, anaphylactic reactions occur with the second exposure to the same allergen (like a second time someone is stung by a bee).

5. Our body does not recognize the allergen during the first exposure, but when exposed to the same allergen again, alarms sound, and an “overreaction” towards the allergen occurs.

6. In the case of pholcodine, it is much rarer and harder to detect because the exposure to one medicine causes our body to become anaphylactic towards another, completely different medicine.

Although this is rare and seems unlikely, increasing scientific evidence points to pholcodine being the culprit for these reactions.

7. The exact way it causes this has not been confirmed yet, but the majority of scientists agree that it is due to the similarities between the chemical structures of pholcodine and NMBAs.

FAQs

Question: Why is the recall of pholcodine happening only now?

Our health ministry has only recently issued a nationwide recall of all products containing pholcodine due to recent studies reinforcing the role of pholcodine in anaphylactic reactions when exposed to NMBAs. The evidence is now strong enough to warrant a recall.

Question: Many drugs cause allergies. Why is this one being recalled?

Pholcodine is different from other drugs in the sense that the anaphylactic reaction is severe and occurs during surgery. There is no telling when someone might need surgery. The pre-exposure or “priming effect” of pholcodine can last up to a year, according to the ALPHO study, and is thus considered to be a major risk for everyone who has used pholcodine.

Question: what should I do if I have been prescribed pholcodine by my doctor/pharmacist recently?

1. Stay calm. Pholcodine doesn’t damage our body by itself, and as long as you are not exposed to NMBA’s, you are perfectly safe
2. If you do have surgery scheduled, you MUST inform your doctors about this, so that the doctors are better prepared to handle any reactions as a consequence of this exposure.
3. Do not throw Pholcodine products or any medications through normal channels, as this will pollute the environment. Return your unwanted medicines, including Pholcodine-containing products, to CARiNG Pharmacy near you. CARiNG Pharmacy can help you to safely dispose of your unwanted medicines.