A LEADING Cypriot psychiatrist said yesterday he had warned the Health Minster two months ago about the dangers of a common drug now being withdrawn in the UK.
Dr Takis Evdokas told the Cyprus Mail he had written to Health Minister Andreas Gavrielides on April 25, warning him that the painkiller Distalgesic was dangerous.
“I never received an answer,” said Evdokas, who issued another letter to the Minster yesterday in the wake of revelations that the UK was phasing out Distalgesic by next year.
The phasing out of Co-proxamol, as it is known in the UK, is mainly because of its frequent use in suicides. Reports in the UK say little is needed to overdose on the drug, making it a popular choice, and that accidental overdose had accounted for one fifth of the 300-400 deaths it had caused in the UK.
Evdokas said one of the main ingredients in Distalgesic was dextropropoxyphene, a mild opiate related to the morphine family.
He said he was alerted to the danger of the drug because he had a patient who took up to 20 tablets a day of Distalgesic, prescribed by his doctor. The patient, he said, entered his programme to reduce the dosage, but Evdokas said that even though he could wean patients from other drugs by reducing doses every week, Distalgesic is so difficult to give up that it could only be done by reducing one tablet every six months.
“In this case, the patient just can’t do it,” he said, adding that at one stage recently the patient ended up in a clinic after fainting.
Evdokas said 60-70 per cent of doctors in Cyprus just prescribed pharmaceuticals without checking into their side effects or what the main ingredients were. “Most don’t know if a product is an opiate and they write prescriptions for them as if they were an Asprin,” he said.
Yiannis Photiou, the general manager of Phadisco, the company that imports Distalgesic, said yesterday they were not the relevant authority to withdraw drugs from the market. This was the responsibility of the Health Ministry, he said.
In any case, he said Distalgesic was “just a painkiller” with no side effects.
Photiou said the normal dosage for the drug was two tablets every four hours and that the only way to overdose was to take around 20 in one go, which would not normally lead to accidental overdose.
“Distalgesic is a cheap painkiller that has been 30 years on the market,” said Photiou. “We have had cases in Cyprus involving Panadols.”
He said the only reason Distalgesic was being withdrawn in the UK was because of its use in suicides and the fact it was being sold over the counter. “In Cyprus, it’s only given on prescription,” he said, adding that it was mainly used by doctors and dentists for mild to medium pain relief and for the duration of around a week or so. “It is not for chronic disease. It’s only a little stronger than Panadol.”
According to the UK National Library of Medicine, no analgesics are devoid of danger in overdose, “but in dextropropoxyphene the evidence suggests that its dangers outweigh its analgesic properties.”
The Patient information leaflet supplied by Cox Pharmaceuticals states: “Like many medicines, Co-proxamol (Cosalgesic) may occasionally cause side-effects in some patients, particularly when you first start taking it. These may include dizziness, drowsiness, headache, nausea or vomiting, which can sometimes be relieved by lying down after taking the tablets. Other effects may be abdominal pain, constipation, light-headedness, and skin rash. Other effects include hallucinations, seeing, hearing or feeling things that are not there, weakness, false sense of well being or uneasiness.”
Only one of the three manufacturers of this product mention these psychiatric side effects in their own data sheet, according to the Adverse Psychiatric Reactions Information Link.
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