Codeine linctus is to be reclassified to a prescription-only medicine due to the risk of abuse, dependency and overdose, the Medicines and Healthcare products Regulatory Agency (MHRA) has announced.

Since 2019, there have been increasing reports in the media of codeine linctus being misused as an ingredient in a recreational drink, commonly referred to as ‘Purple Drank’.

The decision to reclassify the medicine has been made following a consultation launched by the MHRA after Yellow Card reports indicated instances of the medicine being abused, rather than for its intended use as a cough suppressant.

Responses to the consultation identified the pressure pharmacists were under to provide the medicine to those suffering from addiction.

Evidence is limited that codeine linctus is effective in the treatment of short-term dry cough but may be effective in the treatment of long-term cough (lasting over 8 weeks).

Patients with a long-term cough should see advised to see their GP for review of symptoms, and to check for other conditions which may be the cause of the cough.

The brands which will be reclassified are:

• Codeine Linctus BP (LCM Ltd, Pinewood Laboratories Ltd)
• Bells Healthcare Codeine Linctus 15mg/5ml oral solution (Bell Sons & Co [Druggists] Ltd)
• Care Codeine 15mg/5ml oral solution sugar free (Thornton & Ross)
• Galcodine Linctus (Thornton & Ross)
• Pulmo Bailly (Dendron Brands Ltd).

Royal Pharmaceutical Society president, Professor Claire Anderson, has welcomed the decision as a positive step to protect patient safety.

“This decision not only addresses concerns about the misuse and addictive potential of codeine linctus but also underscores the importance of prioritising patient well-being,” she said. “There are many alternative non-codeine-based products available to treat a dry cough.”