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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

To be annoyed at out of date advice from pharmacist?

63 replies

Womnaleplus · 05/12/2013 17:46

Earlier today I tried to purchase a branded ibuprofen/paracetamol mix from behind the counter earlier. I suffer from severe migraines but as I am breastfeeding I am limited to these two painkillers. I was on my own with two small DC, could feel a stinker of a headache coming on but had run out so went to buy some more.

The team flat-out refused to serve me saying that ibuprofen isn't suitable for lactating women. I said I had checked with a midwife and later a bf'ing counsellor, but they were insistent I couldn't have it. So annoying - they're wrong!

AIBU to be irritated? This is the second time I've been refused service in this way (both by pharmacists from the same large chain). I usually omit mention of the bf'ing but was caught on the hop. Certainly won't be telling the truth in future.

OP posts:

Paintyourbox · 05/12/2013 20:49

The reason you can't buy thrush medicines OTC when pregnant is:

The products are not licensed for over the counter sale to pregnant women. This means legally the pharmacist isn't allowed to sell them.
Thrush symptoms can be confused with BV. Untreated BV in pregnancy increases risk of premature labour.

Pobblewhohasnotoes · 05/12/2013 20:52

Why are you buying the combined? You'll get the full doses if you buy them separately.

Original poster

Womnaleplus · 05/12/2013 20:53

Beast that tennis ball idea is amazing - I can just imagine that would feel great mid-migraine and have never read that tip before! Thank you, I will try it.

OP posts:

lyndie · 05/12/2013 20:54

Yes BNF is drugs manual!!! Unhelpful generally for breast feeding except the most basic of drugs.

BFN is excellent source of drugs info for breast feeding women and health professionals.

I'm a GP and I use both

Beastofburden · 05/12/2013 20:59

Hope it works! Does for me. You might need a spare ball to stop the baby nicking it...

mycatlikestwiglets · 05/12/2013 21:24

Ibuprofen is doled out as a painkiller on the wards post-childbirth so is most definitely considered safe when breast feeding. Codeine isn't apparently recommended anymore, although it was the drug of choice when I had DC1 in 2010 so the change must be fairly recent.

Pobblewhohasnotoes · 05/12/2013 21:27

I'm sure I had codeine during labour, something that did fuck all anyway...

CrohnicallySick · 05/12/2013 21:30

Mycat- I think there was a case fairly recently where a baby had an overdose of codeine rough breastfeeding. Apparently the mother had a genetic marker/condition/variant that meant she metabolised codeine differently. However, no one knows if they have the same variant, so ibuprofen or diclofenac is preferred to avoid the risk totally.

CrohnicallySick · 05/12/2013 21:33

Pobble- are you sure it wasn't pethidine (another related painkiller)?

Pobblewhohasnotoes · 05/12/2013 21:45

Nope, absolutely wasn't. My hospital doesn't offer pethidine.

CrohnicallySick · 05/12/2013 21:55

I didn't know that, I thought pethidine was universally offered. Except it's not always appropriate to give- I wasn't allowed it because they knew I was going to theatre soon, and it can't be given too close to the birth in case it affects the baby. Besides, they said I could just wait for the epidural. In the meantime they gave me 2 paracetamol! Now that really did do fuck all!

Pobblewhohasnotoes · 05/12/2013 22:11

I know a lot of hospitals offer diamorphine now. I was in the home from home midwife led part, so if I'd wanted anything else I would have had to have been in the hospital bit.

Next time, epidural all the way!

Goalie · 05/12/2013 22:57

How old is your dc? I can understand a pharmacist advising against for an under 8 week old.

landrover · 05/12/2013 23:11

But yau for thinking placebo effect will work better? never heard that explanation before!

Original poster

Womnaleplus · 06/12/2013 03:04

DC is nine months Goalie.

Landrover, seeing as I'm not asleep , I found lots on the branded versus generic placebo effect, e.g.:
www.placeboeffect.com/expensive-placebo-pills-work-better/

And on the evidence that you can still benefit even though you know it's happening.

And yes the codeine advice seems only to have changed in June this year. I have previously taken it myself but wouldn't really want to be in charge of two kids on it.

OP posts:

StayAwayFromDeliriumDive · 06/12/2013 06:35

The PIL for Nuromol says take extra care when breastfeeding and to take advice when breastfeeding or pregnant. See here:

www.medicines.org.uk/emcmobile/medicine/23856/pil

It puts pharmacists in a difficult position, because the onus is on you as a pharmacist to make the decision on safety, rather than the manufacturer to say it's safe. I would happily sell Nuromol to a breasdtfeeding lady (if they were daft enough to pay for it), but there are others who wouldn't.

aliciagardner · 06/12/2013 06:40

Codeine in breastfeeding guidance changed July 2013.

openerofjars · 06/12/2013 06:49

That explains why I got given codeine post childbirth in June 2013, then.

EvilRingahBitch · 06/12/2013 07:12

OP is right, Nurofen works better than Poundland Ibuprofen for almost everyone. I saw a lovely experiment on the telly with switched packets and the sceptical participants were v. cross with themselves.

Original poster

Womnaleplus · 06/12/2013 07:24

So I'm still daft even though there is evidence to support my assertion? Really?

OP posts:

hedgehogy · 06/12/2013 07:27

YANBU.

I was told to take ibuprofen and paracetamol together (for as long as I needed to) after my c-section earlier this year, and I'm ebf.

hedgehogy · 06/12/2013 07:31

I was also prescribed co-codamol by my GP when I had a breast abscess in July/August. I didn't take it after reading up on it though. (Stuck to ibuprofen and paracetamol). Luckily, as my consultant said I shouldn't have been prescribed it!

CrohnicallySick · 06/12/2013 07:35

That second link is interesting- even though they were told the pills were placebo, they were told that they worked. I wonder what would happen if they were given a pill and told 'we don't think it will work, but let's see'?

If in the latter case, the pills didn't work, then that would have implications for the branded/generic debate. I believe that generics work just as well (as they have the same active ingredient) and will always choose generic over branded. I suspect that means, for me, generics will work just as well. You believe that branded work better due to the placebo effect, so it makes sense that branded would work better for you.

Secondly- they studied IBS. IBS is known to be affected by factors such as stress, that come from within the individual. I suspect that means it is more susceptible to the placebo effect in treatment, this is supported by the fact that in later studies, placebo is at least as effective as the existing licensed treatments for IBS. I say it is more susceptible because it is a functional problem rather than a structural one, therefore the function could be altered through placebo affecting nerve impulses and brain messages. Whereas with a similar structural problem (such as Crohn's) I don't think altered nerve impulses could fix the underlying illness (help with symptoms, yes, but not fix the damage).

Pobblewhohasnotoes · 06/12/2013 07:36

I still wouldn't pay £2.50 (or whatever it is) for Nurofen when Ibuprofen costs 35p.

In hospital we don't dish out nurofen, it's cheap paracetamol and brufen. Can't remember what our kids version is, but it's not Calpol.

Katiebeau · 06/12/2013 07:40

Buy Boots Ibuprofen. They make nurofen. It's the exact same thing.

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