Should co-codamol be on repeat prescription?

[ipadquietly]

Just that really. My 87 year old mother was prescribed it as pain relief for migraine several years ago and has had it on repeat prescription ever since. She says she takes it whenever she gets an 'aura' before a migraine.
She's being prescribed 30 pills a month.

Surely she only orders it when she needs it? With a repeat prescription you only get it when you ask for it. Is she on a lot of medication? Night she benefit from a medication review? So many older people at work take so much they don't know what half of it is for I always book them a med review.

Has she got a massive stockpile?

My DP has to have a prescription review with the pharmacy every couple of months and the GP sometimes requests he come in for an appointment to review his meds.
Honestly I thinknits common that they just keep the repeats for older people going. My grandma had a repeat for 100 paracetamol a month until I made her stop it- she had enough to treat the army for the next decade.I bet your mum has a massive stockpile as I don't think 30 a month would be enough to 'feed' an addiction so she probably is only having a few.

Not being flippant about the addiction, hope you know what I mean. Maybe ask the pharmacist?

I used to get solphadol on repeat prescription which is cocodamol 30s but some pharmacy gives solphadol instead as it's the same thing different name, personally I can't take them for headaches as they Just simply don't work for my headaches, I used to have to take them for pain in leg but if I got a sore head I had to take paracetamol, only once though as not adviced you take both at the same time. However my mum does take cocodamol for different health issues which for her cocodamol helps her headaches so it is possible your mum gets them for migraines.

Do you know if she has been taken them? If it's piling up its maybe worth getting a medical review. It's maybe just the case that she doesn't need to get them as often.

Xxxxx

If she takes it regularly why would it not be on her repeat prescription?

I would suggest that she asks for a medication review. If she automatically repeats and has a stockpile then or she takes them regularly but unnecessarily them the GP needs to review how she takes them. Long term usage of codeine based drugs can be addictive but it can also cause issues with constipation. I am on repeat prescription for many drugs including codeine & paracetamol (which is basically what co-codamol is) and I have my prescription reviewed by my GP every year.

Can you check whether the repeat is being automatically filled, as that sounds like the problem. Most people's repeats are just permission to get another, but now many pharmacies offer an automatic refill service which is handy but probably inappropriate here.

Thanks for your replies, everyone.

The repeat is automatically filed. I made an online prescription request for the first time on her behalf, and took the opportunity to find out what she is getting every month!

She regularly takes 30 co-codamol per month: she has no stockpiles. I'm not sure whether this is enough to feed an addiction, or whether I should be worried about it at her age, as long as she's happy! However, she has been complaining of constipation lately, so this may be a side effect.

She is also on an anti-migraine med (can't remember what it's called) along with BP pills/diuretics/statins. Normal GP fodder for the over-80s.

All of you have confirmed what I thought - she really needs a med review by her new doctor. Thanks.

my mum has cocodomol on repeat prescription, her GP is happy for her to tke it as stronger painkillers like tramadol doesnt agree with her

I don't think she should be taking it every day for years and years without speaking to her GP about it. Mind you, I can't even take those without hallucinating.

Not for migraine no, any consultant neurologist will tell you it should never be given for migraine. it can actually make them worse, she couldbesuffering from medication overuse migraines now due to the amount she is taking. if she was too see a consultant they would stop them cold turkey I'm afraid. They don't seem very sysympathetic to this issue). I'd be questioning why the doctor gave them in the first place this is a well known problem withcoden and headaches.

If you're worried you could also enquire about a dosset box. The gp would do weekly scripts and the pharmacy would make them up for her. All automatically with no ordering or anything.

MigGril She was prescribed them by a consultant! (A different consultant, it has to be said, to the one who prescribed her steroids for a number of years!) I wondered about the migraines being a consequence of the onset of withdrawal. I've just read about medication-overuse migraines, and it very much looks like she has this - particularly the way she takes a cocodamol 'immediately she feels a migraine coming on'. Thanks for this.

That's interesting spotty - thanks.

I'm interested in this as my DF is taking 2 cocodamol every night, for at least a year now.

All repeat medication for patients is reviewed annually. She is using 1 cocodamol a day. I don't understand why you are so worried. While heavy use of cocodamol IN SOME PEOPLE can cause an analgesia associated headache , it would be v unusual at a 1-2 tab/day dose.

Common side effect is constipation.

On the box it says take no more than 3 days in a row as can be addictive.

Had to take some last night - didn't see any side effects of constipation, damn, that's me fucked for another week then

How long ago was she prescribed them. I think cocodamol used to be one of the main treatments for migraine. There are now many better drugs with less addictive tendencies. She shoul probably book an appointment with the GP to discuss this. I could only take codeine based treatments during pregnancy/breast feeding and they got me off it as quickly as possibly due to it's ability to cause headaches.

it isn't addictive for everyone - for some people it is a valuable painkiller which makes life livable. Although there are side-effects which definitely include constipation.

So if she "takes them when she feels a migraine coming on" but is taking 30 a month, does that mean she is having migraines or auras most days? Or taking lots a few days a month?

Either way sounds like she needs to see a doc and get all her meds reviewed - it's very easy to end up taking two drugs that cancel each other out.

Codeine doesn't always cause constipation - I've never had a problem even when taking 60mg 4x daily. Though there was the time I puked in hospital and was diagnosed with d+v. "But I don't have diarrhoea!" "Yes you do, but you're 8 months pregnant and on two constipation-causingg drugs, so you haven't noticed!"

I was told by a pharmacist that co-codamol is the same as the yellow Migraleve tablets so I don't understand the comment that it's not suitable for migraine? It does sound like overuse though & yes it's very bad for causing constipation

You can use it for occasional migraines. But it's no good for chronic migraine (more then 15 pain days a month). And while codeine is a good pain killer for other pain, it really isn't for chronic head pain. It really is now agreed that it shouldn't be used for this. I know quit a few people with chronic migraine myself included and don't know anyone unless medically not able to take anything else taking codeine.

Even just three tablets a week is believed to be a problem with codeine, although this doesn't relate to other painkillers. And strangely only seems to be a big problem of taking it for headpain not other pain. The migraine action association has some good information on it.

Sorry it was on the migraine trusts web site. You mite find this information useful www.migrainetrust.org/medication-overuse-headache