Limited Supplies of Prescription Co-Codamol Confirmed Until Summer
The Scottish government has confirmed that supplies of prescription-strength co-codamol will remain limited until the summer. This shortage affects the strongest form of the painkiller, the 30/500mg dosage, and is part of a UK-wide issue.
The shortage is attributed to delays by the Indian government in authorising the import of ingredients necessary for manufacturing the drug in India.
The Scottish government informed BBC Scotland News that alternative treatment options will be provided to patients affected by the shortage. However, some health boards have cautioned that while other medications are available, none can fully meet the expected increase in demand.
BBC Scotland News has received reports from patients dependent on co-codamol who have been told by their doctors that the medication will not be available until June.
Patient Experiences Amid the Shortage
Jocelin Harrison, who has been taking co-codamol for over 30 years to manage pain from five spinal surgeries, was contacted by NHS Lanarkshire last week. She was advised to reduce her tablets by one per week to
"avoid side effects of stopping suddenly".
She stated:
"The only advice I've been given so far was to reduce the tablets and try to manage my withdrawal symptoms. I was not offered any other advice or possible replacement pain killers and it's a great worry for me and other chronic pain sufferers throughout Scotland and the UK."
Details on Co-Codamol and Usage Guidance
Co-codamol contains the opiate codeine and carries a risk of addiction. It is available in three strengths: 8mg, 15mg, and 30mg of codeine, each combined with 500mg of paracetamol. The lowest strength can be purchased over the counter at pharmacies, while the higher strengths require a prescription.
Patients have been advised to gradually reduce their use of co-codamol, as abrupt cessation can cause withdrawal symptoms such as headaches, nausea, and sweating. Additionally, stopping suddenly may increase pain, particularly in long-term users.
NHS Lanarkshire's website includes a warning stating:
"There are other strengths of co-codamol tablets but there are not enough supplies of these to move everyone onto them."
The guidance further advises that all patients, except those undergoing cancer treatment, should begin tapering their dosage until complete cessation.
No new prescriptions for co-codamol will be issued until supplies normalize, expected in June, though the health board notes this date is not guaranteed.
Alternatives and Health Board Responses
NHS Grampian has issued similar guidance, recommending that pharmacists use professional judgement to prioritise stock and quantities supplied to patients. However, NHS Grampian does not currently advise patients to reduce their intake as NHS Lanarkshire does.
BBC Scotland News understands that the supply issues stem from delayed authorisation by the Indian government concerning imports of codeine-based active pharmaceutical ingredients (APIs) essential for co-codamol production.
Official Statements from Authorities
Alison Strath, the Scottish government's chief pharmaceutical officer, commented:
"Medicine supply is a matter reserved to the UK government. We are aware of limited supplies of the commonly prescribed pain-relief medicine co-codamol and know this may cause some concern.
Supply issues are expected until June 2026 and we are in regular contact with the UK government to seek assurances they are doing all they can to resolve this.
We have issued advice to health boards to ensure patients affected receive accurate information and clear advice.
We would ask that patients do not contact their GP practice or community pharmacy – instead, work is underway to identify those who may be affected, and they will be offered alternative treatment options."
The UK government's Department of Health and Social Care stated that the
"vast majority"of licensed medicines remain in good supply.
A spokesperson added:
"We are aware that co-codamol tablets are currently in limited supply due to manufacturing issues, and are working closely with suppliers to resolve current disruptions and ensure continuity of supply.
We are also engaged with NHS specialist clinicians and have issued comprehensive guidance on how to manage patients during this time, including advice on alternative preparations."
Manufacturing and Global Supply Context
Generic, non-branded medicines such as co-codamol 30/500mg are typically manufactured in China and India. According to recent statistics from the manufacturer Actiza, their products are exported to over 200 countries worldwide.
