Availability of Paracetamol Sold Over the Counter in Europe: A Descriptive Cross-Sectional International Survey of Pack Size Restriction

Basic Clin Pharmacol Toxicol. 2018 Jun;122(6):643-649. doi: 10.1111/bcpt.12959. Epub 2018 Feb 8.

Abstract

Due to the risk of hepatotoxicity when excessive amounts of paracetamol are consumed, Poisons Information Centers (PICs) frequently receive paracetamol-related enquiries. This study examined how widely pack size restrictions of paracetamol sold over the counter have been implemented in Europe and also availability of paracetamol through non-pharmacy outlets and their possible associations with frequency of poisoning enquiries. A cross-sectional European multi-centre questionnaire study was performed using a questionnaire to identify the extent and nature of paracetamol pack size restrictions, non-pharmacy outlet sales and the frequency of paracetamol-related enquiries to PICs. In total, 21 European countries participated. All PICs provided telephone hotline services. In 14 (67%) countries, pack size restrictions had been implemented in pharmacies (range: 8-30 g). No significant difference (median difference 0.7%, p-value = 0.36) was found when comparing median frequencies of paracetamol-related enquiries in countries with pack size restriction to countries without restrictions. A significantly lower median frequency of paracetamol-related enquiries was found in countries without non-pharmacy outlet sales compared to those with such sales (median difference 2.2%, p = 0.02). Pack size restrictions on pharmacy sales of paracetamol have been implemented in two-thirds of examined countries. There was no difference in the proportion of paracetamol-related enquiries to PICs among countries with and without pack size restrictions. However, a lower rate of paracetamol-related enquiries was noted in countries where paracetamol was not available in non-pharmacy outlets.

Publication types

  • Multicenter Study

MeSH terms

  • Acetaminophen / poisoning
  • Acetaminophen / supply & distribution*
  • Analgesics, Non-Narcotic / poisoning
  • Analgesics, Non-Narcotic / supply & distribution*
  • Cross-Sectional Studies
  • Drug Overdose / prevention & control
  • Drug Packaging*
  • Europe
  • Humans
  • Nonprescription Drugs
  • Surveys and Questionnaires

Substances

  • Analgesics, Non-Narcotic
  • Nonprescription Drugs
  • Acetaminophen