The Medicines and Healthcare Products Regulatory Agency (MHRA) has launched a public consultation to propose that codeine linctus is reclassified as a prescription-only medicine. Health professionals and the public have until 15 August to share their views on the potential reclassification.

The consultation has been launched after multiple Yellow Card reports indicate that codeine linctus is being used recreationally for its opioid effects, rather than for its intended use as a cough suppressant, says the MHRA.

“Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences,” said Dr Alison Cave, the MHRA’s chief safety officer.

The consultation has been supported by the Royal Pharmaceutical Society. “We welcome the MHRA consulting in this area, to understand the impact of this potential change on pharmacists, pharmacy teams and the public,” said RPS president Professor Claire Anderson.

“We believe there is insufficient robust evidence for the benefits of codeine linctus in treating coughs safely and appropriately. We also have significant concerns about its misuse and addictive potential, as well as the risk of overdose.

“There are many non-codeine-based products available for the treatment of dry cough. With studies showing up to 60 per cent of people are genetically predisposed to opioid dependence, the role of codeine linctus in treating what is ultimately a self-limiting condition is questionable.”

Codeine is broken down in the body into morphine, which is thought to provide its main activity. However not everybody is able to metabolise codeine. Conversely, others may break it down much more quickly and experience significant side effects. As a result, the risk that a person could become addicted or experience toxic effects will differ between individuals.