Paracetamol, one of the most prescribed drugs in the UK, and probably the most popular over the counter medicine has been recently subject to shortages due to increased demand during coronavirus (COVID-19) pandemic. In the last 1-2 years, surgeries across the countries advised many patients to purchase paracetamol over the counter to reduce the cost of drugs prescribed on the NHS. Paracetamol shortage in the UK has been problematic for many patients who rely on this essential drug to manage their long-term conditions, such as osteoarthritis. Similarly, paracetamol shortage is seen for the liquid preparations such as paracetamol 3 months+ (brand: Calpol Infant) and paracetamol 6 years+ (brand name: Calpol 6+) due to the high demand during the COVID-19 pandemic.
Causes of paracetamol shortage during COVID-19 pandemic
Unprecedented demand for paracetamol due to coronavirus pandemic is solely the main reason for the recent paracetamol shortage in the UK. Media reported on shortages of raw materials from India and China, which also affects the rising prices for paracetamol products.
Paracetamol shortage: legal limits on purchase
The legal limit for the sale of paracetamol from a pharmacy in 100 tablets or capsules. The sale of paracetamol products in supermarkets or other retail outlets is usually limited to 2 packs of 16 paracetamol capsules or tables.
During the COVID-19 pandemic, many pharmacies limited the sale of paracetamol to 1 or 2 boxes of 32 tablets or capsules (the usual box size available in pharmacies).
How to get paracetamol during coronavirus (covid-19) pandemic?
1. Check availably on daily basis
I work in a supermarket pharmacy. So far, during the coronavirus pandemic, we have been getting paracetamol tablets regularly; however, orders are usually limited. Many pharmacies do not receive paracetamol liquid (including Calpol products) as part of their daily deliveries. The shortage of children paracetamol is more significant. Limited stock of paracetamol gets sold quickly, usually within a few hours. With many pharmacies having morning deliveries, I would advise to speak to the pharmacy team and ask about recent deliveries of paracetamol and the best time to get hold of it.
2. As a pharmacy team to keep some on the side
Although not all pharmacies may offer to keep some on the side, I am confident that a pharmacy team would keep some on the side for patients who take paracetamol every day.
3. Packing down of prescription-only paracetamol (POM)
During COVID-19 pandemic, pharmacy regulatory bodies allowed pharmacy teams to pack down, larger packs of paracetamol tablets or capsules, which are licensed as prescription-only medication (POM), usually used to fulfill prescriptions. Although this process is allowed by regulatory bodies, not all pharmacies permit the packing down of paracetamol POM. It is worth asking a pharmacy team whether they would consider doing it.
General Pharmaceutical Council (GPHC) produced a short guide explaining how packing down of prescription-only paracetamol tablets or capsules should be carried out. According to this guide, paracetamol, which is assembled into smaller packs, must be labelled with essential information related to the product, such as name (paracetamol), form (e.g., tablets), dosage instructions and other information. All requirements can be found on the GPHC website.
4. Ask for an emergency supply of paracetamol
In the UK, a pharmacist can make an emergency supply of medication, providing that patients had this medication prescribed before by a doctor. A pharmacist assesses the need for an emergency supply of medication.
A pharmacist can supply medication to cover for up to 30 days of treatment when a request is made for emergency supply. Patients need to cover the cost of drugs when supply is made on the basis of an emergency supply. Age exemption and other exemptions are not valid to cover the cost of medication supplied. Some pharmacies charge a minimum fee for an emergency supply of drugs, herefore the cost of paracetamol supplied via this route may be significantly higher than price of paracetamol available to purchase from the shop or pharmacy. Learn more about the emergency supply of drugs in the pharmacy.
Although some (pharmacists) may argue that this is not an emergency, an emergency supply during paracetamol shortage due to coronavirus pandemic can be justified in a patient’s best interest.
5. Urgent medication supply via NHS 111
In an emergency, patients can be referred to the pharmacy by NHS 111 service to obtain drugs. Patients are referred to a pharmacy of their choice. Similarly to an emergency request, the pharmacist decides if an urgent supply of medication is needed. It is possible to refuse the supply of drugs, even when the referral is made via the NHS 111 service. When visiting the pharmacy or when speaking with the pharmacist over the phone, a request to access a Summary Care Records (SCR) will be made. SCR is an NHS service, which allows a pharmacist to see a summary of repeatable medication alongside other demographic information.
I would NOT recommend using NHS 111 to obtain paracetamol.
- NHS 111 is already under pressure during the coronavirus pandemic.
- The supply of medication under this service will cost NHS £14 + additional cost of the drug supplied.
More details can about the supply of medication via NHS 111 can be found in a separate post, How to get an emergency prescription.
All NHS prescription exemptions apply to patients when supply is made via NHS 111 referral.
6. Ask your GP to prescribe paracetamol tablets or capsules
So far, during the pandemic, I have not seen shortages of paracetamol tablets or capsules, which are licensed as POM products. Asking GP to prescribe paracetamol is another option during the shortage of this drug.
7. Buy combinations of products containing paracetamol
There are several products available on the market for the management of cold and flu products which contain paracetamol. Many combinations products are available in pharmacies. Patients with underlying conditions who take different drugs need to check if they can take a combination product. Common combination products available in pharmacies:
- Paracetamol + decongestant, such as pseudoephedrine (brand names: Sinutab)
- Paracetamol + codeine (Co-codamol), Solpadeine range.
- Paracetamol + caffeine (Panadol Extra Advance)
- Paracetamol + Aspirin + caffeine (Anadin Extra)
- Combination ‘cold and flu’ products, for example, Day and Night Nurse, Beechams All-in-One, Benylin Day & Night, Benylin Four Flu.
Paracetamol shortage: paracetamol alternatives
Lastly, customers/patients may consider the use of different drugs instead of paracetamol in the management of pain or cold and flu symptoms, unless contraindicated, for example:
- Naproxen (Feminex Ultra)
- Topical products containing ibuprofen or diclofenac, which are useful in the management of arthritis
- Topical products containing salicylic acid (Movelat Gel)
There have been some doubts about the use of ibuprofen during the COVID-19 pandemic since The French Health Minister advised the use of paracetamol for the management of coronavirus symptoms. Both NHS and WHO issued advice on the use of ibuprofen in patients with suspected coronavirus infection.