Important changes to osteoarthritic pain treatment

23 Jun 2020

As of June 1, Australians who suffer from osteoarthritis should be aware of some important changes in pharmaceutical access to certain paracetamol products.

Modified-release paracetamol (MR paracetamol), which is commonly used for osteoarthritic pain relief, has been “up-scheduled” from Schedule 2 to Schedule 3, meaning it will now be placed behind the counter at pharmacies and can only be accessed after speaking with your pharmacist.

Examples of MR paracetamol product include Panadol Osteo, Duatrol Osteo, Chemist’s Own Osteo Relief and many more.

Why has MR paracetamol been up-scheduled?

The decision was made after a review by the Therapeutic Goods Association (TGA) driven by “significant health risks associated with the misuse of modified-release paracetamol.”

When taken as directed, MR paracetamol is safe to take and suitable for its recommended use, however there have been cases of misuse causing overdose resulting from consumers not following the use directions. 

Pharmacist and pain management expert Joyce McSwan recommends that Australians with osteoarthritis seek the advice of their pharmacist to determine the most suitable pain medication for them.

“The up-schedule of modified-release paracetamol [as of] June 1 is a good opportunity for Australians with osteoarthritis to speak to their pharmacist or GP about treatment options,” Ms McSwan says.

“The Royal Australian College of General Practitioners guidelines, which doctors in Australia can reference – as do I – recommends some people try an oral non-steroidal anti-inflammatory drug, like ibuprofen, to manage flare-up pain, which can help reduce the inflammation that’s often the underlying cause of acute pain.”

MR paracetamol was up-scheduled in New Zealand in 2019, and was removed from sale altogether in the European Union due to concerns from regulators regarding the lack of appropriate treatment for overdose.

In 2016, for example, there were 8,241 cases of paracetamol overdose reported to the NSW Poisons Information Centre, and 818 (9.8%) of these involved MR paracetamol products.

What is osteoarthritis?

Osteoarthritis – a condition that affects the whole joint including bone, cartilage, ligaments and muscles – affects almost 4 million Australians, and this number is expected to rise to 5.4 million by 2030.

It doesn’t just affect seniors, either. Around two million people with osteoarthritis are aged between 15 and 64 years. It’s the leading cause of chronic pain and the second most common cause of disability and early retirement due to ill health in Australia.

Osteoarthritis can affect any joint, but most often it occurs in the knees, hips, finger joints and big toe. Symptoms can vary, but the most common are pain and stiffness in the joints. Initially, these symptoms are usually worse with activity, but they can be more constant in later disease.

Your doctor will diagnose osteoarthritis from your symptoms and a medical examination. If you’re experiencing symptoms of osteoarthritis, you should consult your doctor before embarking on a treatment program.

As with all medicines, you should take only as directed, and speak with a healthcare professional to ensure you are following the best advice for your osteoarthritis treatment.