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Leyla Hannbeck, head of pharmacy at the National Pharmacy Association, answers three of the 700 questions fielded every day by the NPA’s Pharmacy Services team

What is an alternative to chloroquine sulphate syrup that is suitable for children for malaria chemoprophylaxis?

Chloroquine sulphate syrup (Nivaquine), manufactured by Sanofi, has been discontinued and will no longer be marketed in the UK. Currently, there are no direct alternative products available either as a sulphate or phosphate liquid formulation for malaria chemoprophylaxis. Chloroquine phosphate is still available in a tablet formulation to be used alone (Avloclor tablets) or in combination with proguanil (Paludrine/Avloclor antimalarial travel pack) and could be considered as an alternative for use in children for malaria chemoprophylaxis. NPA Members can access the latest NPA malaria prophylaxis chart. 

Is it a legal requirement to dispense an oral liquid antibiotic in a child-resistant container?

No. It is not a legal requirement to dispense an oral liquid antibiotic in a child-resistant container (CRC) but it is good practice to do so. All medicines should be dispensed in CRCs wherever appropriate. Exempted circumstances for not supplying CRCs include patients requesting that CRCs are not supplied or where transferring the medicine to a CRC could affect the stability of the medicine. Some oral liquid antibiotics are sometimes supplied by the manufacturers without a child safety cap and use of a click-lock cap may result in leakage of the medicine. There are also some products that are no longer classed as being child-resistant once the seal on the original container is broken. However, re-dispensing into a CRC could result in a loss of important product information if this information was attached to the outside of the original container. In circumstances where medicines are supplied without a CRC, the pharmacist must ensure that the patient, or their carer, is notified of the need to store the medicine out of the reach of children. As a matter of good practice, a record of the conversation should be made on the patient’s medication record.

What is the maximum number of non-effervescent capsules or tablets of aspirin and paracetamol that can be sold over the counter?

The Human Medicines Regulations 2012 (Regulation 236) states that non-effervescent aspirin or paracetamol capsules or tablets to be sold to a person at any one time should not exceed 100. There is no legal restriction on the quantity of aspirin or paracetamol effervescent capsules or tablets that can be sold. However, pharmacists are advised to use their professional judgement when dealing with requests from customers for large quantities of effervescent aspirin or paracetamol products.