Certain cough syrups, based on pholcodine, present an unfavorable benefit-risk balance.
A risk of allergic reaction
Medicines covered by the ANSM? Pholcodine-based syrups, used for coughs.
“According to a new study, taking a medicine based on pholcodine, used for cough, exposes you to a significant risk of developing a serious allergy to curares, indicated during general anesthesia, even if the anesthesia has occurs several weeks after taking the medication. Given the non-essential nature of these syrups and the existence of therapeutic alternatives, we consider that their benefit/risk ratio is unfavorable.“, warns the Medicines Agency in its press release.
To protect the population, the organization has adopted a strict policy: marketing authorizations (AMM) in Europe for pholcodine-based syrups have been suspended and all batches concerned have been recalled.
A priori therefore, it is no longer possible to obtain pholcodine today. Which does not exclude having some in stock in the cupboards.
In this case, the ANSM recommends adopting the following procedure:
“If you are using or have ever used a cough syrup containing pholcodine, there is no special monitoring recommended at this time. If, however, you have to undergo general anesthesia, the anesthetist may ask you if you have already consumed this type of syrup. Consider informing him directly if he does not question you on this point himself..”
Other antitussive medications singled out for their adverse effects, this time in the journal Prescrire:
“Among the antitussive medications offered, some expose you to disproportionate adverse effects and should be avoided: ambroxol (Surbronc Expectorant Ambroxol°), bromhexine (Bisolvon°), chlorphenamine (in various combinations), codeine (for cough: Paderyl°), diphenhydramine (Actived cold day and night°), levodropropizine, oxomemazine (Toplexil°), pentoxyverine (Clarix dry cough pentoxyverine 0.15%°), pholcodine (Dimetane without sugar°), promethazine (Phenergan°)“, we can read in a text dating from April 1, 2022.
For these drugs, no effectiveness “significantly better than placebo or non-drug measures” would not have been demonstrated.
Favor natural remedies
A warning approved by Dr Kierzek, who recalls that in the absence of warning signs (high fever, chest pain, severe shortness of breath) coughing is a natural and harmless sign of defense.
“Coughs must be respected; and possibly opt for natural, effective remedies without side effects: honey (not to be given to children under one year old, editor’s note), fruit syrup, thyme herbal tea, etc.“.
If, despite everything, you want to take a cough suppressant “Be careful to read the list provided by the Prescrire magazine and to check the potential side effects of the medication. You can also ask your pharmacist for advice. Finally, be careful with the duration of the intake, which must be a maximum of five days for self-medication..