s NPS Media Releases for September 2012 | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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NPS Media Releases for September 2012

NPS Spokesperson

articles by this author...

Regular information provided by NPS – Better choices, better health - NPS enables people to be medicinewise.

NPS is a valued independent resource for accurate, evidence-based prescribing information and education. Given the marketing pressures applied by global drug companies, NPS plays a vital and unique role across the healthcare sector. For more information please contact Stephanie Childs on (02) 8217 8667 or 0419 618 365 or schilds@nps.org.au

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Shedding new light on sunscreens

Writing in the latest edition of Australian Prescriber, Associate Professor Jane Hanrahan from the Faculty of Pharmacy, University of Sydney writes that UVB is the cause of sunburn, but UVA can be more damaging to the skin. It is therefore best to use broad spectrum sunscreens that block both wavebands. 

Sunscreens were originally developed to prevent sunburn caused by ultraviolet B (UVB) radiation, but we now know that it is just as important for them to block ultraviolet A (UVA) radiation, which is responsible for some types of skin cancers as well as premature ageing of the skin.

“The incidence of skin cancers, particularly melanomas, has continued to increase in Australia despite 30 years of the 'Slip, Slop, Slap' sun protection campaign. This is partly due to the fact that the sun protection factor rating, or SPF, in sunscreens is biased towards protection from UVB rays and prevention of sunburn, but does not measure how effective a sunscreen is at blocking UVA,” Associate Professor Hanrahan writes.

“The newer broad spectrum sunscreens that have been available since the 1990s and protect against UVA and UVB wavebands, provide hope of a decrease in the incidence of some skin cancers in the future.”

New Australian and New Zealand standards now permit sunscreens to have an SPF rating of up to 50+. Previously, only SPF 30+ was available in Australia.

There have been concerns in the past that newer sunscreens, which offer cosmetic benefits in terms of looking more transparent when applied, may in fact be harmful because of the absorption of nanoparticles into the skin, which could have toxic effects on the body. 

The Therapeutic Good Administration, however, found that nanoparticles in sunscreens do not penetrate deep enough into normal intact skin to be toxic. 

“Despite possible concerns about the long-term safety of sunscreens, the benefits of using sunscreen outweigh the possible harms,” Associate Professor Hanrahan concludes. “However sunscreens should only be one part of a sun protection strategy. Staying out of the sun where possible and covering up exposed parts of the body are still a priority.”

Other articles in this issue look at the rise of herpes zoster and an update on antivenom.

To read the full article and others visit www.australianprescriber.com


28 SEPTEMBER 2012 

Shingles cases on the rise

The herpes zoster virus, which causes shingles, is becoming more common as the population ages. In Australia the number of cases has doubled between 2000 and 2010. Hospital emergency departments report a 2–6% increase in cases per year.

Writing in the October edition of Australian Prescriber, Professor Dominic Dwyer and Dr Michael Wehrhahn, infectious diseases specialists at Sydney’s Westmead Hospital, say the recent rise in shingles cases is probably due to a number of factors, and urged more widespread uptake of the herpes zoster vaccine in adults.

“Shingles commonly presents as a painful blistering skin rash on the abdomen,” write the authors. “It is more common in people over the age of 60, so as our population ages we are likely to see more of it. Evidence also shows that recurrent attacks of the virus are more common than previously believed.

“Other reasons for a rise in prevalence are thought to be the increased use of immunosuppressant drugs – making people more susceptible to the virus – and the widespread use of the chickenpox vaccination in children.” (Shingles is caused by the same virus as chickenpox.) 

It is thought that because there is now less chickenpox in children, older people are not boosting their immunity to the virus and so may be more susceptible to shingles later in life. 

The herpes zoster vaccine, available in Australia and recommended for people over the age of 60 since 2009, has been shown to reduce the prevalence of the virus as well as its associated complications. The vaccine can also be considered for younger adults, depending on their clinical circumstances. It should not, however, be given to people with significant immune impairment, such as those on high-dose steroids, some patients with HIV and pregnant women. 

If a person is diagnosed with shingles, an antiviral medicine given within 72 hours of the onset of the rash can reduce the severity and duration of the illness.

“It is also important to treat any pain associated with shingles as early as possible. This can reduce the severity and likelihood of complications, such as prolonged pain,” write the authors.

Although shingles is less contagious than chickenpox, recent research has found the virus in human saliva, meaning it could be more contagious than previously thought. People with the virus should therefore avoid contact with people who may be susceptible, especially pregnant women and people with low immunity. 

Other articles in this issue include shedding new light on sunscreens and an update on antivenoms.

To read the full article and others visit www.australianprescriber.com

28 SEPTEMBER 2012 

October edition of Australian Prescriber

Editorial: The seven-year rule for safer prescribing

Before taking any new drug, you should wait at least seven years from its date of release, according to Sidney Wolfe, Editor of Worst Pills, Best Pills News, USA. Unless it is a rare ‘breakthrough’ drug that offers a clear therapeutic advantage over older proven drugs, it’s worth waiting this amount of time for the information about adverse effects to catch up with the information about benefits, he writes. Half of all warnings about new drugs, including most drug withdrawals, occur within seven years of their launch. The author suggests new drugs should be in a 'DO NOT USE for seven years' category.


Sunscreens were originally developed to prevent sunburn caused by ultraviolet B (UVB) radiation, but as Associate Professor Jane Hanrahan from the Faculty of Pharmacy, University of Sydney explains, it is just as important for them to block ultraviolet A (UVA) radiation. UVA is responsible for some types of skin cancer as well as premature ageing of the skin. Newer, broad spectrum sunscreens have the ability to block both UVA and UVB radiation. Recent advances in sunscreens have led to improved cosmetic acceptability, less systemic absorption and fewer allergic reactions.

Despite possible concerns of long term safety in relation to systemic absorption of sunscreens, the author says that the benefits of using sunscreen outweigh the possible harms. She also discusses important changes to SPF (sun protection factor) ratings in Australia and New Zealand.

Herpes zoster/Shingles: epidemiology, clinical features, treatment and prevention

Shingles (herpes zoster) is becoming more prevalent as the population ages, write Professor Dominic Dwyer and Dr Michael Wehrhahn, infectious diseases specialists at Sydney’s Westmead Hospital. New studies show recurrent attacks are more common than previously thought and recent evidence suggests a rise in prevalence of shingles could be related to the widespread vaccination of children against chickenpox (varicella zoster). Transmission of the virus may also be greater than previously thought. The authors highlight some of the possible complications associated with the virus and give recommendations for treatment and prevention, including the zoster vaccine.

Antivenom update

Antivenoms have been used in Australia since the 1930s but only very recently have their safety and effectiveness been critically examined. Professor Ian Whyte of the Calvary Mater Hospital in Newcastle and Professor Nick Buckley of the Poisons Information Centre in Sydney say that recent research has found one vial of antivenom is sufficient to treat envenomation for all five major groups of Australian snakes, and that repeated or larger initial doses of antivenom does not speed up recovery. 

Please find embargoed copies of these articles attached to this email.

Other articles in this issue look at mood stabilisers and bone turnover markers. The Therapeutic Goods Administration introduces the Database of Adverse Event Notifications, and gives safety updates for drugs used in multiple myeloma and haemophilia.

The full articles and more will be available from 28 September at www.australianprescriber.com.




NPS Head of Programs Ms Karen Kaye says that despite the TGA advice, there are reports some pharmacies are continuing to sell cough and cold medicines for children under 6 years, while others are refusing to sell these medicines for children over 6 years without a prescription.

“This is not only misleading for consumers, but it is a serious safety concern. We urge pharmacists to review the recent advice from the TGA and discontinue sales of cough and cold medicines for children under 6,” says Ms Kaye.

“For children between the ages of 6 and 11, cough and cold medicines can still be sold but only on the advice of a doctor, pharmacist or nurse practitioner. Despite what some pharmacists are saying, these medicines do not require a prescription and their scheduling remains the same.”

As of 1 September 2012 labels on all cough and cold medicines will be changed to reflect the new advice. In the transition phase, current stock can still be sold – where indicated – until the expiry date has been reached.

The new cough and cold medicine warnings — released on 15 August 2012 — followed a review by the TGA which found there was little credible research showing the effectiveness of these medicines, particularly in children. For children under 6, the potential for harm outweighed the potential benefits, with some of the active ingredients shown to cause serious side effects such as seizures or fits. 

“In light of these restrictions, pharmacists and other health professionals are in a good position to advise parents and carers about the management of symptoms and the self-limiting nature of most viral respiratory infections,” says Ms Kaye. 

“Providing practical advice for parents or carers to ease the discomfort of their sick child can go a long way. Most importantly the child should have plenty of rest, drink plenty of water and avoid exposure to cigarette smoke.” 

“Parents or carers can also supervise their child while they breathe in steam from a hot bath or shower in a closed room. A drink made with hot water, honey and lemon is a simple and effective home remedy, and for older children an ice cube or a throat lozenge can soothe a sore throat. If the child has a fever (a temperature higher than 38.5°C) and is uncomfortable, paracetamol can be recommended.” 

If a child’s symptoms do not improve, or worsen, parents or carers should be encouraged to see a doctor or nurse practitioner.

“Importantly, pharmacists should aim to provide parents and carers with consistent information about the use of cough and cold medicines in children which is in line with TGA advice,” says Ms Kaye.

Updated information about cough and cold medicines is available on the NPS MedicineWise website at www.nps.org.au/cough-cold-medicines/

The Pharmaceutical Society of Australia also released a fact sheet for pharmacists summarising the new TGA advice and providing examples of best practice counselling on cough and cold medicines for young children. A fact sheet for pharmacy staff has also been developed and is available on the PSA website

 People with questions about their medicines should speak to their health professional or call Medicines Line on 1300 MEDICINE (1300 633 424, 9am – 5pm, Monday to Friday for the cost of a local call).

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