Meth update

Not surprisingly, federal laws curbing methamphetamine abuse are likely to cause changes in pseudoephedrine sales restrictions at pharmacies, according to the memo.

While approximately 40 states have individually crafted laws that limit access to pseudoephedrine, the federal government has recently stepped up its own efforts to help reduce methamphetamine abuse by passing a law that will restrict the sale of cough and cold products nationwide.

As of April 8, 2006, the new law requires pharmacies to comply with daily sales limits and monthly purchase limits for all nonprescription products containing pseudoephedrine or ephedrine. (See chart on page 96.)

In addition, the law will require pharmacies to keep all products containing pseudoephedrine or ephedrine behind a counter or in a locked cabinet, and all pharmacies must maintain a written or electronic logbook of pseudoephedrine purchases.

Pharmacies must place all products behind a counter or in a locked cabinet by Sept. 30, 2006, the law says.

Pharmacies must comply with both federal and individual state requirements. While many pharmacies have already placed single-ingredient pseudoephedrine products behind a counter, to comply with individual state laws, the new federal law applies to all products that contain any form of pseudoephedrine or ephedrine—which includes pediatric, multiple-ingredient, and liquid formulations.

Given additional constraints in access to pseudoephedrine posed by the new federal law, some supermarket pharmacy patients might be looking for some additional explanation as to why it's become more inconvenient to make their regular medicine purchases. Retail pharmacists could remind patients that methamphetamine abuse is still a widespread problem, and that the new restrictions arise from the federal government's mandate to stem the spread of the abuse and help clean up communities that have been seriously hurt by the meth crisis. More than 12 million Americans ages 12 years and older (comprising 5.2 percent of the population) have tried methamphetamine at least once so far.

Community pharmacists and pharmacy technicians who complete pseudoephedrine transactions have an opportunity to provide patients with this explanation, and at the same time assure them that the OTC products they're able to obtain are completely safe if used properly.

I want a new drug

With access to pseudoephedrine becoming more limited, many patients are instead trying more readily available phenylephrine-based products. These formulations have allowed many patients to once again obtain continuous over-the-counter access to familiar cough and cold products. However, many of them might not be aware that many of their familiar medications now contain a different decongestant.

Although little data exists to support clear clinical differences between pseudopehedrine and phenylephrine, patients accustomed to the effects of pseudoephedrine could be experiencing a slight difference in efficacy when they switch to a phenylephrine-based product.

Pharmacists can help patients through this by making sure that they're aware of the active ingredients contained within the products they purchase, and also by reminding them that pseudoephedrine is still available behind the counter.

Also, pharmacists should make sure that patients are aware of the difference in dosing between the two decongestants. (See chart on page 92.)