Key message: In 2008, legal measures were introduced in the UK to manage the misuse of medicines containing pseudoephedrine or ephedrine. A review of evidence conducted in 2012 shows that the measures are continuing to effectively manage the risk of misuse of these medicines.

Background
The Medicines and Healthcare products Regulatory Agency (MHRA) is the government agency responsible for regulating medicines and medical devices in the UK. We continually review the safety of medicines and vaccines in the UK, and inform healthcare professionals and the public of the latest updates through several means, including public assessment reports.

The following report presents the 2012 review of the impact of measures introduced to control the potential misuse of medicines containing pseudoephedrine (PSE), or ephedrine (EPH), in the manufacture of the Class A controlled drug methylamphetamine. These measures were introduced in 2007–2008, and their impact has been reviewed yearly.

PSE and EPH are nasal decongestantsa contained in many cough and cold medicines sold over-the-counter (OTC) in UK pharmacies. There is concern that PSE and EPH can be extracted from these medicines and used in the illegal manufacture of the Class A controlled drug methylamphetamineb – a highly addictive drug which affects the central nervous system and can cause serious physical and psychological harm. This concern prompted a public consultation in 2007, following which the Commission on Human Medicinesc (CHM) advised that a number of measures should be introduced to control the supply of OTC medicines containing PSE and EPH. These measures included reducing the pack size for OTC products containing PSE and EPH, and a restriction on sale to one pack per transaction.