Asking the GP for Benylin

If I was to visit my GP to ask her to prescribe an antihistamine syrup to help treat a bad cold, would she be happy?

My 1 year old daughter has a cold, and we're all out of medised.  We know medised does wonders for her when she had colds before, but unfortunately now we can't purchase it any more.  Any antihistamine remedies for under-2s must now be obtained via prescription, thanks to the MHRA.

Now the MHRA may have a point, that the risks of accidental overdosing due to the "small body size" and confusion over "using similar products", for a drug that provides "at best, symptomatic relief".  I had a friend phone me less than a year ago to ask what she should do having given her daughter a second dose of piriton after six hours (rather than the 12hour interval specified by the BNFC for that age).  Now she's a university graduate, admittedly not in healthcare, but still smart enough to know she should have read the label.  Add to that the carer's probable sleep deprivation, perhaps it's a wise choice.

The whole art of deciding what medicines are allowed on general sale, pharmacy sale, prescription only or are considered too dangerous for use (i.e. unlicenced) must be a tricky one.  Not only must you weigh up concerns about pharmacology and toxicology, you must also add in a bit of sociology and end-user psychology as to it's eventual use.  I was relieved earlier this year when my personal favorite cold relief tablet narrowly evaded being restricted to prescription-only status, on account of the fear that I might use to to make stimulants in my garage.  Again, it's symptomatic relief - but it's a symptom I really want rid of.

One also has to take into account the professional support in which the medicine is supplied.  Take for example the drugs which have had their licences revoked because the prescribers and pharmacists involved  (myself included) couldn't effectively manage the interactions concerning prolonged QT-intervals, such as cisapride, terfenadine and thioridazine.  The risks would still be there, but better management of those risks could potentially allow greater use for those that would benefit.

So it's off to the GP, in the hope that a 2 minute chat with her followed by a wait at the pharmacy for an amber bottle with a dispensing label on it will guarrantee that I don't accidentally use it alongisde another antihistamine syrup.  Or I could just rub some Karvol on her cot instead, I wonder if anyone's done an RCT comparing the two?

6-10-08