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Liquid codeine prescriptions to require TPP Alberta secure prescription pad

June 10, 2020
Oral liquids containing codeine moves to Type 1 status with TPP Alberta.

As of July 1, 2020, oral liquids containing codeine requiring a prescription will move from Type 2 to Type 1 TPP Alberta status. As a result, these products will require the secure TPP Alberta two-part prescription form.

The change is in response to the growing number of codeine syrup forgeries that are being reported. In 2019, out of the 339 total forgeries reported, 254 were for codeine-containing syrup.

ACP deputy registrar Jeff Whissell says the trend became evident thanks to the information submitted by Alberta’s pharmacies.

“ACP, through the help and support of our regulated members, recognized that prescriptions were routinely being forged for codeine-containing syrups such as Cotridin.”

To address this, ACP conducted a review led by two University of Alberta Faculty of Pharmacy and Pharmaceutical Sciences practicum students, Lisa Chan and Matthew Seguin. Lisa and Matthew researched and developed a presentation for the TPP Alberta steering committee that proposed a secure TPP Alberta pad be required for prescriptions for codeine-containing syrups.

After the review and presentation, the TPP Alberta steering committee forwarded the recommendation to the Council of the College of Physicians and Surgeons of Alberta (CPSA), which approved the recommendation on May 29, 2020.

“Changing the status of oral liquids containing codeine to Type 1 status was important to ACP to reduce the number of forged prescriptions, and more importantly, address the harm that could potentially be caused by those who misuse the medication,” said Whissell.

Whissell says in addition to CPSA, ACP also worked with the TPP Alberta program, the Alberta Pharmacists’ Association, the College and Association of Registered Nurses of Alberta, the Alberta Veterinary Medical Association, the Alberta Medical Association, Alberta Health, and Alberta Health Services to have the change in status approved.

Medications listed as Type 1 by TPP Alberta require a secure, two-part prescription form. The dispenser must be presented with the top copy of the TPP secure form. The prescriber should retain the second copy. The form may also be faxed from the prescriber. For compounds, office use, and veterinarians and Yukon prescriptions, a photocopy must be made by the dispenser and submitted to the TPP for monitoring and the original form or fax must be retained by the pharmacy.

Drug products affected include

  • Acetaminophen Elixir with 8 mg Codeine Phosphate syrup,
  • pms-Acetaminophen with Codeine Elixir,
  • Calmylin ACE,
  • Coactifed,
  • Dimetane C Expectorant,
  • Dimetapp C,
  • Robitussin AC,
  • Teva-Cotridin Expectorant,
  • Teva-Cotridin,
  • Codeine Phosphate Syrup (Laboratoire Atlas Inc.), and
  • Linctus Codeine Blanc (Laboratoire Atlas Inc.).

For more on the TPP Alberta program, visit the CPSA website.