Why won’t my GP prescribe paracetamol?

Q: I am awaiting a knee replacement and taking up to eight paracetamol a day, along with anti-inflammatories, to help control the pain. My GP told me to buy the paracetamol over the counter, but given that I am using so much and can buy only 32 tablets at a time, it is proving quite an inconvenience. Can’t she prescribe me greater quantities (which I would get free as I am in my seventies)?

A: You have fallen foul of a couple of well-intentioned initiatives. The first was designed to reduce the number of people killed, or seriously harmed, following paracetamol overdose. Since 1998 the most you can buy in one go is 32 tablets/capsules (16 in non-pharmacy outlets) – a move that appears to have helped as there has been a subsequent drop in paracetamol-related deaths and liver transplants.

The second is a more recent drive to encourage patients to buy over-the-counter paracetamol for minor illnesses and aches and pains, as the drug is so cheap and the admin costs behind an NHS prescription much higher. Or, to put it another way, the NHS ends up paying at least four times more for paracetamol than you do.

However, although that is fine if you need paracetamol only for a few days, it is not ideal if you require a longer course, and doctors can use their discretion. I would certainly talk to your GP again and see if she is willing to prescribe greater quantities for you – not unreasonable given that you are likely to face a significant wait for your operation (a matter of months rather than weeks).

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