On 20 March 2023, the Drug Control Authority(DCA) decided to cancel the registration and recalled all cough and cold medications containing pholcodine. Pholcodine is an opioid cough suppressant which is classified as a Group C item in Malaysia, meaning it can be sold without a prescription. Pholcodine-containing products examples such as Duro-Tuss Forte Cough Liquid 3mg/ml and Duro-Tuss Expectorant Cough Liquid. These products are indicated for relief of unproductive, irritating coughs associated with common colds, sinusitis, influenza, and upper respiratory tract infections in adults and children two (2) years of age and above.
Malaysia’s DCA cited findings that people who took pholcodine in the past 12 months facing a higher risk of anaphylaxis (a severe life-threatening allergic reaction) if they are given muscle relaxants or neuromuscular blocking agents (NMBAs) when undergoing general anesthesia such as during surgery. The NMBA products that are currently registered with the DCA for use in Malaysia include rocuronium, atracurium, cisatracurium, mivacurium, and suxamethonium. The important thing is the medical staffs should be reminded to stop prescribing, dispensing, selling, or distributing the product immediately, and to give patients with dry cough alternative medication. Lastly, consumers are reminded to check the label or package insert of the product to see if it contains pholcodine. If the product contains pholcodine, they are advised to stop and bring along with their product to seek alternative treatment from a health care provider. For further information, please refer to KKM website. 
Supervised by Ms Nur Hidayah Hamzah (Rph 9530)
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