Day and Night Nurse is popular over the counter medication used for the management of cold and flu symptoms. In the last couple of months both Day and Night Nurse have been out of stock. European Medication Agency (EMA) recommended the withdrawal of pholcodine and pholcodine-containing products from the market putting a question mark on the future of Day Nurse availability. Is Day and Night Nurse discontinued as a result? In 2023 Night Nurse came back in stock, however pholcodine-containing products remained withdrawn from the market. Some pholcodine alternative medicines will also be summarised in this post.
Table of Contents
Day and Nurse range and active ingredients
Day and Night Nurse range consists of Day Nurse capsules or liquid and Night Nurse capsules and liquid.
Active ingredients found in Day Nurse:
- Paracetamol
- Pseudoephedrine Hydrochloride
PholcodineActive ingredients found in Nigh Nurse:
- Dextromethorphan hydrobromide
- Paracetamol
- Promethazine hydrochloride
Day and Night nurse is available as a combination pack containing Day and Night capsules and separate products Day Nurse capsules and liquid and Night Nurse capsules and liquid.
Is Day and Night Nurse discontinued?
One of the active ingredients found in Day Nurse is pholcodine. Pholcodine is a drug used in the management of dry coughs (non-productive), commonly associated with episodes of cold and flu in adults and children.
In December 2022, European Medicines Agency (EMA) revoked marketing authorisation for pholcodine with the recommended withdrawal of pholcodine-containing products.
Additionally, EMA recommended the following:
- Pholcodine should not be prescribed or dispensed by healthcare professionals
- Patients should be advised to stop using pholcodine
- Patients who have general anaesthesia with NMBAs PLANNED should be asked whether they used pholcodine or pholcodine-containing products.
Why was pholcodine discontinued?
EMA’s decision on the withdrawal of pholcodine was based on post-marketing information and safety data (ALPHO study). It was found that the use of pholcodine in the 12 months before general anaesthesia with neuromuscular blocking agents (NMBA) increases the risk of developing a sudden anaphylactic reaction which can be a life-threatening reaction.
What about the UK?
Medicines and Healthcare products Regulatory Agency (MHRA) is performing its own investigation regarding the possible use of pholcodine and the risk of severe allergic reactions when NMBAs are used in general anaesthesia.
Is Night Nurse discontinued?
GSK, the marketing authorisation holder for Day and Night Nurse range has not issued any statements since EMA recommended the withdrawal of pholcodine and pholcodine-containing products from the European market. As of today no official statement on the possible discontinuation of Day or Night Nurse was issued.
Night Nurse does not contain pholcodine, however, there have been ongoing supply issues with Night Nurse since before Christmas 22′. One possible explanation is ongoing supply issues with one of the active ingredients found in Nigh Nurse, dextromethorphan hydrobromide. Other over the counter products containing dextromethorphan, for example, Benylin Dry Cough Syrup have been out of stock for a few months (resolved now).
Supply problems of cough syrups are part of the national shortage of cold medicines in the UK.
Is Day and Night Nurse discontinued – what next?
Day and Night Nurse is a well-recognised brand of cold and flu medicines. Day and Night Nurse have not been discontinued. Possible supply problems with Day Nurse may be explained with the ongoing investigation by MHRA into possible risks described in the previous paragraphs.
Night Nurse came back to stock in 2023, and there have not been any supply problems with this product. Day Nurse however did not.
Are there any Day and Night alternative medicines?
Some pharmacies, noticeably Boots Pharmacy sell their own brands of Day and Night Cold and Flu relief medicines. Boots Day Cold and Flu Relief Oral Solution and Boots Night Cold and Flu Relief Oral Solution, for example, contain the same active ingredients which are found in Day and Night Nurse.
Plenty of other cough and cold medicines contain a similar combination of active ingredients, and many of them are currently out of stock. A detailed review of Day and Night Nurse alternative medicines will follow. Speak to the pharmacist about the best Day Nurse alternative medicine for cough and cold symptoms.
At the moment it is not possible to find pholcodine-containing cough and cold products.
Pholcodeine alternative
Pholcodine is an opioid cough suppressant used to treat dry cough. If you’re looking for alternatives to pholcodine for cough relief, there are several options you can consider:
1. Dextromethorphan: Like pholcodine, DXM is a cough suppressant used in many over-the-counter cough medicines. It’s effective for reducing cough caused by minor throat and bronchial irritation.
Dextromethorphan is used to control symptoms of dry coughs. dextromethorphan-containing products are usually pharmacy-only medicines, which are kept behind the pharmacy counter, for example, Benylin Dry Cough syrup.
2. Guaifenesin: While not a cough suppressant, guaifenesin is an expectorant that helps loosen and thin mucus in the airways, making it easier to cough up. This can be helpful in managing coughs that produce mucus.
3. Honey and Lemon: A natural remedy, honey can soothe the throat and has some cough-suppressing properties. Lemon can help with congestion. Mixing honey and lemon in hot tea or warm water can be a comforting way to alleviate a cough.
No products found.
4. Steam Inhalation: Breathing in steam, such as from a hot shower or a bowl of hot water, can help loosen mucus and ease coughing.
5. Herbal Remedies: Some herbs like thyme, peppermint, and eucalyptus have properties that can help with coughs. Herbal teas or inhalations can be used.
No products found.
6. Antihistamines and Decongestants: If your cough is related to allergies or a cold, medications like antihistamines and decongestants might help.
References
EMA (2022). EMA recommends withdrawal of pholcodine medicines from EU market. Available at: https://www.ema.europa.eu/en/news/ema-recommends-withdrawal-pholcodine-medicines-eu-market Accessed on 04/02/2023
