Your medicines - useful sources of information


Updated February 2008

The BMA's Public Information Unit is often approached by members of the public seeking information about their medicines and their potential side-effects, in addition to wider questions about prescribing.

The BMA is not a clinical organisation, however, and therefore we are not able to provide medical advice regarding patients' medication.

Patients can, of course, ask their GP or hospital doctor about the medicines they are taking and/or speak with their local pharmacist. They can also ask their GP how the medicines they are taking relate to any test results they have had.

However, for people looking for further advice about their medicines or about prescribing issues, the following resources and organisations should be useful sources of information:

BMA guidance on prescribing in general practice and other reports
In 2004, the BMA's General Practitioners Committee (GPC) prescribing subcommittee, produced guidance to meet the increasing demand from individuals and organisations for information relating to prescribing in general practice. This guidance covers topics such as

- prescription intervals
- travel vaccinations
- the prescribing of unlicensed drugs; and
- entitlement to NHS prescriptions if living abroad.

You can link to the BMA's prescribing guidance here.

In May 2005, the BMA's Board of Science published a report on over-the-counter (OTC) medication. This report analyses current trends in the use of OTC medicines and, although it is intended primarily for health professionals, it may also be of interest to patients.

Our Board of Science also published a guide for healthcare professionals on reporting adverse drug reactions in May 2006.


General Medical Council - guidance for doctors on prescribing medicines
The General Medical Council (GMC), the doctors' regulatory body, has updated its guidance for doctors on good prescribing in Good Practice in Prescribing Medicines (2006).

This guidance for doctors covers a wide range of prescribing-related issues, including:

  • basic principles of prescribing
  • keeping up to date and prescribing in patients' best interests
  • prescribing unlicensed medicines
  • prescribing medicines for use outside the terms of their licence (known as off-label prescribing)
  • responsibility for prescribing medicines for hospital outpatients
  • repeat prescribing
  • remote prescribing via telephone, email, fax, video link or a website
  • prescribing anti-obesity medicines

The Medicines and Healthcare products Regulatory Agency (MHRA) is an agency of the Department of Health which is responsible for ensuring that medicines and medical devices meet appropriate safety and performance standards.

The agency licenses all medicines for use in the UK. Once a new drug has received a licence from the MHRA, it is normally referred to the National Institute for Health and Clinical Excellence (NICE) - see below - which will decide whether, and how, this drug should be used within the NHS.

There is information on the MHRA website about how they regulate the use of medicines in the UK. Information covers a wide range of issues, including:
  • the licensing of medicines
  • medicines for children
  • herbal and homeopathic medicines
  • ensuring the quality of medicines
  • the import and export of medicines
  • labels, patient information leaflets and packaging; and
  • medicines advertising
The MHRA's website has a complete A-Z of the hundreds of the subjects it covers, including the advertising of medicines; buying medicines over the internet; herbal medicines safety information; nurse and pharmacist independent prescribing; paracetamol overdose; and testing kits (the A-Z also covers MHRA guidance on medical devices).

In September 2006, the MHRA introduced a new scheme aimed at improving and strengthening the regulation of homeopathic medicines in the UK (covered by either Product Licences of Right (PLRs) for existing homeopathic medicines, or certificates of registration introduced under the Simplified Registration Scheme in 1992).

Under the new National Rules Scheme introduced in 2006, companies are encouraged to register new homeopathic medicines, with the option of re-registering some existing products. For the first time, companies are allowed to include information for patients about products used for the treatment and relief of minor, self-limiting conditions - those that can ordinarily be relieved or treated without the supervision or intervention of a doctor - based on the use of the product within the homeopathic tradition.

All applications under the National Rules Scheme must be accompanied by supporting data on the quality, safety and efficacy of the homeopathic treatment concerned, together with product literature and information about product labelling.

There is information about the new regulations applying to homeopathic medicines on the MHRA website.

For further information you can call the MHRA's Central Enquiry Point on Tel: 020 7084 2000 (weekdays 9am-5pm) or Tel: 020 7210 3000 (other times).

The MHRA's website also provides information about the safety of medicines, including safety warnings, alerts and recalls, and general safety information and advice.

Patients can now report adverse reactions to their medication directly to the MHRA via the Yellow Card website. The Yellow Card Scheme is run by the MHRA, and is used to collect information from health professionals and patients on suspected adverse drug reactions (ADRs) to prescription medicines, herbal remedies and over-the-counter (OTC) medicines.

The British National Formulary (BNF) (a joint publication of the British Medical Association and the Royal Pharmaceutical Society) aims to provide doctors, pharmacists and other healthcare professionals with sound up-to-date information about the use of medicines and any potential side-effects or interactions with other medicines.

The BNF describes each type of medication in terms of:

indications: the condition for which the medication in question should normally be used
cautions: health conditions in which use of the drug in question should be used only with caution
contraindications: any condition which renders the suggested treatment improper or undesirable
side-effects: unwanted effects which may result from the treatment.

The BNF is published twice a year and the most recent edition, BNF 54, was published in September 2007. It has an online Frequently Asked Questions section.

A new version of the BNF specifically for children, BNFC, was launched in September 2005. It is a joint publication of the British Medical Association, the Royal Pharmaceutical Society of Great Britain, the Royal College of Paediatrics and Child Health, and the Neonatal and Paediatric Pharmacists Group.

BNFC is the first comprehensive information resource for doctors, pharmacists, nurses and other healthcare professionals on the medicines used to treat children. It should also be of interest to parents. The guide covers medicines used in treating children aged from 0 to 18, and gives a range of guidance, from choosing the best available drug to specific doses and formulations - information that doctors used to have to find from multiple sources.

The third edition of the BNFC (BNFC 2007) was published in July 2007 and further updated editions are planned every year. In addition, the full contents of the BNFC are available online.

There is also a Nurse Prescribers' Formulary, published by the British Medical Association and the Royal Pharmaceutical Society, in association with the Community Practitioners' and Health Visitors' Association and the Royal College of Nursing. This booklet is designed to assist district and community nurses, who have received the appropriate training, to prescribe for their patients.

Nurses have, in fact, been able to prescribe from a limited formulary of medicines for over 10 years. However, since 1 May 2006, appropriately trained Nurse Independent Prescribers (formerly known as Extended Formulary Nurse Prescribers) have been able to prescribe licensed medicines for any medical condition within their competence, including some Controlled Drugs. There is a Frequently Asked Questions section on Nurse Prescribing on the Department of Health (DH) website.

Regulations to allow independent prescribing by pharmacists also came into effect in May 2006. The Royal Pharmaceutical Society of Great Britain provides information about pharmacist prescribing on its website.

There is further information about non-medical prescribing on the DH website; this allows nurses, pharmacists and optometrists to prescribe medicines within the limits of their clinical competence.


The electronic Medicines Compendium (eMC) is an online database providing information about prescription and over-the-counter (OTC) medicines. It is produced by Datapharm Communications Ltd, set up as a not-for-profit company by the Association of the British Pharmaceutical Industry (ABPI) in 1977.

Pharmaceutical manufacturers have to submit certain information to the MHRA (see above) before their products can be licensed, including:

  • The Summary of Product Characteristics (SPC): this document describes the properties, effects and warnings about the medicine and is written to guide healthcare professionals in the use of the medicine.
  • The Patient Information Leaflet (PIL): the PIL is the leaflet intended to be read by the patient and is included in the medicines packaging.

Both these documents are available on the eMC website for each licensed medicine (in addition to electronic Data Sheets on each medicine, primarily intended for healthcare professionals). Every year there are many changes to SPCs and PILs, so once the new information has been approved by the MHRA, the information is updated on the eMC. Pharmaceutical companies submit the information directly to the site and are responsible for keeping it up to date. Visitors to the website can search by brand name, generic name or company.


Patient Information Leaflets for the visually impaired
A recently launched website, (X-PIL) has also been developed by eMC to make patient information leaflets (PILs) accessible to the visually impaired. (For the visually impaired, the RNIB Medicines Information Line is also free to use and available 7 days a week, 24 hours a day: Tel 0800 198 5000).


The Royal Pharmaceutical Society of Great Britain (RPSGB) is the regulatory and professional body for pharmacists. It maintains the register of pharmacists and pharmacy premises and members of the public can contact the RPSGB for information about the pharmacy profession. It has also produced a Code of Ethics for pharmacists and pharmacy technicians (available in a pdf format on their website). A revised version of the Code is expected by August 2007, following a fundamental review.

Their website also allows the public to access a wide range of RPSGB publications. The RPSGB's main contact number is: Tel (020) 7735 9141.


Purchasing medicines online and the internet pharmacy logo scheme
  • Purchasing medicines online
The BMA's Public Information Unit is contacted regularly by members of the public, considering the purchase of prescription medicines via the internet, and wishing to check a medicine's status and safety.

As the BMA is not a clinical body, we cannot provide information on particular medicines or treatments, although we are concerned about the potential risks posed to the public by the ungoverned availability of prescription medicines on the internet. Indeed, the BMA would advise patients to exercise caution in purchasing any medicines online, unless they are from a registered pharmacy. The World Health Organisation has estimated that 50% of medicines available from sites which conceal their physical address are counterfeit. (Reference 1).

People who acquire prescription medicines without a consultation with a healthcare professional risk being supplied with medicines that are not safe or suitable for them to use. Those who purchase such drugs will not have the underlying causes of their medical problem diagnosed and treated by a doctor. The public also benefit from the advice of a qualified pharmacist when they collect prescription medicines in person.

The Royal Pharmaceutical Society of Great Britain (RPSGB) considers that buying medicines from websites that are not connected to registered pharmacies can present a number of risks:
  • there is no opportunity for an appropriately qualified health professional to assess whether the medicine is safe and appropriate for a patient to use, or to advise on how the medication should be taken;
  • the safety and quality of medicines sold by unqualified internet suppliers cannot be guaranteed;
  • the medicines may not meet UK standards or may be past their 'sell by date', in which case their effectiveness may be reduced.
The Medicines and Healthcare products Regulatory Agency (MHRA) which regulates the use of medicines and medical equipment in the UK, has produced cautionary guidance on buying medicines on the internet for those patients who still wish to do so.

The MHRA Enforcement Team currently monitors internet sites in the UK, especially those known to be selling prescription-only medicines. The MHRA has taken action against a number of UK websites supplying prescription-only medicines inappropriately and some prosecutions have taken place; it has no control over overseas websites, however, although it does refer dubious websites to the relevant regulatory bodies overseas.

Patients with concerns about a website that is supplying medicines from non-registered pharmacy premises can contact the MHRA at info@mhra.gsi.gov.uk or Tel 020 7084 2000.

The RPSGB also maintains a database that allows the public to search for information on the legal classification of particular medicines.
  • The internet pharmacy logo scheme
If patients do wish to purchase medicines online they should approach a reputable pharmacy. All retail pharmacies in Great Britain, including those providing internet services, must be registered with the Royal Pharmaceutical Society of Great Britain (RPSGB). Those seeking information on the registration status of a particular pharmacy or pharmacist can contact the RPSGB's Registration Division at registration@rpsgb.org, Tel 020 7572 2322.

In January 2008 the RPSGB introduced an internet pharmacy logo scheme to help the public identify health websites linked to registered pharmacies. The logo will be seen on the front page of a participating online pharmacy site to indicate that the website offering to sell medicines, or provide other pharmacy services, is connected to a registered pharmacy. By clicking on the logo, visitors are linked to a page on the RPSGB website where they can check that the internet pharmacy site is, indeed, registered.

The RPSGB’s conditions of use for the internet pharmacy logo require any pharmacy website to clearly display:
  • the name of the owner of the business
  • the address of the pharmacy at which the business is conducted
  • where applicable, the name of the superintendent pharmacist
  • information about how to confirm the registration status of the pharmacy and pharmacist (i.e. by contacting the RPSGB)
  • details of how to make a complaint about the on-line services provided
The Association of the British Pharmaceutical Industry has endorsed the scheme, but stated that retail pharmacies “offer the only truly secure way of ensuring the safe dispensing of prescription medicines”.


The ABPI Code of Practice for the Pharmaceutical Industry was first outlined by the Association of the British Pharmaceutical Industry (ABPI) in 1958; (the ABPI is the trade organisation for the pharmaceutical industry in the UK).

The Code of Practice has been regularly revised since then, in consultation with the British Medical Association (BMA), the Royal Pharmaceutical Society (RPS) and the Medicines and Healthcare products Regulatory Agency (MHRA).

The Code governs the UK-based pharmaceutical industry's relations with healthcare professionals and the information that is made available to the general public about medicines. The aim of the Code is to ensure that "the promotion of medicines to health professionals and to administrative staff is carried out within a robust framework to support high quality patient care". (Reference 2).

Compliance with the Code is obligatory for ABPI member companies; around 50 non-member companies have also agreed to comply, voluntarily, with it.

The Prescription Medicines Code of Practice Authority (PMCPA) was established by the ABPI on 1 January 1993 to ensure that the ABPI Code of Practice for the Pharmaceutical Industry would be properly implemented. The Authority operates a complaints procedure whereby complaints about the promotional material used by pharmaceutical companies can be investigated.

You can access the ABPI Code of Practice for the Pharmaceutical Industry (2006) and information about the PMCPA, including a leaflet about the PMCPA, here.


The Proprietary Association of Great Britain represents the manufacturers of over-the-counter medicines and food supplements in the United Kingdom. It maintains a website which includes a searchable directory of medicines and food supplements that are available 'over the counter' from pharmacists. Goods can be searched for by brand and product name, or by entering symptoms.


The National Institute for Health and Clinical Excellence (NICE) is an independent organisation, responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health in England and Wales.

It provides patients, health professionals and the public with clinical guidance on current best practice. It looks at individual health technologies (including medicines, medical devices, diagnostic techniques and procedures) and at the clinical management of different medical conditions.

The NICE website provides guidance on the treatment of a wide range of conditions, such as cardiovascular disease, eye conditions and cancer; this includes advice on the medicines that health professionals should prescribe for patients.

Clinical guidance for the NHS in Scotland is developed separately by NHS Quality Improvement Scotland, which acts as an umbrella body for several organisations, including the Scottish Medicines Consortium (SMC). The SMC advises on the clinical effectiveness and cost effectiveness of all newly licensed medicines.

The Scottish Intercollegiate Guidelines Network (SIGN) also produces guidelines for health professionals and patients about the best clinical tests and treatments that are available in Scotland.


The Medicines Partnership is an initiative supported by the Department of Health, aimed at helping patients to get the most out of the medicines they take by involving them as partners in decisions about their treatment and supporting them in medicine-taking.

The Medicines Partnership Programme is now part of the National Prescribing Centre (NPC) Plus. The Partnership has published several useful booklets, including 'A question of choice: compliance in medicines taking' and 'Focus on your medicines' - a booklet to help patients prepare for their medication review in primary care.

It has also developed resources to help people with learning disabilities to understand and make informed choices about the medicines they are taking.
The DH website also provides comprehensive information about prescriptions and prescribing policy.


Ask About Medicines Week (AAMW) is a national initiative aimed at helping people to understand more about the medicines they take and to make the most appropriate use of them. It also aims to encourage health professionals to support patients in asking questions about their medication.

AAMW originally came about as a result of a collaboration between the Task Force on Medicines Partnership, the Promoting Excellence in Consumer Medicines Information Working Group and Developing Patient Partnerships. It now also works with a wide range of other bodies, including health professionals, government, industry and voluntary sector patient organisations.

AAMW's website provides the public and patients with access to sources of reliable medicines information, including the directory Finding and Using Information about Health and Medicines (3rd edition 2007).


The Department of Transport has produced advice for drivers on over-the-counter medicines and their potential for creating unwanted sleepiness while driving.



References

1. World Health Organisation Fact sheet No 275 ( 2006) Counterfeit Medicines. Available at: http://www.who.int/mediacentre/factsheets/fs275/en/

2. Prescription Medicines Code of Practice Authority website. Available at http://www.pmcpa.org.uk/?q=codeofpractice

© British Medical Association 2008

Log in to your BMA here