A patient presents a prescription from France for co-codamol 30/500 mg tablets in English. What is the most appropriate course of action?

• A. Refuse because from another country
• B. Supply the prescription and counsel the patient
• C. Quote that it's illegal
• D. Refer to UK prescriber

Answer: (B)

When a patient presents a prescription from another country, the pharmacist should treat it as valid for dispensing a medicine in the UK if it is legitimate, in English (or appropriately translated), and for a medicine that can be legally supplied here. Co-codamol contains codeine, so it requires a prescription; a French prescription written in English can be dispensed provided it includes the needed details and the prescriber is reputable.

In this scenario, dispensing the medicine with thorough counseling is appropriate. Check the prescription for essential details (patient name, prescriber details, date, dose, quantity), confirm there are no red flags about authenticity, and verify that the medicine is suitable for the patient (consider allergies, other medicines, liver function, and potential interactions). Then counsel on safe use: how to take the tablets, the maximum daily amounts for paracetamol and for codeine in combination products, potential side effects like drowsiness or constipation, risks of dependency with codeine, the importance of not exceeding total daily paracetamol intake from all sources, avoiding alcohol, driving precautions if sedated, and when to seek medical help.

If any doubt about the prescription’s validity or details arises, you would seek clarification or contact the prescriber. But simply having a valid foreign prescription written in English for a UK-allowable medicine is not in itself a reason to refuse; the best action is to supply with appropriate patient counseling.