Codeine: changes coming into effect on 31 December 2023

There has been an amendment to the Misuse of Drugs Regulations 2001 re Codeine, which will come into force on 31 December 2023.

Amendment of regulation 8

  1. In regulation 8 (compounding of drugs specified in Schedules 2 and 5)1
    (a) in paragraph (8), at the end insert -
“(c) Notwithstanding the provisions of section 4(1)(b) of the Act, a specified registered chiropodist or specified registered podiatrist may, when acting in such capacity, supply or offer to supply the following controlled drugs—

                                  (i)  co-codamol 8/500, 15/500 and 30/500,

                                   (ii)  co-dydramol 10/500, and

                                   (iii)  codeine phosphate.”

(b) after paragraph (8) insert -

“(8A) In paragraph (8)(c) “specified registered chiropodist” and “specified registered podiatrist” mean the registered chiropodists and registered podiatrists specified in paragraph 11 of Part 1 and paragraph 2 of Part 4 of Schedule 17 to the Human Medicines Regulations 2012 (against whose names are recorded in the relevant register annotations signifying that they are qualified to use the medicine specified).”

The changes to legislation are not changing existing practice governed by the written authority. POM-S annotated Podiatrists will continue to be able to supply a maximum of a 3-day supply in accordance with Royal Pharmaceutical Society guidance. Commercial pack sizes are usually 28, 30 or 32 tablets, for co-codamol, co-dydramol, and codeine phosphate, with a 3-day supply usually equating to 24 tablets when taking 8 every 24 hours. Podiatrists are not permitted to split packs; this can only be done by a Pharmacist.

Podiatrists who are POM(S) annotated through the HCPC may:

  • Supply no more than is required for a 3-day course, vis a vis the smallest pack size supplied by the manufacturer / pharmacy, i.e., a pack size of 28.
  • Provide clear instruction to the patient that it is a 3-day course, and that there will be some tabs left over (as they are not packed by the manufacturer as a 3-day course).
  • Recommend the patient return the remaining tabs (i.e. the 'spares' remaining after the 3-day course is completed) back to the pharmacy for safe disposal.


Royal College of Podiatry
8 December 2023


1   Regulation 8(1)(d) was amended by SI 2012/973.