Panadol has made a big change to its packet sizes ahead of new paracetamol rules coming into force next year, but there are concerns over the impact on people living with chronic pain.

Haleon, the manufacturer of Panadol, announced this week new pack sizes will soon appear on shelves across Australia.

This comes after a 2023 Therapeutic Goods Administration (TGA) decision to reduce the the maximum size of packs for paracetamol products sold at retail stores and pharmacies.

The decision was made in an attempt to reduce rates of paracetamol poisonings, which were found to have lead to hundreds of hospitalisations due to liver damage and up to 50 deaths every year in Australia.

National Drug and Alcohol Research Centre Associate Professor Natasa Gisev and postdoctoral research fellow Ria Hopkins told TND that it was important to note paracetamol is one of the most widely used pain medications in Australia, and the number of harmful cases was relatively low given the extent of use in the community.

But the TGA had to balance ongoing access to paracetamol with safety.

“The change to pack sizes is minimal, with packs sold in supermarkets reducing from 20 to 16 tablets, which represents two fewer doses when being used as directed,” Gisev and Hopkins said.

“The important thing for the public to note is that access to paracetamol is not being removed and paracetamol is not being made prescription only.”

From February 1, 2025, new restrictions on paracetamol will:

• Reduce the maximum size of packs available for general sale from retailers like supermarkets and convenience stores from 20 to 16 tablets or capsules
• Reduce the maximum size of packs available in pharmacies without the supervision of a pharmacist from 100 to 50 tablets or capsules
• Make other pack sizes of up to 100 tablets or capsules available only under the supervision of a pharmacist.

Painaustralia CEO Monika Boogs said she was glad the TGA had decided not to go ahead with other considered paracetamol restrictions, such as purchase limits and requiring prescriptions for under-18 purchasers.

Barrier to relief

But the reduced pack size could present an additional barrier to relief for people living with chronic pain who use paracetamol products regularly.

About 3.4 million Australians live with chronic pain, with one in five people aged 45 and over affected by the condition that can make even simple daily activities like washing the dishes a difficult venture.

Boogs said people with chronic pain living in regional or rural areas had less access to supermarkets and pharmacies and would be particularly affected by smaller paracetamol pack sizes.

She said they could face judgement for having to buy more packs to meet their usual needs.

“They have to travel long distances, it’s not like they just have a corner shop,” Boogs said.

“They could face questions when they are [buying extra packs] … and that just adds a bit more to the stress and the stigma that they already often do feel when they have chronic pain.”

It is also unclear how pack size changes will affect shelf prices.

Haleon told TND the manufacturer had worked hard to absorb “as much of the cost as possible” involved in the changes to pack sizes.

“In packs where the number of tablets has decreased, Haleon has recommended to its retailers that the retail price be reduced,” Haleon said.

“Ultimately, the price at which Panadol is sold to consumers is set by the retailer.”

A YouGov survey commissioned by Haleon this year found 72 per cent of Australians said paracetamol was their first choice for pain relief when treating and managing everyday pain.