What are the Categories of Medications?

Medications are grouped into specific categories based on their safety, how they are accessed, and how they are regulated. These categories help ensure medicines are used correctly and prevent any harm. Each type of medication, from everyday painkillers to highly regulated drugs, has a clear purpose and rules around its use. This guide explains the main categories of medications and what makes them different.

Prescription drugs and over-the-counter options are terms many people know. But there are more categories to consider. Each has specific purposes and rules around its use.

Prescription-Only Medicines (POM)

Prescription-Only Medicines (POMs) can only be prescribed by a qualified healthcare professional. Typically, doctors, dentists, and certain specialist nurses or pharmacists can provide prescriptions.

Examples of healthcare professionals authorised to prescribe these medications include:

• General practitioners (GPs)
• Hospital doctors
• Specialist nurses (with appropriate training)
• Pharmacist prescribers

POMs are not available for people to buy directly. They treat conditions that require medical supervision. This is because these medicines may have serious side effects, need specialist administration, or require a diagnosis for safe use.

Examples of Prescription-Only Medicines include:

• Antibiotics (to treat bacterial infections)
• Blood pressure medications like beta blockers
• Strong painkillers such as morphine
• Antidepressants to treat mental health conditions

The tight regulation of POMs ensures they are used correctly for the right patients in the right situations.

Pharmacy Medicines (P)

Pharmacy Medicines (P) can be purchased without a prescription, but only from a pharmacy. A pharmacist or trained member of staff must assess whether it is safe for a person to take the medication.

Pharmacy Medicines often treat less serious conditions like minor pains, allergies, or cold symptoms. The involvement of the pharmacist ensures that the medication is taken correctly, minimising risks.

Common examples of Pharmacy Medicines include:

• Low-strength painkillers like ibuprofen for mild pain
• Antihistamines for hay fever or allergies
• Emergency contraception (morning-after pill)
• Cough syrups or decongestant tablets

Buying Pharmacy Medicines requires dialogue with the pharmacy team. They may ask questions about symptoms, other medications, or the patient’s health conditions. This helps to prevent interactions or misuse.

General Sales List Medicines (GSL)

General Sales List Medicines (GSL) are the least restricted category. They are safe enough to be sold without pharmacist supervision. These medicines can be purchased in supermarkets, convenience stores, or online.

GSL medicines are used to treat mild conditions that do not require professional input. They come in small, safe doses with clear instructions, making them suitable for self-care.

Examples of General Sales List Medicines include:

• Paracetamol or aspirin (small pack sizes)
• Cough lozenges
• Simple antacids for heartburn
• Laxatives for occasional constipation

Even though these medicines are widely accessible, people must still take care to follow the instructions provided on the packaging. Misusing GSL medicines can have health consequences.

Controlled Drugs (CD)

Controlled Drugs (CDs) have stricter rules because they can be misused, addictive, or lead to harm if wrongly used. These drugs are regulated under the Misuse of Drugs Regulations 2001. Healthcare professionals hold additional responsibilities when prescribing, dispensing, and storing Controlled Drugs.

Examples of Controlled Drugs include:

• Strong opioids like codeine, morphine, or fentanyl
• Some benzodiazepines (for anxiety or insomnia)
• Amphetamines (like those used for ADHD or narcolepsy)

Extra measures overseeing Controlled Drugs include:

• Restricted prescribing rights (only some doctors and specialists)
• Careful recording of who has taken the medication
• Secure storage in pharmacies and healthcare centres

Patients prescribed Controlled Drugs may receive smaller quantities to reduce the risk of misuse. These medications are vital to treating severe pain or managing specific conditions, but they come with added safeguards.

Specialist-Only Medications

Some drugs are classified as Specialist-Only Medications. This means they are prescribed and administered only under the care of a specialist doctor or hospital team. These medicines often have complex treatment protocols, requiring expert supervision.

Examples of Specialist-Only Medications include:

• Certain cancer treatments like chemotherapy drugs
• Medications for rare conditions
• Some immunosuppressants for transplant patients

Specialist-Only Medications involve detailed patient monitoring, sometimes in a hospital setting. This ensures safety and correct dosing.

Unlicensed Medicines

Unlicensed medicines are those that do not have a product licence for use in the UK. A healthcare professional may prescribe an unlicensed medicine if they believe it is the best option for the patient. This is typically done when no licensed alternative is available.

Examples of situations where unlicensed medicines are used include:

• Medicines where research supports their use but licensing has not been processed
• Treating conditions in children when no suitable paediatric medicine exists
• Medicines imported for specific rare conditions

Doctors explain clearly why unlicensed medicines are needed. They talk about potential risks and benefits, including how the medicine could help.

Over-the-Counter Variants of Prescription Drugs

There are instances where drugs that are usually only available by prescription may also exist as over-the-counter variants in lower doses or smaller pack sizes. An example of this is ibuprofen. Prescription-strength ibuprofen is a POM, while lower doses are sold as GSL or P with fewer restrictions.

Medicines can sometimes change their classification. For example, a Prescription-Only Medicine might become available as a Pharmacy Medicine if proven safe for wider use.

Borderline Substances

Borderline Substances are medicines or products that treat medical conditions but are not classified strictly as medicines. These include some foods and vitamins used for medical purposes.

Examples include:

• Nutritional supplements for specific illnesses
• Specific foods for those with metabolic disorders
• Infant formulas for cows’ milk protein intolerance

In the UK, the Advisory Committee on Borderline Substances decides these classifications. Borderline Substances are often available on prescription.

Herbal and Homeopathic Medicines

Herbal and homeopathic products are used by some individuals. However, these products fall under separate regulations and do not always follow the same classification as conventional medications.

Herbal medicines are derived from plants. Some are licensed as Traditional Herbal Remedies, which means they meet specific safety requirements. Examples include products containing valerian for sleep or echinacea for cold symptoms.

Homeopathy uses highly diluted substances to trigger healing. Homeopathic products can only be purchased from registered pharmacies or specialists. Their effectiveness is widely debated, and they should not replace essential medical treatment.

Vaccine Medicines

Vaccines are a unique category. They prevent infections by triggering the body’s immune response. Vaccines are Prescription-Only Medicines but can be given at NHS clinics and GPs following guidelines.

Examples of UK vaccines include:

• The flu vaccine (often seasonal)
• COVID-19 vaccines
• Childhood vaccines (such as MMR – measles, mumps, rubella)

Monitoring and reporting any side effects is part of ensuring the continued safety of vaccines.

What Influences the Classification of Medicines?

Several factors influence how medicines are categorised. These include:

• The medicine’s safety profile: Does it have severe side effects?
• The potential for misuse or addiction
• The need for professional guidance on proper use
• The seriousness of the health condition it treats

Regulators like the Medicines and Healthcare Products Regulatory Agency (MHRA) assess medicines before approving their classification. Medicines can move between categories (a process called reclassification), following a detailed review of new evidence.

Conclusion

Medicines in the UK come in distinct categories with different purposes and regulations. This framework protects patient safety and ensures appropriate use of medications. Whether it’s a Prescription-Only Medicine, a General Sales List product, or a Controlled Drug, each type serves its role. Understanding how these categories work helps you make informed decisions about your health and treatment options.

If you have questions about a specific medicine, ask your GP, pharmacist, or healthcare provider. Following their advice ensures safe and effective use of all types of medicines.