Pharmacy

We provide medicines and medicines information to patients, carers and other healthcare professionals in a timely manner.

Pharmacy is dedicated to providing quality use of medicines via the following services:

  • Outpatient pharmacy service.
  • Medicines information including: medicine specific genetic counselling and publications.
  • In-patient and clinical pharmacy service.
  • Quality use of medicines including adverse drug reaction reporting and antimicrobial stewardship.
  • Research, teaching and clinical trials services.

 

Pharmacy Outpatient Services

The outpatient pharmacy is located on the lower ground floor of the main hospital, most accessible from Hensman Road. The Pharmacy is open from 8:30am to 5pm Monday to Friday.

 

Medication during my hospital stay

It is important for your medical team to know exactly what medicines you are taking in case they interact with medicines used in hospital.

Pharmacy can provide written information to patients, such as consumer medicine information leaflets and discharge medicines lists.

If you have any concerns or have experienced any unexpected or troublesome side effects from your medicines, let your pharmacist, nurse or doctor know.

If you require any medicines on discharge, you will receive a prescription and can purchase your medication at the hospital pharmacy or your local community pharmacy. Your ward pharmacist will be able to discuss your medicines in more detail as part of your hospital discharge.

 

What to bring

  • Your medications.
  • Your Medicare card.
  • Your Health Care Card, Pension card or safety net card (if you have one).

 

Cost of Medications

You will be charged a contribution fee for all medicines that are dispensed from our pharmacy at discharge or as an outpatient. The amount of the patient contribution fee is determined by commonwealth and state regulations and adjusted every year on 1st January in line with the consumer price index (CPI).

If you choose to get your medications from the hospital, you will get a payment advice which you can pay on the day of discharge with cash, EFTPOS, MasterCard, Visa or cheque or an invoice will be posted to your home.

If you believe you may experience difficulty in paying for your prescribed discharge medications please talk to your nurse, midwife, doctor or the KEMH Social Work department during your stay in hospital.

 

Cashier

Opening hours: 8:45am to 4:45pm, Monday to Friday (closed weekends and public holidays).

 

Lady talking on the phone

Medicine Information line

The Obstetric Medicines Information Service at WNHS provides mothers, families and health professionals information about the safe use of medicines during pregnancy and when breastfeeding.

The Medication Safety Line is available on (08) 6458 2723 and provides information to women anywhere across Western Australia between 8.30am and 5.00pm Monday to Friday. Women, unsure of the effects of medication either prescribed or over the counter, can call to receive reassurance from qualified Pharmacists.

Often uncertain about the safety of taking medications during pregnancy and breastfeeding, the line provides an enormously valuable resource for WA Women.

Medicines information in pregnancy and breastfeeding - helpline (PDF)

Medicines and Breastfeeding

The importance of breastfeeding is well recognised with benefits for both the mother and infant. Breast milk provides babies with unique nutrients that are ideal for their immune protection, growth and development.

Many breastfeeding mothers need to be treated with medicines, either for a chronic illness requiring ongoing therapy or for an acute illness requiring only a few days therapy. Some mothers stop breastfeeding while taking medications to treat these conditions because of unfounded concern or inappropriate advice.

It is widely accepted that medications transfer into human milk to some degree, although the amount is generally quite low and this is why most medicines are considered safe to take while breastfeeding. Only rarely does the amount transferred into breastmilk produce clinically relevant doses in the infant.

The safety of breastfeeding while a mother is taking a medication may be assessed by weighing the risks of potential adverse effects in the baby, against the benefits of the medicine for the mother and the benefits of breastfeeding for the baby and mother.

 

Minimising Transfer of medications into Breastmilk

  • Avoid using medicines unless they are necessary.
  • Your doctor will prescribe the lowest dose for your condition.
  • Think of ways to choose a dose that reduces how much is passed into breastmilk e.g. use a decongestant nasal spray rather than an oral decongestant.
  • To reduce the amount of medicine in the breastmilk, time your feed eg. taking a dose immediately after a feed, or before baby’s longest sleep period.

 

Important information

When taking any medicine, watch for signs of possible side effects in your baby such as increased sleepiness, poor feeding, rash and severe diarrhoea.

If these are troublesome and continued, contact your doctor

Always ask your Pharmacist what is in a medicine and tell them you are breastfeeding.

 

Commonly used Medications

Aches and pain - Analgesics

  • Non-steroidal anti-inflammatory medicines (NSAIDs) like ibuprofen or diclofenac have low transfer to breast milk and are considered safe to use to relieve pain and inflammation.
  • Paracetamol can be used safely during breastfeeding to treat mild pain or reduce fever.
  • Low doses of aspirin, less than 150mg daily, are considered safe to take. Larger doses should be avoided as they may be harmful to your breastfed infant.
  • Medications containing codeine
    Medications containing codeine are no longer recommended for pain relief in breastfeeding mothers.
    Codeine metabolises to morphine in the body and a small number of people produce higher than expected morphine levels in their blood resulting in an increased risk of transfer to the infant via the breastmilk. Alternative pain control medicines as mentioned above are recommended.

 

Cold and Flu

Body aches and pain – see above (analgesics)

Nasal symptoms

  • Steams inhalations and saline (sodium chloride) nasal spray may be used to relieve a blocked nose while breastfeeding.
  • Decongestant nasal sprays (oxymetazoline, xylometazoline) may be used for 3 to 5 days.
  • Avoid oral preparations containing pseudoephedrine as it may reduce milk production or cause irritability in a breastfed baby.

Cough

  • A cough is usually self-limiting. If treatment is required, use guaifenesin, bromhexine or senega and ammonia mixture for a chesty cough.
  • A cough suppressant like pholcodine or dextromethorphan is considered safe for a dry cough. Avoid combination preparations containing pseudoephedrine and phenylephrine – always ask your pharmacist what is in a medicine.

Sore throat

  • Lozenges or throat gargles containing local anaesthetic, antibacterial agents or benzydamine may be used while breastfeeding.
  • Avoid products containing povidone-iodine (e.g. Betadine®) as it may affect the thyroid function of your baby.

 

Allergies and hayfever - Antihistamines

  • Non-drowsy antihistamines such as loratadine, desloratadine and fexofenadine are present in very small amounts in breastmilk and are considered safe to use whilst breastfeeding. Drowsy antihistamines such as cetirizine, dexchlorpheniramine or diphenhydramine may make your baby drowsy, so less sedating antihistamines are preferred.
  • Nasal sprays containing beclomethasone, fluticasone or budesonide may be used while breastfeeding. Topical eyedrops for allergies and hayfever may be used as the amount transferred into breastmilk is low. Eye drops containing antazoline and naphazoline are considered safe to use.

 

Anti-infectives

Which antibiotics are safe?

Most antibiotics transfer into breastmilk, but the amount ingested by an infant is unlikely to cause serious harmful effects. However some antibiotics can cause changes in gut bacteria and infants should be observed for adverse effects such as diarrhoea, vomiting, skin rashes or thrush.

Penicillin antibiotics (including amoxicillin, amoxicillin with clavulanate and flucloxacillin), cefalexin, erythromycin and azithromycin are considered safe. Metronidazole is considered safe in doses up to 400mg three times a day, although it may give the milk a bitter taste.

What can I use to treat worm infections?

Both pyrantel and mebendazole are considered safe as they are poorly absorbed from the gut and are unlikely to be passed into breast milk in clinically relevant amounts.

What can I use for vaginal thrush?

Topical antifungal cream and pessaries containing clotrimazole, miconazole and nystatin are safe to use while breastfeeding.

A single dose of oral fluconazole is considered safe to use whilst breastfeeding.

What can be used to treat cold sores?

Ice is a recommended treatment which can be applied to the affected area.

Antiviral medicines such as aciclovir cream can be used in breastfeeding, and if the cold sores are severe an oral course of aciclovir or valaciclovir from your doctor would be considered safe to use whilst breastfeeding. These options are preferred to famciclovir which has no published data on how much enters breastmilk.

 

Head Lice

Non-insecticidal treatment ─ 10 Days Hair Conditioner Method: Apply plenty of hair conditioner to the dry hair until saturated, use ordinary comb to remove tangles, then use metal fine tooth nit comb in 4 directions (forward, backward, left and right). Remove lice from comb. Rinse out and dry hair. Repeat every 1 to 2 days over a 10 day treatment period.

Insecticidal treatment – Permethrin, Dimeticone or pyrethrin / piperonyl butoxide can also be used if needed. Treatment should be repeated in 7 days to kill lice that have hatched.

 

Flu vaccine

Breastfeeding mothers may continue to breastfeed after immunisation with flu (influenza) vaccine.

 

Antidepressants

Some antidepressants are considered compatible with breastfeeding. Talk to your doctor or pharmacist to discuss your options and for further advice.

 

Herbal preparations

There is very little information available on the distribution of herbal preparations into breast milk, or their effects on lactation. Care should be exercised with their use. Talk to your doctor or pharmacist to discuss your options and for further advice.

 

Oral contraceptives

The progesterone-only “minipill” is the preferred oral contraceptive for breastfeeding women as transfer to milk is minimal and lactation is not affected.

The combined estrogen-progesterone pill may decrease the quantity and alter the composition of breastmilk. It may be considered after 6 weeks if breastfeeding is well established.

Last Updated: 17/12/2021