Symptoms
The most-read stories of the year highlight where clinical practice, regulation and professional reform collided.
From sweeping Therapeutic Guidelines updates to unresolved scheduling decisions and award wage reform, these five stories captured pharmacists’ attention and reflected the pressures shaping practice in 2025.
1. Therapeutic Guidelines overhaul UTI treatment
The Therapeutic Guidelines on antibiotics underwent the biggest update in TG history, encompassing 1,400 medicine recommendations to reflect new evidence and rising antimicrobial resistance.
The first stage targeted infections managed in primary care, with one of the most significant shifts made to the management of urinary tract infections (UTIs). Trimethoprim is no longer first-line therapy for uncomplicated cystitis in non-pregnant adults due to resistance in Escherichia coli (E. coli). Instead, nitrofurantoin is now recommended as the preferred first-line option, with fosfomycin and cefalexin listed as alternatives.
This update impacted pharmacists offering UTI treatment services nationwide, particularly in states such as New South Wales – where trimethoprim was previously first-line therapy.
2. Is Rikodeine still being rescheduled?
Last year, the TGA made an interim decision to upschedule dihydrocodeine due to concerns about potential misuse, abuse and dependence. The TGA Delegate’s interim decision was to amend the Pharmacist Only entry for dihydrocodeine to restrict undivided oral liquid preparations to a maximum primary pack size of 100 mL from 1 October 2025.
But the final decision is yet to be published, with a public consultation process causing the delay. In September 2024, the TGA confirmed that final decisions had been deferred while the consultation responses were further considered.
In the meantime, dihydrocodeine scheduling remains unchanged – with pharmacists continuing to field frequent requests for Rikodeine, often from patients without symptoms of dry cough.
3. Hiprex becomes a Pharmacist Only medicine
Methenamine hippurate, sold as Hiprex and Uramet, officially became a Pharmacist Only medicine on 1 October 2025. Previously unscheduled and available as a general sales medicine, the aim of the change was to ensure pharmacist oversight and safer use.
While a Pharmacy Only designation was considered, the TGA concluded this would not prevent inappropriate use among people who have not been medically assessed.
4. What you need to know about the paracetamol regulation changes
From 1 February 2025, paracetamol pack sizes sold in pharmacies changed as part of the TGA’s final decision on paracetamol access controls. Packs containing 50–100 tablets or capsules became Pharmacist Only medicines and general-sale pack sizes reduced from 20 to 16 tablets, among other changes – with the aim of reducing the amount of paracetamol stored in households to prevent harm from intentional overdose.
Each year, around 225 Australians are hospitalised with liver injury due to paracetamol overdose, with the highest rates among adolescents and young adults, particularly females.
Pharmacists should act as ‘champions for the change’, reinforcing safe use and helping to limit surplus paracetamol in homes, said PSA Senior Pharmacist – Strategic Policy, Peter Guthrey MPS at the time.
‘The data on intentional overdose involving paracetamol is alarming … scheduling changes are not the full solution, but are a strategy which could make a positive difference if it changes the patterns of paracetamol supply,’ he said.
5. Fair Work publishes gender undervaluation decision on pharmacist award
In April, the Fair Work Commission’s Expert Panel for pay equity in the care and community sector issued its initial decision on the Gender-based undervaluation – priority awards review, making significant determinations for the Pharmacy Industry Award 2020, under which most community pharmacists are employed.
The Expert Panel found that pharmacists covered by the award have been subject to gender-based undervaluation, with the assessment considering factors such as:
- historical undervaluing
- the exercise of ‘invisible skills’
- caring work
- workforce qualifications.
To address this undervaluation, the Expert Panel determined a total increase of 14.1% to minimum wage rates, implemented over three equal instalments – the first occurring on 30 June this year, with subsequent changes to follow on 30 June 2026 and 30 June 2027.
Pay increases also extend to intern pharmacists. And because penalty rates are calculated as loadings on minimum hourly rates, they also increased accordingly.
But the decision did not automatically result in pay rises for all pharmacists. The award sets minimum remuneration, and those already paid above the new minimums did not receive increases directly from the determination. The Panel noted that 12.7% of pharmacists have their pay set strictly by the award, with the proportion likely higher in community settings.
What else was popular?
The following articles rounded out positions 6-10 in the most-read list in 2025:
- What impact will Wegovy have on the obesity epidemic?
- TGA issues two new safety alerts for GLP-1 RA products
- Goodbye CAL I, hello expanded CAL 18
- Pharmacist-led medicine substitutions now possible (QLD)
- New CAL medicine storage guidance
Next week, AP commences its summer series, highlighting some of the best CPD and articles you may have missed through the year.
