Hospital Pharmacists: what they are doing now
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
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[post_content] => PSA’s newest State Manager shares her vision for a more connected profession and broader pharmacist-led care.
When Divya Lal stepped into the role of PSA New South Wales State Manager last month, she did so with a clear sense of purpose. Just weeks into the role, she brought together leading health figures, including NSW Chief Health Officer Dr Kerry Chant, NSW Minister for Health Ryan Park and PSA CEO Bridget Totterman, alongside new and emerging pharmacy leaders at the PSA in NSW Parliament 2026 breakfast – held at NSW Parliament on 27 May.
‘It’s about collaboration to strengthen the NSW healthcare system, caring for our communities, and capability – utilising pharmacists to their full capabilities,’ she told the room.
With experience spanning community pharmacy, pharmacy ownership, business development, and professional services, Ms Lal has spent her career at the intersection of clinical practice and system-level thinking – with a clear focus on mentoring the next generation of pharmacists.
[caption id="attachment_32327" align="aligncenter" width="379"]
A pop-up pharmacy clinic offering screening services after breakfast[/caption]
‘A strong connection to the profession begins in the first year of university and continues throughout a pharmacist’s career,’ she said. ‘By creating more opportunities for students, interns, and early career pharmacists to engage with experienced pharmacists, we can build confidence, strengthen professional networks, and inspire the next generation of leaders within the profession.’
It's a philosophy that reflects both her personal journey and her vision for the future of the pharmacy profession in her new role with PSA.
‘I am proud to advocate on behalf of more than 11,500 pharmacists across NSW, particularly as we continue to expand opportunities for pharmacists and contribute to improved patient care,’ Ms Lal told AP.
‘I want our members to feel supported, connected, and represented. I am here to listen and I hope to meet as many pharmacists as possible.’
Building bridges
The parliamentary event served as Ms Lal’s opening statement as PSA NSW State Manager. Bringing together parliamentarians from both sides of the chamber, NSW Health figures, and PSA and pharmacy leaders – it was designed to build momentum for expanded scope of practice.
After being introduced by Ms Lal, PSA NSW Branch Committee President Luke Kelly made the case for reform by making it personal.
Recovering from a recent knee replacement, Mr Kelly watched nurses quietly withhold his blood pressure medication when his readings dropped too low.
‘It struck me that this is such a sensible thing to do – not bother the surgeon or my GP for such an obvious step,’ he said.
‘This was nurses working within their scope. And it's exactly why PSA is advocating for pharmacists to work within theirs. We are faced with obvious solutions that the current framework doesn't allow us to provide.’
A government listening
In his address, NSW Minister for Health Ryan Park highlighted the government’s view of pharmacists as central to the system's future.
‘We are committed to continuing to expand the role and scope of practice that pharmacists play,’ Minister Park said. ‘We need to make healthcare more accessible to the community, and that means looking at the way we take pressure off the system and use our skilled professionals across a range of healthcare professions.’
Pointing to the success of recent reforms – including the roll-out of oral contraceptive continuation, UTI treatment and skin infection services – he also took the opportunity to announce the expansion of the new intranasal influenza vaccine, FluMist, to children aged 2–17.
‘This is all about trying to make healthcare as accessible and as affordable as we can, but also to prepare our community for what could be a very challenging winter – and you are at the front line of that,’ Minister Park told attendees.
He also acknowledged the particular importance of pharmacists in regional, rural, and remote communities, where the ‘tyranny of distance’ means pharmacists often need to fill healthcare gaps.
‘Those rural and regional and remote members here today – thank you,’ Minister Park said. ‘Because you do an enormous amount of lifting, often more than what your city counterparts have to work through.’
He also spoke to the next generation, referencing conversations with young pharmacists across the state who are eager to put their full training to use.
‘They're highly trained, highly skilled individuals, and we as a government need to be looking at ways in which we can provide them, in a safe and evidence-based way, with the opportunity to continue to develop their careers.’
What’s next for scope of practice?
For Ms Lal, the breakfast event was a starting point in the push to expand what pharmacists can do.
‘There is a growing need for NSW to progress towards broader scope of practice models, including the management of additional acute conditions, expanded chronic disease management services, preventive healthcare initiatives, and the removal of unnecessary barriers to pharmacist-led vaccination services,’ she said.
Rather than a turf war, she sees this as a rebalancing of the healthcare system in favour of patients.
‘Scope expansion is not about replacing other healthcare professionals. It is about ensuring patients receive timely care from the most appropriate clinician,’ she said.
‘As highly trained medicines experts and one of the most accessible healthcare professionals, pharmacists are well positioned to improve access to care, reduce treatment delay, and contribute to better health outcomes.’
She is also focused on connecting the diverse sectors of pharmacy – hospital, general practice, community, industry, prescribing, academia and compounding, among others – in ways that allow pharmacists to move between roles and continue growing throughout their careers.
‘As our industry changes and new roles emerge, I see it as a responsibility to connect the different parts of pharmacy together,’ Ms Lal said. ‘Whether a pharmacist is seeking to expand their scope of practice, transition into a new area, or pursue leadership opportunities, PSA can play a pivotal role in supporting that journey.’
[post_title] => What does the future of pharmacy look like in NSW?
[post_excerpt] => At a recent event with NSW Health, PSA’s newest State Manager shared her vision for a more connected profession and expanded pharmacist care.
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[post_content] => The Fair Work Ombudsman has published the updated pay guide for the Pharmacy Industry Award 2020, with new rates taking effect from the first full pay period on or after 30 June 2026.
CORRECTION: This article has been updated. An earlier version of this article incorrectly stated that the new pay rates included increments for both the pay equity correction and the Annual Wage Review, when in fact, this rate only contained the pay equity correction.
The Pharmacy Industry Award rates, which will include the 4.75% Annual Wage Review increment, will be in effect for pay cycles commencing on or after 1 July 2026. Please note, these rates have not yet been published.
The article also incorrectly compared the pay rates to the Pharmacy Industry Award, which was in effect for pay cycles commencing on or after 30 June 2025, rather than the current rates effective on or after 1 July 2025, this has now been corrected
Australian Pharmacist apologises for this error and any confusion it may have caused.
The updated guide applies the second instalment of a 3-year gender undervaluation correction. However, it does not include the Annual Wage Review Increment, which will commence for pay cycles which commence on or after 1 July 2026.
What are the new hourly rates?
The base hourly rate for a pharmacist on the award for pay cycles starting on or after 30 June 2026 will rise from $38.14 to $39.85.
[table id=34 /]
*Pharmacy Industry Award 2020 [MA000012] – Fair Work Ombudsman effective 1 July 2025
Pharmacy interns also benefit from the gender disparity increment increase, with first-half-of-training interns moving from $31.05/hr to $32.44/hr, and second-half interns from $32.11/hr to $33.55/hr.
For pharmacists working beyond standard Monday–Friday hours, the following changes apply.
Entry level pharmacist:
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $47.68 | $49.81 | +$2.13 |
| Saturday (8am–6pm) | $47.68 | $49.81 | +$2.13 |
| Sunday (7am–9pm) | $57.21 | $59.78 | +$2.57 |
| Public holiday | $85.82 | $89.66 | +$3.84 |
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $53.45 | $55.85 | +$2.40 |
| Saturday (8am–6pm) | $53.45 | $55.85 | +$2.40 |
| Sunday (7am–9pm) | $64.14 | $67.02 | +$2.88 |
| Public holiday | $96.21 | $100.53 | +$4.32 |
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[post_content] => Many complementary medicines beginning with ‘G’ have been associated with a risk of bleeding that pharmacists should know.
The culprits
A few come to mind. Ginkgo biloba contains ginkgolide B, which inhibits platelet-activating factor in vitro. In case reports, ginkgo has been associated with prolonged bleeding time.1,2
[caption id="attachment_32004" align="alignright" width="200"]
Claire Antrobus FPS[/caption]
Garlic has been linked to decreased platelet aggregation and spontaneous bleeding; but a placebo-controlled study reported no change in INR with concomitant warfarin use.2
Ginger can inhibit platelet aggregation in vitro. A case report describes increased INR when ginger was combined with warfarin. However, controlled studies show no effect on warfarin pharmacokinetics or pharmacodynamics at recommended doses.1,2 Case reports have also shown increased INR in patients taking warfarin who started taking glucosamine.1,2 Panax ginseng contains antiplatelet components shown to inhibit platelet aggregation and thromboxane formation in vitro. Evidence on interactions with warfarin is conflicting.1,2 Goldenseal contains the alkaloid berberine, reported in in vitro and animal studies to inhibit platelet aggregation and increase bleeding risk.1
When risks stack up
While individual products might carry a modest bleeding risk at standard doses, the risk may increase when patients combine supplements, use higher doses or amounts, or use them alongside antiplatelet agents like aspirin or anticoagulants, such as warfarin.
Consider bleeding risk factors, including recent surgery, existing anticoagulation therapy, bleeding disorders or planned procedures.1
Practical recommendations
When dispensing anticoagulants or antiplatelet agents, use a non-judgemental approach to directly ask the patient if they are taking any complementary medicines. Asking about complementary medicine use is an important part of medication history taking.1 Document supplement use in the patient’s clinical record. Counsel patients to inform prescribers and surgeons about supplement use at least 2 weeks before elective procedures. Advise patients to watch for nosebleeds or unexplained bruising.1
What the evidence says
The clinical evidence for the bleeding risk of complementary medicines varies. The combination of in vitro data, case reports and individual variation in response supports caution.1,2 The Complementary medicines section of the Australian Pharmaceutical Formulary and Handbook contains useful information about bleeding risks and interactions with anticoagulants and antiplatelet agents for specific complementary medicines.
- Sansom LN, editor. Australian Pharmaceutical Formulary and Handbook. 2026. At: https://apf.psa.org.au
- Preston C, ed. Stockley’s drug interactions. London: Pharmaceutical Press; 2026
[post_title] => The 'G' list: complementary medicines with bleeding risks
[post_excerpt] => Many complementary medicines beginning with ‘G’ have been associated with a risk of bleeding that pharmacists should know.
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[title_attribute] => The ‘G’ list: complementary medicines with bleeding risks
[title] => The ‘G’ list: complementary medicines with bleeding risks
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
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[post_content] => PSA’s newest State Manager shares her vision for a more connected profession and broader pharmacist-led care.
When Divya Lal stepped into the role of PSA New South Wales State Manager last month, she did so with a clear sense of purpose. Just weeks into the role, she brought together leading health figures, including NSW Chief Health Officer Dr Kerry Chant, NSW Minister for Health Ryan Park and PSA CEO Bridget Totterman, alongside new and emerging pharmacy leaders at the PSA in NSW Parliament 2026 breakfast – held at NSW Parliament on 27 May.
‘It’s about collaboration to strengthen the NSW healthcare system, caring for our communities, and capability – utilising pharmacists to their full capabilities,’ she told the room.
With experience spanning community pharmacy, pharmacy ownership, business development, and professional services, Ms Lal has spent her career at the intersection of clinical practice and system-level thinking – with a clear focus on mentoring the next generation of pharmacists.
[caption id="attachment_32327" align="aligncenter" width="379"] A pop-up pharmacy clinic offering screening services after breakfast[/caption]
‘A strong connection to the profession begins in the first year of university and continues throughout a pharmacist’s career,’ she said. ‘By creating more opportunities for students, interns, and early career pharmacists to engage with experienced pharmacists, we can build confidence, strengthen professional networks, and inspire the next generation of leaders within the profession.’
It's a philosophy that reflects both her personal journey and her vision for the future of the pharmacy profession in her new role with PSA.
‘I am proud to advocate on behalf of more than 11,500 pharmacists across NSW, particularly as we continue to expand opportunities for pharmacists and contribute to improved patient care,’ Ms Lal told AP.
‘I want our members to feel supported, connected, and represented. I am here to listen and I hope to meet as many pharmacists as possible.’
Building bridges
The parliamentary event served as Ms Lal’s opening statement as PSA NSW State Manager. Bringing together parliamentarians from both sides of the chamber, NSW Health figures, and PSA and pharmacy leaders – it was designed to build momentum for expanded scope of practice.
After being introduced by Ms Lal, PSA NSW Branch Committee President Luke Kelly made the case for reform by making it personal.
Recovering from a recent knee replacement, Mr Kelly watched nurses quietly withhold his blood pressure medication when his readings dropped too low.
‘It struck me that this is such a sensible thing to do – not bother the surgeon or my GP for such an obvious step,’ he said.
‘This was nurses working within their scope. And it's exactly why PSA is advocating for pharmacists to work within theirs. We are faced with obvious solutions that the current framework doesn't allow us to provide.’
A government listening
In his address, NSW Minister for Health Ryan Park highlighted the government’s view of pharmacists as central to the system's future.
‘We are committed to continuing to expand the role and scope of practice that pharmacists play,’ Minister Park said. ‘We need to make healthcare more accessible to the community, and that means looking at the way we take pressure off the system and use our skilled professionals across a range of healthcare professions.’
Pointing to the success of recent reforms – including the roll-out of oral contraceptive continuation, UTI treatment and skin infection services – he also took the opportunity to announce the expansion of the new intranasal influenza vaccine, FluMist, to children aged 2–17.
‘This is all about trying to make healthcare as accessible and as affordable as we can, but also to prepare our community for what could be a very challenging winter – and you are at the front line of that,’ Minister Park told attendees.
He also acknowledged the particular importance of pharmacists in regional, rural, and remote communities, where the ‘tyranny of distance’ means pharmacists often need to fill healthcare gaps.
‘Those rural and regional and remote members here today – thank you,’ Minister Park said. ‘Because you do an enormous amount of lifting, often more than what your city counterparts have to work through.’
He also spoke to the next generation, referencing conversations with young pharmacists across the state who are eager to put their full training to use.
‘They're highly trained, highly skilled individuals, and we as a government need to be looking at ways in which we can provide them, in a safe and evidence-based way, with the opportunity to continue to develop their careers.’
What’s next for scope of practice?
For Ms Lal, the breakfast event was a starting point in the push to expand what pharmacists can do.
‘There is a growing need for NSW to progress towards broader scope of practice models, including the management of additional acute conditions, expanded chronic disease management services, preventive healthcare initiatives, and the removal of unnecessary barriers to pharmacist-led vaccination services,’ she said.
Rather than a turf war, she sees this as a rebalancing of the healthcare system in favour of patients.
‘Scope expansion is not about replacing other healthcare professionals. It is about ensuring patients receive timely care from the most appropriate clinician,’ she said.
‘As highly trained medicines experts and one of the most accessible healthcare professionals, pharmacists are well positioned to improve access to care, reduce treatment delay, and contribute to better health outcomes.’
She is also focused on connecting the diverse sectors of pharmacy – hospital, general practice, community, industry, prescribing, academia and compounding, among others – in ways that allow pharmacists to move between roles and continue growing throughout their careers.
‘As our industry changes and new roles emerge, I see it as a responsibility to connect the different parts of pharmacy together,’ Ms Lal said. ‘Whether a pharmacist is seeking to expand their scope of practice, transition into a new area, or pursue leadership opportunities, PSA can play a pivotal role in supporting that journey.’
[post_title] => What does the future of pharmacy look like in NSW?
[post_excerpt] => At a recent event with NSW Health, PSA’s newest State Manager shared her vision for a more connected profession and expanded pharmacist care.
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[post_content] => The Fair Work Ombudsman has published the updated pay guide for the Pharmacy Industry Award 2020, with new rates taking effect from the first full pay period on or after 30 June 2026.
CORRECTION: This article has been updated. An earlier version of this article incorrectly stated that the new pay rates included increments for both the pay equity correction and the Annual Wage Review, when in fact, this rate only contained the pay equity correction.
The Pharmacy Industry Award rates, which will include the 4.75% Annual Wage Review increment, will be in effect for pay cycles commencing on or after 1 July 2026. Please note, these rates have not yet been published.
The article also incorrectly compared the pay rates to the Pharmacy Industry Award, which was in effect for pay cycles commencing on or after 30 June 2025, rather than the current rates effective on or after 1 July 2025, this has now been corrected
Australian Pharmacist apologises for this error and any confusion it may have caused.
The updated guide applies the second instalment of a 3-year gender undervaluation correction. However, it does not include the Annual Wage Review Increment, which will commence for pay cycles which commence on or after 1 July 2026.
What are the new hourly rates?
The base hourly rate for a pharmacist on the award for pay cycles starting on or after 30 June 2026 will rise from $38.14 to $39.85.
[table id=34 /]
*Pharmacy Industry Award 2020 [MA000012] – Fair Work Ombudsman effective 1 July 2025
Pharmacy interns also benefit from the gender disparity increment increase, with first-half-of-training interns moving from $31.05/hr to $32.44/hr, and second-half interns from $32.11/hr to $33.55/hr.
For pharmacists working beyond standard Monday–Friday hours, the following changes apply.
Entry level pharmacist:
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $47.68 | $49.81 | +$2.13 |
| Saturday (8am–6pm) | $47.68 | $49.81 | +$2.13 |
| Sunday (7am–9pm) | $57.21 | $59.78 | +$2.57 |
| Public holiday | $85.82 | $89.66 | +$3.84 |
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $53.45 | $55.85 | +$2.40 |
| Saturday (8am–6pm) | $53.45 | $55.85 | +$2.40 |
| Sunday (7am–9pm) | $64.14 | $67.02 | +$2.88 |
| Public holiday | $96.21 | $100.53 | +$4.32 |
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[post_content] => Many complementary medicines beginning with ‘G’ have been associated with a risk of bleeding that pharmacists should know.
The culprits
A few come to mind. Ginkgo biloba contains ginkgolide B, which inhibits platelet-activating factor in vitro. In case reports, ginkgo has been associated with prolonged bleeding time.1,2
[caption id="attachment_32004" align="alignright" width="200"] Claire Antrobus FPS[/caption]
Garlic has been linked to decreased platelet aggregation and spontaneous bleeding; but a placebo-controlled study reported no change in INR with concomitant warfarin use.2
Ginger can inhibit platelet aggregation in vitro. A case report describes increased INR when ginger was combined with warfarin. However, controlled studies show no effect on warfarin pharmacokinetics or pharmacodynamics at recommended doses.1,2 Case reports have also shown increased INR in patients taking warfarin who started taking glucosamine.1,2 Panax ginseng contains antiplatelet components shown to inhibit platelet aggregation and thromboxane formation in vitro. Evidence on interactions with warfarin is conflicting.1,2 Goldenseal contains the alkaloid berberine, reported in in vitro and animal studies to inhibit platelet aggregation and increase bleeding risk.1
When risks stack up
While individual products might carry a modest bleeding risk at standard doses, the risk may increase when patients combine supplements, use higher doses or amounts, or use them alongside antiplatelet agents like aspirin or anticoagulants, such as warfarin.
Consider bleeding risk factors, including recent surgery, existing anticoagulation therapy, bleeding disorders or planned procedures.1
Practical recommendations
When dispensing anticoagulants or antiplatelet agents, use a non-judgemental approach to directly ask the patient if they are taking any complementary medicines. Asking about complementary medicine use is an important part of medication history taking.1 Document supplement use in the patient’s clinical record. Counsel patients to inform prescribers and surgeons about supplement use at least 2 weeks before elective procedures. Advise patients to watch for nosebleeds or unexplained bruising.1
What the evidence says
The clinical evidence for the bleeding risk of complementary medicines varies. The combination of in vitro data, case reports and individual variation in response supports caution.1,2 The Complementary medicines section of the Australian Pharmaceutical Formulary and Handbook contains useful information about bleeding risks and interactions with anticoagulants and antiplatelet agents for specific complementary medicines.
- Sansom LN, editor. Australian Pharmaceutical Formulary and Handbook. 2026. At: https://apf.psa.org.au
- Preston C, ed. Stockley’s drug interactions. London: Pharmaceutical Press; 2026
[post_title] => The 'G' list: complementary medicines with bleeding risks
[post_excerpt] => Many complementary medicines beginning with ‘G’ have been associated with a risk of bleeding that pharmacists should know.
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[title_attribute] => The ‘G’ list: complementary medicines with bleeding risks
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
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[post_content] => PSA’s newest State Manager shares her vision for a more connected profession and broader pharmacist-led care.
When Divya Lal stepped into the role of PSA New South Wales State Manager last month, she did so with a clear sense of purpose. Just weeks into the role, she brought together leading health figures, including NSW Chief Health Officer Dr Kerry Chant, NSW Minister for Health Ryan Park and PSA CEO Bridget Totterman, alongside new and emerging pharmacy leaders at the PSA in NSW Parliament 2026 breakfast – held at NSW Parliament on 27 May.
‘It’s about collaboration to strengthen the NSW healthcare system, caring for our communities, and capability – utilising pharmacists to their full capabilities,’ she told the room.
With experience spanning community pharmacy, pharmacy ownership, business development, and professional services, Ms Lal has spent her career at the intersection of clinical practice and system-level thinking – with a clear focus on mentoring the next generation of pharmacists.
[caption id="attachment_32327" align="aligncenter" width="379"] A pop-up pharmacy clinic offering screening services after breakfast[/caption]
‘A strong connection to the profession begins in the first year of university and continues throughout a pharmacist’s career,’ she said. ‘By creating more opportunities for students, interns, and early career pharmacists to engage with experienced pharmacists, we can build confidence, strengthen professional networks, and inspire the next generation of leaders within the profession.’
It's a philosophy that reflects both her personal journey and her vision for the future of the pharmacy profession in her new role with PSA.
‘I am proud to advocate on behalf of more than 11,500 pharmacists across NSW, particularly as we continue to expand opportunities for pharmacists and contribute to improved patient care,’ Ms Lal told AP.
‘I want our members to feel supported, connected, and represented. I am here to listen and I hope to meet as many pharmacists as possible.’
Building bridges
The parliamentary event served as Ms Lal’s opening statement as PSA NSW State Manager. Bringing together parliamentarians from both sides of the chamber, NSW Health figures, and PSA and pharmacy leaders – it was designed to build momentum for expanded scope of practice.
After being introduced by Ms Lal, PSA NSW Branch Committee President Luke Kelly made the case for reform by making it personal.
Recovering from a recent knee replacement, Mr Kelly watched nurses quietly withhold his blood pressure medication when his readings dropped too low.
‘It struck me that this is such a sensible thing to do – not bother the surgeon or my GP for such an obvious step,’ he said.
‘This was nurses working within their scope. And it's exactly why PSA is advocating for pharmacists to work within theirs. We are faced with obvious solutions that the current framework doesn't allow us to provide.’
A government listening
In his address, NSW Minister for Health Ryan Park highlighted the government’s view of pharmacists as central to the system's future.
‘We are committed to continuing to expand the role and scope of practice that pharmacists play,’ Minister Park said. ‘We need to make healthcare more accessible to the community, and that means looking at the way we take pressure off the system and use our skilled professionals across a range of healthcare professions.’
Pointing to the success of recent reforms – including the roll-out of oral contraceptive continuation, UTI treatment and skin infection services – he also took the opportunity to announce the expansion of the new intranasal influenza vaccine, FluMist, to children aged 2–17.
‘This is all about trying to make healthcare as accessible and as affordable as we can, but also to prepare our community for what could be a very challenging winter – and you are at the front line of that,’ Minister Park told attendees.
He also acknowledged the particular importance of pharmacists in regional, rural, and remote communities, where the ‘tyranny of distance’ means pharmacists often need to fill healthcare gaps.
‘Those rural and regional and remote members here today – thank you,’ Minister Park said. ‘Because you do an enormous amount of lifting, often more than what your city counterparts have to work through.’
He also spoke to the next generation, referencing conversations with young pharmacists across the state who are eager to put their full training to use.
‘They're highly trained, highly skilled individuals, and we as a government need to be looking at ways in which we can provide them, in a safe and evidence-based way, with the opportunity to continue to develop their careers.’
What’s next for scope of practice?
For Ms Lal, the breakfast event was a starting point in the push to expand what pharmacists can do.
‘There is a growing need for NSW to progress towards broader scope of practice models, including the management of additional acute conditions, expanded chronic disease management services, preventive healthcare initiatives, and the removal of unnecessary barriers to pharmacist-led vaccination services,’ she said.
Rather than a turf war, she sees this as a rebalancing of the healthcare system in favour of patients.
‘Scope expansion is not about replacing other healthcare professionals. It is about ensuring patients receive timely care from the most appropriate clinician,’ she said.
‘As highly trained medicines experts and one of the most accessible healthcare professionals, pharmacists are well positioned to improve access to care, reduce treatment delay, and contribute to better health outcomes.’
She is also focused on connecting the diverse sectors of pharmacy – hospital, general practice, community, industry, prescribing, academia and compounding, among others – in ways that allow pharmacists to move between roles and continue growing throughout their careers.
‘As our industry changes and new roles emerge, I see it as a responsibility to connect the different parts of pharmacy together,’ Ms Lal said. ‘Whether a pharmacist is seeking to expand their scope of practice, transition into a new area, or pursue leadership opportunities, PSA can play a pivotal role in supporting that journey.’
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[post_excerpt] => At a recent event with NSW Health, PSA’s newest State Manager shared her vision for a more connected profession and expanded pharmacist care.
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[post_content] => The Fair Work Ombudsman has published the updated pay guide for the Pharmacy Industry Award 2020, with new rates taking effect from the first full pay period on or after 30 June 2026.
CORRECTION: This article has been updated. An earlier version of this article incorrectly stated that the new pay rates included increments for both the pay equity correction and the Annual Wage Review, when in fact, this rate only contained the pay equity correction.
The Pharmacy Industry Award rates, which will include the 4.75% Annual Wage Review increment, will be in effect for pay cycles commencing on or after 1 July 2026. Please note, these rates have not yet been published.
The article also incorrectly compared the pay rates to the Pharmacy Industry Award, which was in effect for pay cycles commencing on or after 30 June 2025, rather than the current rates effective on or after 1 July 2025, this has now been corrected
Australian Pharmacist apologises for this error and any confusion it may have caused.
The updated guide applies the second instalment of a 3-year gender undervaluation correction. However, it does not include the Annual Wage Review Increment, which will commence for pay cycles which commence on or after 1 July 2026.
What are the new hourly rates?
The base hourly rate for a pharmacist on the award for pay cycles starting on or after 30 June 2026 will rise from $38.14 to $39.85.
[table id=34 /]
*Pharmacy Industry Award 2020 [MA000012] – Fair Work Ombudsman effective 1 July 2025
Pharmacy interns also benefit from the gender disparity increment increase, with first-half-of-training interns moving from $31.05/hr to $32.44/hr, and second-half interns from $32.11/hr to $33.55/hr.
For pharmacists working beyond standard Monday–Friday hours, the following changes apply.
Entry level pharmacist:
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $47.68 | $49.81 | +$2.13 |
| Saturday (8am–6pm) | $47.68 | $49.81 | +$2.13 |
| Sunday (7am–9pm) | $57.21 | $59.78 | +$2.57 |
| Public holiday | $85.82 | $89.66 | +$3.84 |
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $53.45 | $55.85 | +$2.40 |
| Saturday (8am–6pm) | $53.45 | $55.85 | +$2.40 |
| Sunday (7am–9pm) | $64.14 | $67.02 | +$2.88 |
| Public holiday | $96.21 | $100.53 | +$4.32 |
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[post_content] => Many complementary medicines beginning with ‘G’ have been associated with a risk of bleeding that pharmacists should know.
The culprits
A few come to mind. Ginkgo biloba contains ginkgolide B, which inhibits platelet-activating factor in vitro. In case reports, ginkgo has been associated with prolonged bleeding time.1,2
[caption id="attachment_32004" align="alignright" width="200"] Claire Antrobus FPS[/caption]
Garlic has been linked to decreased platelet aggregation and spontaneous bleeding; but a placebo-controlled study reported no change in INR with concomitant warfarin use.2
Ginger can inhibit platelet aggregation in vitro. A case report describes increased INR when ginger was combined with warfarin. However, controlled studies show no effect on warfarin pharmacokinetics or pharmacodynamics at recommended doses.1,2 Case reports have also shown increased INR in patients taking warfarin who started taking glucosamine.1,2 Panax ginseng contains antiplatelet components shown to inhibit platelet aggregation and thromboxane formation in vitro. Evidence on interactions with warfarin is conflicting.1,2 Goldenseal contains the alkaloid berberine, reported in in vitro and animal studies to inhibit platelet aggregation and increase bleeding risk.1
When risks stack up
While individual products might carry a modest bleeding risk at standard doses, the risk may increase when patients combine supplements, use higher doses or amounts, or use them alongside antiplatelet agents like aspirin or anticoagulants, such as warfarin.
Consider bleeding risk factors, including recent surgery, existing anticoagulation therapy, bleeding disorders or planned procedures.1
Practical recommendations
When dispensing anticoagulants or antiplatelet agents, use a non-judgemental approach to directly ask the patient if they are taking any complementary medicines. Asking about complementary medicine use is an important part of medication history taking.1 Document supplement use in the patient’s clinical record. Counsel patients to inform prescribers and surgeons about supplement use at least 2 weeks before elective procedures. Advise patients to watch for nosebleeds or unexplained bruising.1
What the evidence says
The clinical evidence for the bleeding risk of complementary medicines varies. The combination of in vitro data, case reports and individual variation in response supports caution.1,2 The Complementary medicines section of the Australian Pharmaceutical Formulary and Handbook contains useful information about bleeding risks and interactions with anticoagulants and antiplatelet agents for specific complementary medicines.
- Sansom LN, editor. Australian Pharmaceutical Formulary and Handbook. 2026. At: https://apf.psa.org.au
- Preston C, ed. Stockley’s drug interactions. London: Pharmaceutical Press; 2026
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[post_content] => Meet the award-winning pharmacists recognised for their exceptional contributions to patients, communities and the profession.
The PSA acknowledged the outstanding contributions, leadership, and dedication of the five pharmacists who were recognised at the PSA Victorian Pharmacist Awards.
The 2026 award recipients are:
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[post_content] => Body weight may reduce the effectiveness of oral emergency contraception (EC). Here's how pharmacists can help navigate this nuance in your consultations.
A patient walks into a pharmacy and asks for emergency contraception. During the consultation, they disclose that they are breastfeeding, so the pharmacist recommends levonorgestrel.
But what if the patient weighs more than 70 kg?
The effectiveness of oral EC may be reduced by body weight, particularly for levonorgestrel.
Given the average Australian woman weighs 72 kg, weight is an important factor to consider during EC consultations.
Weighing up first-line therapy
Levonorgestrel is widely stocked in Australian pharmacies, with 2024 research revealing 98% of pharmacies have this EC on hand compared with 70% for ulipristal acetate.
This gap is problematic, as for most people, ulipristal is first-line therapy. It’s particularly problematic for people >70kg who wish to use emergency contraception to avoid pregnancy.
The Australian Pharmaceutical Formulary and Handbook (APF’s) treatment guide for emergency contraception states that for people with a BMI above 26 kg/m² or weight above 70 kg, ulipristal is the preferred first-line option. Above 85 kg or BMI above 30 kg/m², effectiveness is unknown.
Crafting conversations
Part of what makes these thresholds challenging in practice is that weight does not always correlate with what pharmacists might expect.
'Weight and BMI can be really hard to assess, particularly when people are so fit,’ said Ruth Nona, pharmacist and researcher at James Cook University in Cairns. ‘If somebody does CrossFit and has a higher muscle mass, they may be heavier on the scale, but they may not appear so.’
As such, Queensland-based pharmacy intern Lindsay Cameron has developed a consultation approach that sidesteps weight assumptions entirely.
‘I don’t ask for a specific weight. I ask whether they think they may fall into that category,’ she said. ‘I usually say, “I’ll ask a few questions so I can recommend the most appropriate EC for you.” Then I explain, “Ulipristal is generally more effective than other oral EC options, unless it is contraindicated or unsuitable, because it can delay ovulation even when hormone levels are rising. That gives it a longer window to work. In particular, if you think you may weigh over 70 kg, I recommend ulipristal, as the other option may be less effective”.’
Ms Cameron will further tweak her approach, often based on the patient's body language, if she detects any sensitivity around weight.
‘I might use myself as an example,’ she said. ‘For example, I will say, “I would choose this option because I am over 70 kg and I don't want an unplanned pregnancy”,’ she said.
Ms Nona also emphasises the importance of ensuring that patients are given all the information they need to make an informed choice. ‘When someone presents to the pharmacy seeking emergency contraception, they have already made an informed decision to prevent pregnancy. It is important that patients understand the differences in effectiveness between the two emergency contraception options, as well as how weight may also influence that effectiveness.’
When oral EC isn’t enough
For patients above 85 kg, the conversation should extend beyond oral EC. The copper intrauterine device (IUD), inserted within 120 hours of unprotected sex, is the most effective option regardless of weight.
However, the main barrier is often access rather than clinical appropriateness. The copper IUD requires insertion by a trained medical professional, and appointments are not always readily available, particularly in regional, rural and remote areas.
The APF is clear that pharmacists should always supply oral EC and refer, not withhold the oral option while waiting for an IUD appointment.
Ms Nona makes this a routine part of conversations with people seeking emergency contraception.
‘When considering BMI, if a patient is thought to weigh over 85 kg, we should always discuss the option of a copper IUD with them, as it is 99% effective,' Ms Nona said. ‘Another benefit of a copper IUD is that it offers ongoing, long-term contraception.'
'If they can't get to the doctor [immediately], we would supply oral EC and refer them to a GP or sexual health clinic,’ she said.
When ulipristal is contraindicated
While ulipristal is the first-line treatment option, offering protection for a wider weight range, it’s important to understand when it’s contraindicated.
As suggested earlier in the article, ulipristal is generally second line in breastfeeding mothers.
For people >70kg who are breastfeeding, the APF treatment guidelines recommends 3 mg (2 tablets) levonorgestrel as first line treatment.
However, this is off-label use, and based on international guidance. Its clinical efficacy is unknown.
‘[As] the effectiveness of double dosing levonorgestrel is not known … we should inform the patient that they should follow up with a doctor.’ Ms Nona said.
The other most common contraindication is drug-drug interactions. The most significant interaction with ulipristal involves progestogens.
‘You cannot use ulipristal and progestogen within 5 days of each other as it reduces the effectiveness of both,’
Ms Nona reflects this is something she sees frequently in practice:.
‘That could be because the patient was taking a progestogen-containing oral contraceptive such as Slinda, if they missed a couple of pills or ceased taking it, or if they took levonorgestrel.’
CYP3A4-inducing medicines – including carbamazepine, phenytoin, rifampicin, topiramate and St John's Wort – used within the previous 4 weeks also affect both oral EC options. In this scenario, the APF recommends a 3 mg dose of levonorgestrel – noting that a copper IUD is preferred where feasible, explicitly stating that double-dose ulipristal is not recommended.
For more information on emergency contraception, access the Australian Pharmaceutical Formulary and Handbook.
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[post_content] => PSA’s newest State Manager shares her vision for a more connected profession and broader pharmacist-led care.
When Divya Lal stepped into the role of PSA New South Wales State Manager last month, she did so with a clear sense of purpose. Just weeks into the role, she brought together leading health figures, including NSW Chief Health Officer Dr Kerry Chant, NSW Minister for Health Ryan Park and PSA CEO Bridget Totterman, alongside new and emerging pharmacy leaders at the PSA in NSW Parliament 2026 breakfast – held at NSW Parliament on 27 May.
‘It’s about collaboration to strengthen the NSW healthcare system, caring for our communities, and capability – utilising pharmacists to their full capabilities,’ she told the room.
With experience spanning community pharmacy, pharmacy ownership, business development, and professional services, Ms Lal has spent her career at the intersection of clinical practice and system-level thinking – with a clear focus on mentoring the next generation of pharmacists.
[caption id="attachment_32327" align="aligncenter" width="379"] A pop-up pharmacy clinic offering screening services after breakfast[/caption]
‘A strong connection to the profession begins in the first year of university and continues throughout a pharmacist’s career,’ she said. ‘By creating more opportunities for students, interns, and early career pharmacists to engage with experienced pharmacists, we can build confidence, strengthen professional networks, and inspire the next generation of leaders within the profession.’
It's a philosophy that reflects both her personal journey and her vision for the future of the pharmacy profession in her new role with PSA.
‘I am proud to advocate on behalf of more than 11,500 pharmacists across NSW, particularly as we continue to expand opportunities for pharmacists and contribute to improved patient care,’ Ms Lal told AP.
‘I want our members to feel supported, connected, and represented. I am here to listen and I hope to meet as many pharmacists as possible.’
Building bridges
The parliamentary event served as Ms Lal’s opening statement as PSA NSW State Manager. Bringing together parliamentarians from both sides of the chamber, NSW Health figures, and PSA and pharmacy leaders – it was designed to build momentum for expanded scope of practice.
After being introduced by Ms Lal, PSA NSW Branch Committee President Luke Kelly made the case for reform by making it personal.
Recovering from a recent knee replacement, Mr Kelly watched nurses quietly withhold his blood pressure medication when his readings dropped too low.
‘It struck me that this is such a sensible thing to do – not bother the surgeon or my GP for such an obvious step,’ he said.
‘This was nurses working within their scope. And it's exactly why PSA is advocating for pharmacists to work within theirs. We are faced with obvious solutions that the current framework doesn't allow us to provide.’
A government listening
In his address, NSW Minister for Health Ryan Park highlighted the government’s view of pharmacists as central to the system's future.
‘We are committed to continuing to expand the role and scope of practice that pharmacists play,’ Minister Park said. ‘We need to make healthcare more accessible to the community, and that means looking at the way we take pressure off the system and use our skilled professionals across a range of healthcare professions.’
Pointing to the success of recent reforms – including the roll-out of oral contraceptive continuation, UTI treatment and skin infection services – he also took the opportunity to announce the expansion of the new intranasal influenza vaccine, FluMist, to children aged 2–17.
‘This is all about trying to make healthcare as accessible and as affordable as we can, but also to prepare our community for what could be a very challenging winter – and you are at the front line of that,’ Minister Park told attendees.
He also acknowledged the particular importance of pharmacists in regional, rural, and remote communities, where the ‘tyranny of distance’ means pharmacists often need to fill healthcare gaps.
‘Those rural and regional and remote members here today – thank you,’ Minister Park said. ‘Because you do an enormous amount of lifting, often more than what your city counterparts have to work through.’
He also spoke to the next generation, referencing conversations with young pharmacists across the state who are eager to put their full training to use.
‘They're highly trained, highly skilled individuals, and we as a government need to be looking at ways in which we can provide them, in a safe and evidence-based way, with the opportunity to continue to develop their careers.’
What’s next for scope of practice?
For Ms Lal, the breakfast event was a starting point in the push to expand what pharmacists can do.
‘There is a growing need for NSW to progress towards broader scope of practice models, including the management of additional acute conditions, expanded chronic disease management services, preventive healthcare initiatives, and the removal of unnecessary barriers to pharmacist-led vaccination services,’ she said.
Rather than a turf war, she sees this as a rebalancing of the healthcare system in favour of patients.
‘Scope expansion is not about replacing other healthcare professionals. It is about ensuring patients receive timely care from the most appropriate clinician,’ she said.
‘As highly trained medicines experts and one of the most accessible healthcare professionals, pharmacists are well positioned to improve access to care, reduce treatment delay, and contribute to better health outcomes.’
She is also focused on connecting the diverse sectors of pharmacy – hospital, general practice, community, industry, prescribing, academia and compounding, among others – in ways that allow pharmacists to move between roles and continue growing throughout their careers.
‘As our industry changes and new roles emerge, I see it as a responsibility to connect the different parts of pharmacy together,’ Ms Lal said. ‘Whether a pharmacist is seeking to expand their scope of practice, transition into a new area, or pursue leadership opportunities, PSA can play a pivotal role in supporting that journey.’
[post_title] => What does the future of pharmacy look like in NSW?
[post_excerpt] => At a recent event with NSW Health, PSA’s newest State Manager shared her vision for a more connected profession and expanded pharmacist care.
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[post_content] => The Fair Work Ombudsman has published the updated pay guide for the Pharmacy Industry Award 2020, with new rates taking effect from the first full pay period on or after 30 June 2026.
CORRECTION: This article has been updated. An earlier version of this article incorrectly stated that the new pay rates included increments for both the pay equity correction and the Annual Wage Review, when in fact, this rate only contained the pay equity correction.
The Pharmacy Industry Award rates, which will include the 4.75% Annual Wage Review increment, will be in effect for pay cycles commencing on or after 1 July 2026. Please note, these rates have not yet been published.
The article also incorrectly compared the pay rates to the Pharmacy Industry Award, which was in effect for pay cycles commencing on or after 30 June 2025, rather than the current rates effective on or after 1 July 2025, this has now been corrected
Australian Pharmacist apologises for this error and any confusion it may have caused.
The updated guide applies the second instalment of a 3-year gender undervaluation correction. However, it does not include the Annual Wage Review Increment, which will commence for pay cycles which commence on or after 1 July 2026.
What are the new hourly rates?
The base hourly rate for a pharmacist on the award for pay cycles starting on or after 30 June 2026 will rise from $38.14 to $39.85.
[table id=34 /]
*Pharmacy Industry Award 2020 [MA000012] – Fair Work Ombudsman effective 1 July 2025
Pharmacy interns also benefit from the gender disparity increment increase, with first-half-of-training interns moving from $31.05/hr to $32.44/hr, and second-half interns from $32.11/hr to $33.55/hr.
For pharmacists working beyond standard Monday–Friday hours, the following changes apply.
Entry level pharmacist:
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $47.68 | $49.81 | +$2.13 |
| Saturday (8am–6pm) | $47.68 | $49.81 | +$2.13 |
| Sunday (7am–9pm) | $57.21 | $59.78 | +$2.57 |
| Public holiday | $85.82 | $89.66 | +$3.84 |
| Shift | Current | New | Increase |
| Evening Mon–Fri (7pm–9pm) | $53.45 | $55.85 | +$2.40 |
| Saturday (8am–6pm) | $53.45 | $55.85 | +$2.40 |
| Sunday (7am–9pm) | $64.14 | $67.02 | +$2.88 |
| Public holiday | $96.21 | $100.53 | +$4.32 |
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[post_content] => Many complementary medicines beginning with ‘G’ have been associated with a risk of bleeding that pharmacists should know.
The culprits
A few come to mind. Ginkgo biloba contains ginkgolide B, which inhibits platelet-activating factor in vitro. In case reports, ginkgo has been associated with prolonged bleeding time.1,2
[caption id="attachment_32004" align="alignright" width="200"] Claire Antrobus FPS[/caption]
Garlic has been linked to decreased platelet aggregation and spontaneous bleeding; but a placebo-controlled study reported no change in INR with concomitant warfarin use.2
Ginger can inhibit platelet aggregation in vitro. A case report describes increased INR when ginger was combined with warfarin. However, controlled studies show no effect on warfarin pharmacokinetics or pharmacodynamics at recommended doses.1,2 Case reports have also shown increased INR in patients taking warfarin who started taking glucosamine.1,2 Panax ginseng contains antiplatelet components shown to inhibit platelet aggregation and thromboxane formation in vitro. Evidence on interactions with warfarin is conflicting.1,2 Goldenseal contains the alkaloid berberine, reported in in vitro and animal studies to inhibit platelet aggregation and increase bleeding risk.1
When risks stack up
While individual products might carry a modest bleeding risk at standard doses, the risk may increase when patients combine supplements, use higher doses or amounts, or use them alongside antiplatelet agents like aspirin or anticoagulants, such as warfarin.
Consider bleeding risk factors, including recent surgery, existing anticoagulation therapy, bleeding disorders or planned procedures.1
Practical recommendations
When dispensing anticoagulants or antiplatelet agents, use a non-judgemental approach to directly ask the patient if they are taking any complementary medicines. Asking about complementary medicine use is an important part of medication history taking.1 Document supplement use in the patient’s clinical record. Counsel patients to inform prescribers and surgeons about supplement use at least 2 weeks before elective procedures. Advise patients to watch for nosebleeds or unexplained bruising.1
What the evidence says
The clinical evidence for the bleeding risk of complementary medicines varies. The combination of in vitro data, case reports and individual variation in response supports caution.1,2 The Complementary medicines section of the Australian Pharmaceutical Formulary and Handbook contains useful information about bleeding risks and interactions with anticoagulants and antiplatelet agents for specific complementary medicines.
- Sansom LN, editor. Australian Pharmaceutical Formulary and Handbook. 2026. At: https://apf.psa.org.au
- Preston C, ed. Stockley’s drug interactions. London: Pharmaceutical Press; 2026
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
