Because of the inconvenience and longer time required to punch out the
tablets, strip packaging may reduce the number of
tablets that can be readily swallowed by adults with self-
poisonings. In fact, hospital-based studies of
paracetamol poisoning in the U.K. and Hong Kong have shown that
blister packs were associated with fewer
tablets being ingested and large overdoses were mostly from loose preparations. In Australia, following the change in packaging for
carbamazepine from bottles of
tablets to
blister packs, a marked decrease in the reported number of
tablets ingested by patients was seen. Reducing the maximum number of
tablets that can be available in individual preparations or prescriptions may also reduce the likelihood of severe
poisonings. In France, but not in the UK, the content of each pack of
paracetamol has been legally limited to 8 g. This was thought to be one reason why severe liver damage and deaths after
paracetamol poisonings are less common in France than in the UK. Medicated
oils containing
methyl salicylate pose the threat of rapid-onset, severe
salicylate poisoning if swallowed. To reduce the amount of
methyl salicylate that can be readily swallowed, the
methyl salicylate content and the size of the bottle and its opening should be restricted. In adults with
Dettol poisoning, serious complications such as pulmonary aspiration are more likely if a large amount is ingested. Similarly, the risk may be reduced by restricting the size of bottle and its opening.