Exclusive: Pharmacies offering unregulated intravenous vitamin drips to the public, which lack evidence of effectiveness, risk eroding trust in the pharmacy sector, community pharmacists have said.
A fast-growing wellness trend, intravenous nutrient therapy – commonly known as IV vitamin drips – is increasingly promoted by social media influencers and celebrities, with suggestions that the drips can help to boost hydration, energy, improve immunity and fight the signs of ageing.
The IV vitamin infusions are now available from various pop-up locations and private clinics across the UK , with The Pharmacist finding that some pharmacies are also offering the service for hundreds of pounds.
However, some pharmacists are concerned that the activity is not one that pharmacies should be involved with, claiming that pharmacies offering the service are acting ‘unprofessionally’. Pharmacists also told The Pharmacist that they were concerned about a lack of regulation relating to the drips.
Pharmacists offering the service have argued to that the profession is ‘well placed’ to offer the service which is becoming increasing more popular with patients.
When approached by The Pharmacist, the Royal Pharmaceutical Society (RPS) said they would not be taking a stance on the drips until more evidence has been published. The MHRA, however, has told The Pharmacist it is aware of the activity and was currently in ‘active talks’ with the sector about ‘compliance’.
‘Unprofessional, unregulated and therefore unsafe’
Graham Stretch, clinical director of Brentworth (Brentford and Isleworth) primary care network in Hounslow, West London, compared the drips to ‘snake oil’, and called for more regulation around the service.
‘We’re putting patients in danger by injecting them unnecessarily and it’s only a matter of time before something goes wrong and a patient experiences an anaphylactic shock or serious infection.
‘Pharmacists will get blamed; it would impact the image of the entire profession,’ he suggested.
The drips are unregulated by the MHRA as they are not considered to be medicines.
However, the MHRA told The Pharmacist last week (10 May) that it was ‘aware of several companies offering intravenous nutritional therapy products’, and that it was in ‘active discussions’ with the sector to ensure regulatory compliance.
‘If a pharmacy has the intention of administering a product for a medicinal purpose, that product and its associated advertising are required to be in full compliance with all relevant aspects of medicines legislation,’ they explained.
Darren Powell, clinical lead at NHS Digital and relief pharmacist manager at Weldricks, agreed with Mr Stretch that more regulation was needed, and called on the RPS to publish guidance for pharmacists on the new practice.
‘My current view is this seems awfully close to homoeopathy, which I feel as a profession we shouldn't be actively promoting,’ he said.
‘I certainly would welcome any advice and a consideration by the RPS from a professional perspective,’ Mr Powell added.
A spokesperson from the RPS said the body would not take a position on the drips until more evidence of their efficiency and safety emerged.
Wing Tang, RPS head of professional standards, said: ‘Medical treatments need an evidence-based to show they are safe and effective before being used in a healthcare setting such as a pharmacy.
‘We would need to be assured IV vitamin drips have full marketing authorisations and are used by this licensing.
‘If the evidence-base and assurance are not in place, we would not be able to support pharmacist involvement,’ she said.
Mr Stretch went on to argue that any guidance or advice published in the future should ‘advise pharmacists against supplying IV vitamin drips as they are unprofessional, unregulated and therefore unsafe.’
Ade Williams, superintendent pharmacist at Bedminister Pharmacy in Bristol, claimed that pharmacies that offer IV vitamin drips are trading in the ‘trust and respect’ the sector has earnt over the pandemic for ‘financial gain’.
‘I think most of the public understands this sort of practice is highly questionable; many know it’s rubbish.
‘If they see that their local NHS pharmacy is offering it, how does that reflect on the sector and the NHS as a whole?
‘It will make people question all we do, and we will lose public trust as respectable clinical professionals,’ he said.
Mr Williams questioned whether regulation in the case of vitamin drips was necessary for pharmacists to make the right decision on matters such as this.
‘Is it really the GPhC’s and RPS’ role to always tell us what is right and what is wrong? Shouldn’t we, as responsible health care professionals, be able to make our own moral judgement on something like this?’
He added: ‘In my view, it’s concerning that some pharmacists still need to be told what good and bad practice is.’
‘I’m catering to a market’
Two studies into IV vitamin drips found no statistically significant clinical improvements in patients when measured against a placebo.
However, some pharmacists believe the product is suitable to be offered in their pharmacies.
A contractor who wished to remain anonymous, had been running an IV vitamin clinic at his pharmacy premises for three years.
He told The Pharmacist that he believed it was acceptable for a pharmacist to offer the vitamin service ‘as long as it’s safe’.
‘I don’t tell my patients that IV vitamin drips work, but I do tell them they are safe and may help their health and wellness,’ he said.
‘I consider helping my patients reach their optimum health as part of my job as a pharmacist and using supplements alongside a healthy lifestyle may help them reach this,’ he explained.
NHS England said the adverts were misleading and potentially dangerous and warned the public against using the drips.
According to the anonymous, the service has grown in popularity since the pandemic.
‘People care more about their health than ever before and are looking for new ways to look after their bodies and in some cases, that includes using IV vitamin drips.
‘I’m catering to a market; my patients want access to this service and pharmacists are well placed to provide it.
‘Pharmacists and our premises are regulated by the GPhC. This means pharmacists can be trusted to provide a service like this as everything we do is monitored.’
Typically, in a medical setting, a patient who has anything injected intravenously would have a thorough medical history taken.
Infusion of vitamins potentially puts the liver and kidneys under stress, and to go ahead without screening the liver and kidney function first is prohibited by the National Institute for Clinical Excellence (NICE) in the UK.
The pharmacist said he ensures the pharmacist at his store providing this service is well trained in providing intravenous services.
‘Patient safety must come first’
Similarly, Sam Faris, manager of Mayfair Pharmacy in London, which also offers IV drips, said he does not fear harming his patients as his staff who offer the service are ‘fully trained’.
‘Sometimes, we get a doctor in to insert the drips and they take the patient’s blood beforehand to find out what deficiencies they have,’ Mr Faris told The Pharmacist.
However, Mr Williams claimed that even when a service is ‘safe’ that does not always mean a pharmacist should be providing it.
‘We as healthcare professionals have a duty to do good above all else -- and this involves weighing up benefits and risks of each service,’ he said.
‘Pharmacies have visible financial remuneration for providing certain services, which means we must be really careful when picking which services we offer to our patients; we don’t want our patients to think we are trying to rip them off.’
‘Our patients and their safety must always come first,’ Mr Williams added.
The cost of a vitamin drip can range from £50 to £2,000 -- depending on the vitamin or therapy.
‘The expensive service exploits people who are very scared of getting sick or maybe have underlying health issues,’ Mr Williams suggested.
Mr Faris said that the service is popular with celebrities and influencers in his central London pharmacy.
‘Most people who come into the pharmacy for an IV drip are celebrities, coming in for drips to help their hangovers after a night of drinking,’ Mr Faris said.