Under medicines legislation, registered paramedics can administer a range of parenteral medicines on their own initiative for the immediate, necessary treatment of sick or injured persons without the usual requirement for a prescription or directions of a prescriber.

Two paramedics

List of medicines which may only be administered by ambulance paramedics on their own initiative for immediate, necessary treatment of sick or injured persons

  • Diazepam 5 mg per ml emulsion for injection
  • Succinylated Modified Fluid Gelatin 4 per cent intravenous infusion
  • Prescription Only Medicines containing one or more of the following substances but no other active ingredient:
    • Adrenaline Acid Tartrate
    • Adrenaline Hydrochloride
    • Amiodarone
    • Anhydrous Glucose
    • Benzylpenicillin
    • Compound Sodium Lactate Intravenous Infusion (Hartmann's Solution)
    • Ergometrine Maleate
    • Frusemide
    • Glucose
    • Heparin Sodium (NB: Administration is only allowed for the purpose of cannula flushing.)
    • Lignocaine Hydrochloride
    • Metoclopramide
    • Morphine Sulphate
    • Nalbuphine Hydrochloride
    • Naloxone Hydrochloride
    • Ondansetron
    • Paracetamol
    • Reteplase
    • Sodium Chloride
    • Streptokinase
    • Syntometrine
    • Tenecteplase 

Registered paramedics: Legal position on obtaining wholesale supplies of medicines
The law also allows registered paramedics to obtain stocks of the injectable medicines which they can administer on their own initiative as well as pharmacy medicines for administration in the course of a business operated by them. The parenteral medicines available to paramedics are above.

Paramedics will note that the legal provisions for individuals do not cover all the medicines listed in the guidelines issued by the Joint Royal Colleges Ambulance Liaison Committee (JRCALC). These additional medicines are generally only available to paramedics in the course of the business of an ambulance trust or other body entitled to receive wholesale supplies of an extended range of medicines.

Contact for further information
For further information on this part of our site, please contact our Sale and Supply section, MHRA, 151 Buckingham Palace Road, Victoria, London, SW1W 9SZ, telephone 020 3080 6392 or email the MHRA Central Enquiry Point

Page last modified: 19 November 2013