S0 to S6: what medicine schedules mean

Every medicine registered in South Africa is assigned a schedule from 0 to 6 under the Medicines and Related Substances Act. The number describes how tightly its supply is controlled — based on how risky it is to use without supervision and how likely it is to be misused.

A higher number does not simply mean a stronger medicine. It means more control over who can hand it to you and what record must be kept.

• Schedule 0 — general sale. Available from ordinary retailers, including supermarkets.
• Schedules 1 and 2 — pharmacy medicines. You do not need a prescription, but a pharmacist must be involved in the sale, which is why they are behind the counter and why you get asked questions.
• Schedules 3 and 4 — prescription only. A doctor, dentist or other authorised prescriber must prescribe them, and the pharmacy keeps a record.
• Schedules 5 and 6 — controlled substances. Prescription only, with stricter record-keeping, tighter limits on repeats, and rules about how long a prescription stays valid.

Scheduling often depends on the strength and the pack size rather than the ingredient alone. paracetamol is Schedule 0 in small packs and moves up in larger ones. Codeine combinations sit at Schedule 2 at low doses and higher when the codeine content increases.

This is deliberate. It allows a medicine to be conveniently available for a two-day problem while limiting the quantity someone can accumulate without any professional contact.

The questions a pharmacist asks about a Schedule 1 or 2 medicine are not obstruction — they are the mechanism by which a medicine is allowed to be sold without a doctor at all. Answering them honestly, including about your other medicines and conditions, is what makes the system safe.