Bulgaria’s Ministry of Health announced stringent restrictions on pharmaceutical vending machines after severe incidents involving minors hospitalised due to a viral TikTok “paracetamol challenge,” according to Euractiv.
The dangerous trend, sweeping Europe, encouraged teenagers to compete in consuming excessive doses of over-the-counter painkillers, resulting in critical intoxications across cities including Sofia, Burgas, and Stara Zagora.
Under the new rules, vending machines—previously permitted only on licensed pharmacy premises after operating hours—will face significantly reduced product ranges and stringent packaging limits. Paracetamol sales will be capped at 12 tablets (500mg each), while ibuprofen packages shrink to 10 tablets (200mg each).
Popular medications like aspirin and paracetamol-based combinations will vanish entirely from machines, alongside the removal of ketoprofen and anti-spasmodic pitofenone. Only three high-safety heartburn/ulcer treatments remain exempt from the ban on combination medicines. Health authorities warn:
Excessive consumption poses a direct threat to life and health. Paracetamol overdose can cause severe liver, kidney, and central nervous system damage, and in extreme cases, can be fatal.
Dimitar Marinov, President of the Bulgarian Pharmaceutical Union, stressed that only medicines “truly safe for self-use in small doses” will remain available. He acknowledged the limitations of regulation.
Anyone determined to do something reckless will always find a way. Just because someone might hang themselves with a rope doesn’t mean we should ban ropes. But we can try to prevent accidental harm and warn children.
Machines will now carry prominent warnings advising that medications should not be used beyond three days without medical consultation. While Marinov expressed hope the viral trend has subsided, he underscored that “safe access to medicines must be guaranteed,” a nod to ongoing parliamentary debates about expanding drug access in rural areas lacking pharmacies.
The restrictions complicate Bulgaria’s earlier ambitions to deploy vending machines as a solution for underserved communities. In March 2024, amendments to the Medicinal Products Act had authorised machines in villages without pharmacies to improve access to basic remedies like pain relievers and antihistamines.
