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The warning triangle

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Changes

  • : Deleted outdated information and added three new active substances to the list: clobazam, lorazepam and remimazolam.
  • : Moved relevant information from Q&A to content information and with that removed Q&A and outdated information
  • : Moved the warning triangle list from pdf to the page

The warning triangle is there to inform you that you need to consider your ability to drive when using a medicinal product. Medicinal products for human use with active substance(s) stated in the warning triangle list shall bear the warning triangle.

The warning triangle

The intention of the warning triangle is to inform you that you need to consider your ability to drive when you use a medicinal product.

Which medicinal products shall bear the warning triangle?

All medicinal products for human use containing active substance(s) stated in the warning triangle list from the NOMA shall bear the warning triangle. This also applies for parallell imported medicinal products and medicinal products that are solely used in hospitals.

Which medicinal products shall not bear the warning triangle?

Medicinal products with active substance(s) which are not on the warning triangle list shall not bear the warning triangle on the package.

Veterinary medicinal products shall not bear the warning triangle.

Even if the product information to the medicinal product states that the medicine affects the ability to drive, a warning triangle must not be applied on the package if the active substance is not on the warning triangle list. The requirement regarding the warning triangle is not connected to the information given in section 4.7 “Effects on ability to drive and use machines” of the SmPC and section 2 “Driving and using machines” of the PL. The requirement regarding the warning triangle is connected to medicinal products falling under the categories listed in Annex 1, chapter 14 § 36 in the regulation of the driving license “førerkortforskriften”. 

New medicinal products

All new medicinal products containing active substance(s) included in the warning triangle list shall bear the warning triangle on the packaging. 

If the active substance(s) is not on the list, but is an active substance that can be considered to be in the group of benzodiazepines, opioids, antihistamines (1. generation) and substitution (LAR) treatment, the NOMA will inform you together with the granting of the marketing authorisation if the medicinal product shall bear the warning triangle.

Multilingual package

It is possible with a multilingual package even though the warning triangle is only required for one or more languages, but not all languages included on the packaging. 

For purely national procedure and the MRP/DCP the warning triangle on the multilingual packaging can be hidden by a sticker (see the Q&A to the Guideline on Nordic packages(External link).)

For centralised procedure the warning triangle is a Norwegian Blue box requirement. If there are different requirements in the countries included in the multilingual pack, several Blue boxes needs to be included on the package.

Requirements regarding design

There are requirements regarding the design of the warning triangle. The warning triangle must appear as a red, isosceles triangle on a white background. The corners are pointed, with one of the corners pointing upwards. Minimum length of the sides is 10 mm (0.4 inches). The minimum width of the frame is approx. 2 mm (0.08 inches). The colour shall be signal red in colour code C: 0, M: 96, Y: 90 K: 2 (or similar).

The warning triangle list

The warning triangle list came into force on 01.07.2018. The purpose is to harmonise the warning triangle guidance and Annex 1, chapter 14 § 36 in the regulation of the driving license “førerkortforskriften”.

Medicinal products Active substance ATC-code
Substitution (LAR) treatment buprenorphine N07BC
Substitution (LAR) treatment levomethadone N07BC
Substitution (LAR) treatment methadone N07BC
Cannabinoides delta-9-tetrahydrocannabinol (THC) N02BG10
Benzodiazepine derivates and benzodiazepine related drugs clonazepam N03AE
Benzodiazepine derivates and benzodiazepine related drugs alprazolam N05BA
Benzodiazepine derivates and benzodiazepine related drugs diazepam N05BA
Benzodiazepine derivates and benzodiazepine related drugs clobazam N05BA
Benzodiazepine derivates and benzodiazepine related drugs lorazepam N05BA
Benzodiazepine derivates and benzodiazepine related drugs oxazepam N05BA
Benzodiazepine derivates and benzodiazepine related drugs nitrazepam N05CD
Benzodiazepine derivates and benzodiazepine related drugs midazolam N05CD
Benzodiazepine derivates and benzodiazepine related drugs remimazolam N05CD
Benzodiazepine derivates and benzodiazepine related drugs zopiclone N05CF
Benzodiazepine derivates and benzodiazepine related drugs zolpidem N05CF
Opioids for acute and chronic pain therapy  opium A07DA02
Opioids for acute and chronic pain therapy  buprenorphine N02A
Opioids for acute and chronic pain therapy  fentanyl N02A, N01AH
Opioids for acute and chronic pain therapy  hydromorphone N02A
Opioids for acute and chronic pain therapy  ketobemidone N02A
Opioids for acute and chronic pain therapy  morphine N02A
Opioids for acute and chronic pain therapy  oxycodone N02A
Opioids for acute and chronic pain therapy  pethidine N02A
Opioids for acute and chronic pain therapy  tapentadol N02A
Opioids for acute and chronic pain therapy  tramadol N02A
Opioids for acute and chronic pain therapy  ethylmorphine R05DA, R05FA
Opioids for acute and chronic pain therapy  codeine R05DA, N02AJ
Opioids for acute and chronic pain therapy  hydrocodone R05DA
Opioids for acute and chronic pain therapy  sufentanil N01AH
Opioids for acute and chronic pain therapy  alfentanil N01AH
Opioids for acute and chronic pain therapy  remifentanil N01AH
Antihistamines for hypnotica  hydroxyzine N05BB01
Antihistamines for hypnotica  doxylamine R06AA09
Antihistamines for hypnotica  alimemazine R06AD01
Antihistamines for hypnotica  promethazine R06AD02

The list will be updated whenever a new active substance, which is considered to be in the group of categories of a medicinal product listed in Annex 1, chapter 14, § - 36 in the regulation of the driving license “førerkortforskriften”, has been granted a marketing authorisation.