Traveling out of the country on a business trip or holiday? Before you leave Indian shores, buy all the medicines you may require during your trip and make sure you have them in adequate quantity. Or else you may well end up buying the wrong medication in a foreign country.
Prescription medicines are difficult to get overseas and over-the-counter medicines have their own problems.
When doctors prescribe medicines, they invariably write down the brand name. But there is no guarantee the Indian brand name will get you the same medication in a foreign country. That country may have a drug with an identical brand name, but its active ingredient may be quite different. Sometimes so different as to cause life-threatening reactions.
For example, in India, the brand name Flomax represents an antibiotic and the active ingredient is Ofloxacin. But if you were to show a prescription for it in the United States, you would get a medicine for enlarged prostate, containing Tamsulosin as its active ingredient. And if you were to present the same prescription in Italy, you would get an anti-inflammatory drug with the active ingredient being Morniflumate. If the handwriting of the prescribing doctor is not very legible and you were to show it in Japan, Flomax may well be read as Flomox and you may be sold a medication to treat infection, with Cefcapene Pivoxil Hcl as the active ingredient.
A case in point is that of an American citizen who traveled to Serbia and ran out of Dilacor XR, prescribed for high blood pressure. In Serbia, Dilacor, marketed by a local company, was a brand name for Digoxin, used for the treatment of heart failure and abnormal heart rhythm, requiring blood tests for close monitoring of the amount of drug in the body to avoid adverse effects. The traveller, unaware of all this, took it regularly and had to eventually be hospitalized with life-threatening drug toxicity. Following a newspaper report, the US Food and Drug Administration last year issued a public health advisory.
The FDA, in its advisory, says it found 18 foreign drug products that use the same brand name as in the US, but contain different active ingredients. The advisory does not refer to drugs sold in India, so I compared some of the brand names and active ingredients in the FDA list with those sold in India, with the help of ‘Drug Today’, a ready reckoner for current medical formulations.
Take Rubex, for example. In India, it is a gel for musculo-skeletal disorders. But in the US, it is a drug for cancer; in Ireland, a tablet for Vitamin C deficiency. The brand name Canesten denotes Clotrimazole for fungal infections in 28 countries including India. In the US, if you ask for Canesten, you may well get Cenestin — for menopause.
In India and the US, Allegra is a medicine for allergies with Fexofenadine HCL as the active ingredient. But in Germany, if you think Allegro is a German name for Allegra, you are mistaken. Allegro is meant for headache and the active ingredient is Frovatriptan.
Increased travel makes it imperative for pharma companies and regulators to sit together and eliminate drug confusions. But till then, consumers need to take every precaution to ensure they don’t end up with wrong medication.
(The author is a senior journalist and consumer affairs expert)