Activists have criticised the Union health ministry’s ban on around 300 common drug combinations.
Comparing it to the Maggi controversy — in which the snack was termed unsafe and banned, before being declared safe again — they said the decision was hasty.
The Union government has banned medicines that contain more than two drugs that tackle the same symptoms. For instance, a common medicine used for fever and cold contains paracetamol, phenylephrine and caffeine — all three are used to treat these symptoms.
Explaining the ban, the health ministry said there is no need to prescribe such drug combinations. Industry experts said the rationale behind the ban could be to curb unnecessary prescription of combination drugs. For instance, a patient with a cold does not need a medicine that treats fever.
RP Yajurvedi (Rao), president Society for Awareness of Civil Rights, a non-profit in Mumbai for patient rights, said the decision could cause a shortage of the drugs. “It is not in the interest of patients,” he said.
Doctors are divided in their opinions. “We have been prescribing these combinations for several years and they have been effective. A patient may think the ban is due to some adverse effect of these drug combos. How do we explain this overnight ban to them?” said Dr Pratit Samdani, physician, Breach Candy Hospital. “The government should not have given them licences in the first place.”
Some doctors said certain combinations of drugs could be causing resistance to those medicines in patients.
The drug delivery system — a mechanism by which the drug is administered — depends on these combinations and the interactions between the different ingredients of the combination.
“Why give an unnecessary combination drug which treats cold and fever, when the patient has only fever? This has fuelled antibiotic resistance in the community,” said Dr Nitin Shah, paediatrician, PD Hinduja Hospital, Mahim.
A combination of two antibiotics or two anti-inflammatory drugs does not necessarily translate into better cure, said doctors.
“There is a need to address the issue but an overnight ban is not an answer. It means some drugs which are used widely will be unavailable,” said Yajurvedi (Rao). “What will the industry do with the raw materials and the unsold drugs?”
On Tuesday, the All-India Organisation of Chemists and Druggists wrote to the Drug Controller General of India asking them to reconsider the ban. “It is very difficult for chemists to find out the several brands of these combination drugs, stop the sale and return the huge stock to manufacturers. This may force us to shut down shops and find out all the related brands. It will take at least 30 days to complete the formalities and it will affect the availability of medicines,” said Jagganath Shinde, president of the organisation.
According to Dr Om Shrivastav, infectious disease consultant, implementing the ban is a challenge. “Nimesulide is already banned but it is still being used in such combinations. These irrational combinations of various formulations affect organs such as kidney and also result in gastrointestinal complications,” said Dr Shrivastav.