Be cautious about OTC drugs

By Syed Akbar
Hyderabad: Suffering from headache, loose motions or common cold? Just don't rush to a chemist for an over-the-counter (OTC) medicine. Chances are that you may develop nausea, severe allergic reactions, kidney failure or even cancer.
More often than not the blame does not lie with the chemist but with the type of drug he gives you. As many as a dozen generic or basic drugs, which have been banned world-wide, are freely available in twin cities. Strangely enough, these drugs enjoy the legal status as they are yet to be banned by the Indian government.
"For a drug to be banned the Central government needs concrete evidence supported by research studies on its bad side-effects. Unfortunately, in India we do not have post-drug follow-up records. Pharmaceutical companies take advantage of this", argues R Uday Bhaskar, secretary-general of All-India Drug Control Officers' Confederation.
He, however, wants these drugs to be banned as "what is bad for people in the USA and Europe is equally bad for Indians, whether we have post-drug follow-up studies or not".
The Central government has banned 76 categories of Fixed Dose Combination or individual drugs. Ironically, the government banned these drugs only after the manufacturers voluntarily withdrew them. Rofecoxid is one such drug. It was found to be dangerous to heart patients. However, many irrational combination drugs are still sold freely.
Some of the drugs banned in the USA, European Union, Australia and developed countries but still available in India are:
Analgin (pain-killer), Cisapride (acidity, constipation), Droperidol (anti-depressant), Furazolidone (anti-diarrhoea), Nimesulide (pain-killer, fever), Nitrofurazone (anti-bacterial cream), Phenolphthalein (laxative), Phenylpropanolamine (cold and cough), Oxyphenbutazone (non-steroidal anti-inflammatory), Piperazine (anti-worms) and Quiniodochlor (anti-diarrhoeal).
Nimelsulide, a non-steroidal anti-inflammatory drug, has been banned in many countries for its reported liver toxicity. The Central government approved Nimelsulide in 1994 for treatment of painful inflammatory musculo-skeletal disorders but many doctors prescribe it for ordinary pain and fever. Nimelsulide and Cyproflaxin (100 mg) have been banned for paediatric use but doctors continue to prescribe them for children.
Dr SV Chandrasekhar, consultant surgeon of Apollo Hospitals, says drugs like analgin should not be used for children while furazolidone is equally bad for adults and children. "Combination drugs are not advisable. When a patient suffers from one problem why should he or she be given a combination of drugs? Vitamins are always sold in combination. A person does not suffer from deficiency of several vitamins or minerals at a time. Overdose may cause severe problems", he points out.


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The side-effects:
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1. Analgin (it is used in dozens of drugs including Novalgin): Causes bone marrow depression, ulcers and reflex action.
2. Cisapride (available under brand names Ciza and Syspride): Causes irregular heartbeat and palpitation.
3. Droperidol (brand name Droperol): Affects the heart and blood circulation.
4. Furazolidone (Furaxone, Lomofen): Nausea, severe headache, cancer and damage to intestines.
5. Nimesulide (Nise, Nimulid): Causes liver failure.
6. Nitrofurazone (Furacin): Causes cancer.
7. Phenolphthalein (Agarol): Found to be carcinogenic.
8. Phenylpropanolamine (D'Cold, Vicks Action-500): May lead to stroke.
9. Oxyphenbutazone (Sioril): Bone marrow depression.
10. Piperazine (Piperazine): Causes damage to nerves.
11. Quiniodochlor (Enteroquinol): Damages eyesight.