The Scene of Banned Drugs in India

 

Sunita Panchawat1* and Nupoor Sharma2

1Department of Pharmaceutical Sciences, Mohanlal Sukhadia University, Udaipur (Raj.)

2B. N. Institute of Pharmaceutical Sciences, Udaipur (Raj.)

*Corresponding Author E-mail: sunita_pharma2008@rediffmail.com

 

 

ABSTRACT:

India is becoming a hub for the availability and usage of banned/harmful medicines like Nimesulide, D’cold, Novalgin, Lomofen, Rofecoxib etc. A drug is banned on the basis of risk versus benefit ratio evaluated through post marketing surveillance and Adverse Drug Reaction Reporting System. Pharmaceutical negligence among doctors can lead to hazardous effects on the general health of a patient. The present study was planned to explore about awareness of banned drugs among educated youth and people related to this profession. Government should spread the information of drugs side effect. Doctors should not prescribe these drugs to protect the human health.

 

KEYWORDS: Banned Drugs, Phenylpropanolamine, Novalgin, Sulfadoxin, Antimalarial etc.

 

INTRODUCTION:

According to the world Drug Report, the global trade industry generates over $320 billion annually. The drug trafficking business creates large scale employment opportunities legally and illegally. Illegal drugs can kill people, result of laboratory tests confirmed that the fake anti-malarial drugs, which are manufactured in china but labeled ‘made in India’, contained only sulfadoxine and no pyrimethamine, whereas original drugs contains both sulfadoxine 500mg and pyrimethamine 25 mg.(1) The health sector is seriously affected by the increasing production and promotion of certain banned and fake drugs in all across the country. How often does a patient ask his doctor on the possible side effects” of a medicine, he has been prescribed? Hardly ever, as they don’t know that their favorite medicine is banned in many countries.(2) Medical profession is getting defamed and crippled in India because of various factors like self medication, lack of knowledge among doctors, inefficient government policies, unethical drug promotion and medical commercialization. A drug is banned on the basis of risk versus benefit ratio evaluated through post marketing surveillance and Adverse Drug Reaction Reporting system.(3)

 

The main objective of this review is to create awareness and knowledge regarding banned/harmful drugs/drug combinations in India.

 

News Related To Banned Drugs

However the risk benefit ratio is context specific and dosage specific, says, Dhananjay Bhakhle, executive vice president, medical research, Lupin. “ Such has not been found to be uniform outside India; while some countries would ban it, some would continue with its usage based on its independent data studies”, says DG Shah, director general of Indian Pharmaceutical Association. (4)

 

However, if a drug has been objectively found to be inefficacious or found to have serious side effects or the manufacturer has withdrawn it, and then it needs to be pulled out of Indian market as well. Many pharmaceutical companies such as Ranbaxy, Cipla, Sun pharma, Glenmerk, Merk, Abbott and Alkem continue to market drugs containing phenylpropanolamine (PPA), which has been banned by Central Drugs Standard Control Organization (CDSCO) for serious side effects, the ban has been stayed by Madras High Court. “Once a drug has been banned, a clear publicity should be made about it so that all stockholders and doctors, chemists and patients are aware of this”, says Urmila Thatte, Head of Clinical Pharmacology at the Mumbai based KEM hospital.(4) However at times harmful drug can be very effective to treat a more severe condition. For instance, Thioridazone an anti-psychotic drug known to cause a fetal condition called neuroleptic malignant syndrome, has been found to be effective in the treatment of multi-drug resistant tuberculosis.(5)

 

Irrational Use of Drugs

Irrational and inappropriate use of certain drugs like Nimesulide, which is a non-steroidal anti-inflammatory drug, poses an alarming situation for India, due to its potential to cause hepatotoxicity (especially in children due to prolonged use to treat fever and pain), cholestatis, pruritis, colon cancer, coagulopathy and seizers in smokers over a period of time. It is not used in USA, Finland, Spain, Bangladesh, Portugal, Singapore and Israel but is still used in India.(4)

 

Indian healthcare industry is seen to be growing at a rapid pace and is expected to become a US $ 280 billion industry by 2020.(6)

 

The health sector is severely affected by the increasing production and promotion of certain banned and fake drugs in all across the country. Nimesulide is one of the most commonly used medicine in the country to cure pain and fever. It has been banned in many countries for causing serious side effects.(7) Phenylpropanolamine is used in cough syrups. There are reports from abroad that it is causing cardiac problems and that’s why its use has been restricted in many countries. (8)  

 

Some of the common ones that are easily available and people use frequently without doctor’s prescription are Nise, Nimulid, D’cold, Vicks action 500, Enteroquinol and Novalgin. These are used as analgesic, antipyretic, cough and cold and anti-diarrheal, but latest research shows that long term use can affect human health in various ways by damaging liver, causing irregular heartbeats, depression, blood pressure fluctuations damage to sight etc. (9)  

 

This is the prime reason most of European countries have disqualified banned on the manufacturing consumption of these drug. Even countries such as Bangladesh have banned nimesulide for both adults and children, but unfortunately the Indian government has turned a blind eye to the entire issue. (10) Drugs like analgin, furazolidone  nitrofurazone are banned for use even in animal in the United States. (11)  

 

Irrational drug combinations: Needs awareness

Use of combination of drug is common practice, the selection of optimal dose and optimal combination has remained largely a matter of trial and error. The basis of many fixed dose drug combination being taught to the undergraduate medical students and also being prescribed; appears to be irrational to pharmacologists.

 

Table1. Some irrational fixed dose drug combinations available in the Indian market

Combinations

Irrationality

1. Norfloxacin + Metronidazole; Norfloxacin + Tinidazole; Norfloxacin +Tinidazole + Loperamide; Norfloxacin + Tinidazole + Dicyclomine; Norfloxacin + Ornidazole; Ciprofloxacin + Tinidazole; Ofloxacin +

Tinidazole; Ofloxacin + Metronidazole; Ofloxacin + Ornidazole; Gatifloxacin + Ornidazole.

Though claimed to be broad spectrum, combining (antiamoebic) with fluoroquinolone (antibacterial) is irrational because patient suffers only from one type of diarrhoea. Using this combination adds to cost, adverse effects and may encourage resistance.

2. Nimesulide + Diclofenac; Nimesulide + Dicyclomine + Simethicone; Nimesulide + Paracetamol; Nimesulide + Cetirizine + Pseudoephedrine; Nimesulide + Paracetamol + Tizanidine.

Nimesulide a controversial drug has been banned in many countries. It is a sorry state of affairs that its combinations are readily available over the counter. Combining two NSAIDs may increase the side effects of both the NSAIDs. There is little documentary evidence that a preparation containing more than one analgesic is more effective than a single ingredient preparation.

3. Amoxycillin + Cloxacillin

Amoxycillin is inactive against staphylococcus, as most strains produce ß-lactamase and cloxacillin is not so active against streptococci. For any given infection, one of the components is useless but adds to cost and adverse effect. Since amount of each drug is halved, efficacy is reduced and chances of selecting resistant strains are increased.

4. Domperidone + Rabeprazole; Domperidone + Esomeprazole

Increased incidence of rhabdomyolysis.

5. Simvastatin + Nicotinic acid; Atorvastatin + Nicotinic acid

Probability of myopathy is increased.

6 .Roxithromycin + Ambroxol; Ciprofloxacin + Ambroxol; Gatifloxacin + Ambroxol; Cefadroxil + Ambroxol; Cefixime + Ambroxol + Lactobacillus

Many trials have failed to show superior efficacy of the combination over use of ambroxol alone in respiratory tract infection.  Gatifloxacin is withdrawn.

7. Fluconazole + Tinidazole; Doxycycline + Tinidazole; Tetracycline + Metronidazole

Combining two antimicrobial agents to increase the spectrum of activity is irrational, as the patient may need only one drug. The key point is to make a correct diagnosis.

8. Enalapril + Losartan

Combining two drugs affecting the same pathway is irrational; it doesn’t add to efficacy.

9. Cetirizine + Phenylpropanolamine + Dextromethorpan;  Cetirizine + Phenylpropanolamine + Paracetamol; Levocetirizine+ Paracetamol + Phenylpropanolamines.

Phenylpropanolamine is a banned drug; yet it is a part of many cough and cold remedies. Besides its potential to cause stroke (more so in hypertensives), it can aggravate diabetes, glaucoma and prostate enlargement.

10. Diazepam + Dried aluminium hydroxide gel + Aluminium glycinate + Oxyphenonium; Diazepam + Magaldrate + Oxyphenonium; Diazepam + Dried aluminium hydroxide gel + Magnesium trisilicate + Dimethylpolysiloxane.

Antacids raise the gastric pH and reduce the absorption of benzodiazepines.

11. Cisapride + Omeprazole; Mosapride + Pantoprazole ; Ondansetron + Pantoprazole.

In patients with gastro esophageal reflux disease, the use of this combination has shown no benefit due to the addition of prokinetic drugs.

 

CIMS lists more than 100 irrational combinations which are not approved in any developed country but are being marketed in India. This fact has to be taught to undergraduate medical students in their formative years of learning. So that once they address medical ailments like malaria, tuberculosis, AIDS, hypertension etc, they should be more logical in selecting appropriate drug combinations and should not be swayed by marketing tricks and false claims made by the pharmaceutical industry. The pharmacological basis of combining each ingredient in the formulation should be taught. Selection of p drugs, rational drug use, use of rational drug combinations and ethical laboratory practices should be inculcated in the student’s curriculum during their clinical training.(12)

 

Misuse of Drugs

Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harm and risks of each drug. (13) Illegal drugs, along with alcohol, tobacco, cocaine and opiate drugs create large social costs to society. Cocaine and opiate drugs first became criminalized in 1914, followed by marijuana in 1937, in US. The criminalization of these drugs has led to the modern “war on drugs”, characterized by strict enforcement of drug variations and policing attempts directed at shutting down the drug trade. (14) 

 

Scholars and policymakers however have questioned whether the “war on drugs” is really the optimal policy, with some suggestinn that legalization and regulation may be a better alternative. Milton and Rose friedman, famous promoters of free markets and choice, promoted legalization of illicit drugs.

 

However much harm drugs do to those who use them seeking to prohibit their use does even more harm both to users of drugs and to the rest of us. Legalizing drugs would simultaneously reduce the amount of crime and improve law enforcement. It is hard to conceive of any other single measure that would accomplish so much to promote law and order. (15)


 

 

 

 

Table2 List of drugs prohibited for manufacture and sale through gazette notifications under section 26a of drugs and cosmetics act 1940 by the ministry of health and family welfare

S. No.

Drug Name

Notification No. & Date

1

Amidopyrine

GSR NO. 578(E) Dated 23.07.1983

2

Fixed dose combinations of vitamins with anti-inflammatory agents and tranquilizers

GSR NO. 578(E) Dated 23.07.1983

3

Fixed dose combinations of Atropine in Analgesics and Antipyretics

GSR NO. 578(E) Dated 23.07.1983

4

Fixed dose combinations of Strychnine and Caffeine in tonics

GSR NO. 578(E) Dated 23.07.1983

5

Fixed dose combinations of Yohimbine and Strychnine with Testosterone and Vitamins

GSR NO. 578(E) Dated 23.07.1983

6

Fixed dose combinations of Iron with Strychnine, Arsenic and Yohimbine

GSR NO. 578(E) Dated 23.07.1983

7

Fixed dose combinations of Sodium Bromide/chloral hydrate with other drugs

GSR NO. 578(E) Dated 23.07.1983

8

Phenacetin

GSR NO. 578(E) Dated 23.07.1983

9

Fixed dose combinations of antihistaminic with anti-diarrhoeals.

GSR NO. 578(E) Dated 23.07.1983

10

Fixed dose combinations of Penicillin with Sulphonamides.

GSR NO. 578(E) Dated 23.07.1983

11

Fixed dose combinations of Vitamins with Analgesics

GSR NO. 578(E) Dated 23.07.1983

12

Fixed dose combinations of any other Tetracycline with Vitamin C

GSR NO. 578(E) Dated 23.07.1983

13

Fixed dose combinations of Hydroxyquinoline group of drugs with any other drug except for preparations meant for external use

Substituted vide GSR NO. 793(E) Dated 13.12.1995

14

Fixed dose combinations of Corticosteroids with any other drug for internal use except for preparations meant for meter dose inhalers and dry powder inhalers

Substituted vide GSR NO. 738(E) Dated 09.10.2009

15

Fixed dose combinations of Chloramphenicol with any other drug for internal use

Substituted vide GSR NO. 1057(E) Dated 03.11.1988

16

Fixed dose combinations of crude Ergot preparations except those containing Ergotamine, Caffeine, analgesics, antihistamines for the treatment of migraine, headaches

Substituted vide GSR NO. 304(E) Dated 07.06.1991

17

Fixed dose combinations of Vitamins with Anti TB drugs except combination of Isoniazid with Pyridoxine Hydrochloride (Vitamin B6)

GSR NO. 578(E) Dated 23.07.1983

18

Penicillin skin/eye Ointment

GSR NO. 578(E) Dated 23.07.1983

19

Tetracycline Liquid Oral preparations

GSR NO. 578(E) Dated 23.07.1983

20

Nialamide

GSR NO. 578(E) Dated 23.07.1983

21

Practolol

GSR NO. 578(E) Dated 23.07.1983

22

Methapyrilene, its salts

GSR NO. 578(E) Dated 23.07.1983

23

Methaqualone

GSR NO. 49(E) Dated 31.01.1984

24

Oxytetracycline Liquid Oral preparations

GSR NO. 322(E) Dated 03.05.1984

25

Demeclocycline Liquid Oral preparations

GSR NO. 322(E) Dated 03.05.1984

26

Combination of anabolic Steroids with other drugs.

GSR NO. 863(E) Dated 22.11.1985

27

Fixed dose combination of Oestrogen and Progestin (other than oral contraceptive) containing per tablet Estrogen content of more than 50 mcg (equivalent to Ethinyl Estradiol) and content of more than 3 mg(equivalent to Norethisterone Acetate) and all fixed dose combination injectable preparations containing synthetic Oestrogen and Progesterone.

Substituted vide GSR NO. 743(E) Dated 10.08.1989

28

Fixed dose combination of Sedatives/ hypnotics/anxiolytics with analgesics-antipyretics.

GSR NO. 999(E) Dated 26.12.1990

29

Fixed dose combination of Rifanpicin, isoniazid and Pyrazinamide, except those which Provide daily adult dose given below:

Drugs Minimum Maximum

Rifampicin 450 mg 600 mg

Isoniazid 300 mg 400 mg

Pyrazinamide 1000mg 1500 mg

Substituted vide GSR NO. 100(E) Dated 11.02.2003

30

Fixed dose combination of Histamine H-2 receptor antagonists with antacids except for those combinations approved by Drugs Controller, India.

GSR NO. 999(E) Dated 26.12.1990

31

The patent and proprietary medicines of fixed dose combinations of essential oils with alcohol having percentage higher than 20% proof except preparations given in the Indian Pharmacopoeia.

GSR NO. 999(E) Dated 26.12.1990

32

All Pharmaceutical preparations containing Chloroform exceeding 0.5% w/w or v/v whichever is appropriate.

GSR NO. 999(E) Date d 26.12.1990

33

Fixed dose combination of Ethambutol with INH other than the following:INH Ethambutol 200 mg. 600 mg. 300 mg. 800 mg.

GSR NO. 69(E) Dated 11.02.1991

34

Fixed dose combination containing more than one antihistamine.

GSR NO. 69(E) Dated 11.02.1991

35

Fixed dose combination of any anthelmintic with cathartic/purgative except for piperazine/Santonim.

GSR NO. 69(E) Dated 11.02.1991

36

Fixed dose combination of Salbutamol or any other bronchodilator with centrally acting anti-tussive and/or antihistamine.

Substituted vide GSR NO. 290(E) Dated 16.04.2008

37

Fixed dose combination of laxatives and/or anti-spasmodic drugs in enzyme preparations.

GSR NO. 69(E) Dated 11.02.1991

38

Fixed dose combination of Metoclopramide with systemically absorbed drugs except fixed dose combination of metoclopramide with aspirin/paracetamol

Substituted vide GSR NO. 603(E) Dated 24.08.2001

39

Fixed dose combination of centrally acting, antitussive with antihistamine, having high atropine like activity in expectorants.

GSR NO. 395(E) Date d 19.05.1999

40

Preparations claiming to combat cough associated with asthma containing centrally acting antitussive and/ or an antihistamine.

GSR NO. 395(E) Dated 19.05.1999

41

Liquid oral tonic preparations containing glycerophosphates and/or other phosphates and / or central nervous system stimulant and such preparations containing alcohol more than 20% proof.

GSR NO. 395(E) Dated19.05.1999

42

Fixed dose combination containing Pectin and/or Kaolin with any drug which is systemically absorbed from GI tract except for combinations of Pectin and/or Kaolin with drugs not systemically absorbed.

GSR NO. 395(E) Dated 19.05.1999

43

Chloral Hydrate as a drug.

GSR NO. 304(E) Dated 07.06.1991

44

Dovers Powder I.P.

GSR NO. 612(E) Dated09.08.1994

45

Dover’s Powder Tablets I.P.

GSR NO. 612(E) Dated 09.08.1994

46

Antidiarrhoeal formulations containing Kaolin or Pectin or Attapulgite or Activated Charcoal.

GSR NO. 731(E) Dated30.09.1994

47

Antidiarrhoeal formulations containing Phthalyl Sulphathiazole or Sulphaguanidine or Succinyl Sulphathiazole.

GSR NO. 731(E) Dated 30.09.1994

48

Antidiarrhoeal formulations containing Neomycin or Streptomycin or Dihydrostreptomycin including their respective salts or esters.

GSR NO. 731(E) Dated 30.09.1994

49

Liquid Oral antidiarrhoeals or any other dosage form for pediatric use containing Diphenoxylate Lorloperamide or Atropine or Belladona including their salts or esters or metabolites Hyoscyamine or their extracts or their alkaloids.

GSR NO. 731(E) Dated 30.09.1994

50

Liquid Oral antidiarrhoeals or any other dosage form for pediatric use containing halogenated hydroxyquinolines.

GSR NO. 731(E) Dated 30.09.1994

51

Fixed dose combination of antidiarrhoeals with electrolytes.   

GSR NO. 731(E) Dated 30.09.1994

52

Patent and Proprietary Oral Rehydration Salts other than those conforming to the following parameters:

(a) Patent and Proprietary oral rehydration salts on reconstitution to one litre shall contain:

Sodium – 50 to 90 milliosmoles

Total osmolarity – 240-290 milliosmoles Dextrose: Sodium molar ratio – Not less than 1:1 and not more than 3:1

(b) Patent and proprietary cereal based oral rehydration salts on reconstitution to one litre shall contain:

Sodium – 50 to 90 milliosmoles

Total osmolarity – Not more than 290

milliosmoles

Precooked rice – equivalent to not less than 50gms and not more than 80gms as total replacement of dextrose

(c) Patent and proprietary oral rehydration salts (ORS) may contain amino acids in addition to oral rehydration salts conforming to the parameters specified above and labelled with the indication for “Adult Chloretic Diarrhea Only”

(d) Patent and proprietary oral rehydration salts (ORS) shall not contain mono or polysaccharides

 Saccharin sweetening agent.

GSR NO. 57(E) Dated 07.02.1995

53

Fixed dose combination of Oxyphenbutazone or Phenylbutazone with any other drug.

GSR NO. 633(E) Dated 13.09.1995

54

Fixed dose combination of Analgin with any other drug.

GSR NO. 405(E) Dated 03.06.1996

55

Fixed dose combination of dextropropoxyphene with any other drug other than anti-spasmodics and/or non-steriodal anti-inflammatory drugs (NSAIDS).

GSR NO. 633(E) Dated 13.09.1995

56

Fixed dose combination of a drug, standards of which are prescribed in the Second Schedule to the said Act with an Ayurvedic, Siddha or Unani drug.

GSR NO. 633(E) Dated 13.09.1995

57

Mepacrine Hydrochloride (Quinacrine and its salts) in any dosage form for use for female sterilization or contraception.

GSR NO. 499(E) Dated 14.08.1998

58

Fenfluramine

GSR NO. 499(E) Dated 14.08.1998

59

Dexfenfluramine.

GSR NO. 499(E) Dated 14.08.1998

60

Fixed dose combination of Diazepam and Diphenhydramine Hydrochloride.

GSR NO. 169(E) Dated 12.03.2001

61

Cosmetics Licensed as toothpaste/tooth powder containing tobacco.

GSR NO. 444(E) Dated 30.04.1992

62

Fixed dose combination of Vitamin B1Vitamin B6 and Vitamin B12 for human use

GSR NO. 93(E) Dated 25.02.1997

63

Fixed dose combination of haemoglobin in any form (natural or synthetic).

GSR NO. 702(E) Dated 14.10.1999

64

Fixed dose combination of Pancreatin or Pancrelipase containing amylase, protease and lipase with any other enzyme.

GSR NO. 814(E) Dated 16.12.1999

65

Fixed dose combination of Nitrofurantoin and trimethoprim.

GSR NO. 814(E) Dated 16.12.1999

66

Fixed dose combination of Phenobarbitone with any anti-asthmatic drugs.

GSR NO. 170(E) Dated 12.03.2001

67

Fixed dose combination of Vitamin B1Vitamin B6 and Vitamin B12 for human use

GSR NO. 170(E)Dated 12.03.2001

68

Fixed dose combination of Phenobarbitone with Hyoscin and/or Hyoscyamine

GSR NO. 170(E) Dated 12.03.2001

69

Fixed dose combination of Phenobarbitone with Ergotamine and/or Belladona

GSR NO. 170(E) Dated 12.03.2001

70

Fixed dose combination of Haloperidol with any anti-cholinergic agent including Propantheline Bromide.

GSR NO. 170(E) Dated 12.03.2001

71

Fixed dose combination of Nalidixic Acid with any anti-amoebic including Metronidazole.

GSR NO. 170(E) Dated 12.03.2001

72

Fixed dose combination of Loperamide Hydrochloride with Furazolidone

GSR NO. 170(E) Dated 12.03.2001

73

Fixed dose combination of Cyproheptadine with Lysine or Peptone.

GSR NO. 170(E) Dated 12.03.2001

74

Astemizole

GSR NO. 191(E) Dated 05.03.2003

75

Terfinadine

GSR NO. 191(E) Dated 05.03.2003

76

Phenformin

GSR NO. 780(E) Dated 01.10.2003

77

Rofecoxib and its formulations

GSR NO. 810(E) Dated 13.12.2004

78

Valdecoxib and its formulations

GSR NO. 510(E) Dated 28.07.2005

79

Diclofenac and its formulations (for animal use)

GSR NO. 499(E) Dated 04.07.2008

80

Rimonabant.

GSR NO. 884(E) Dated 11.12.2009

81

Rosiglitazone

GSR NO. 910(E) Dated 12.11.2010

82

Nimesulide formulations for human use in children below 12 years of age.

GSR NO. 82(E) Dated 10.02.2011

83

Cisapride and its formulations for human use.

GSR NO. 82(E) Dated 10.02.2011

84

Phenypropanolamine and its formulations for human use.

GSR NO. 82(E) Dated 10.02.2011

85

Human Placental Extract and its formulations for human use except its

1. Topical application for wound healing, and

2. Injection for pelvic inflammatory disease.

Substituted vide GSR NO. 418(E) Dated 30.05.2011

86

Sibutramine and its formulations for human use.

GSR NO. 82(E) Dated 10.02.2011

87

R-Sibutramine and its formulations for human use.

GSR NO. 82(E) Dated 10.02.2011

88

“Gatifloxacin formulation for systemic use in human by any route including oral and injectable”.

GSR NO. 218(E) Dated 16.03.2011

89

Tegaserod and its formulations

GSR NO. 218(E) Dated 16.03.2011

90

Letrozole for induction of ovulation in anovulatory infertility.

GSR NO. 752(E) Dated 12.10.2011

91

Serodiagnostic test kits for diagnosis of tuberculosis

GSR 432(E) dated 07.06.2012 & GSR 433(E) dated 07.06.2012

92

Dextyropropoxyphene and formulations containing Dextropropoxyphene for human use.

G.S.R. No. 332 (E) datetd 23-5-2013

93

Fixed dose combination of Flupenthixol+Melitracen for human use.

G.S.R. No. 377 (E) dated 18-6-2013

94

Analgin and all formulations containing Analgin for human use.

G.S.R. No. 378 (E) dated 18-6-2013

95

Pioglitazone and all formulations containing Pioglitazone for human use.

G.S.R. No. 379 (E) dated 18-6-2013

 

 

 

Drug control strategy

Present drug control efforts utilize several techniques in attempt to achieve their goal of eliminating illegal drug use:

·        Disrupting the market for drugs.

·        Prevention efforts that rely on community activism, public information campaigns to educate the public on the potential dangers of drug use.

·        Law-enforcement efforts against elements of the supply chain, through surveillance and undercover work. (16)

 

CONCLUSION:

Awareness of people related to ban drugs is poor. People use these drugs without knowing adverse drug reaction (ADR) or side effect related to them. Government should spread the knowledge and information of drugs side effects and their lethal consequences. Doctors should not prescribe these banned drugs. Pharmacist should up to date regarding drugs and their usage. Once a drug is banned, a clear publicity should be made about it, so that all doctors, chemists and patients are aware of this. The drug packs should contain label with details of adverse drug reactions or side effects. Medical colleges should involve in generating awareness about harmful drugs or drug combination. We need to understand the expected and unexpected drug reactions and conduct assessment to schools and colleges. Therefore, these banned drugs should be in knowledge of all medical fraternity in welfare of the community.

 

REFERENCES:

1.       India’s Illegal drugs. My Economist. www.myeconomistwordpress.com/indias.illegal.drugs.

2.       Gaurav Sharma, Anuj Dixit, Swapnil Awasthi, A.K. Awasthi. Some common Indian drugs should be banned in India. International Journal of Pharmaceutical Research and Development. 3(5); 2011:  48-52.

3.       Dipika Bumb and Vela Desai, Alarming medicines: A survey on 100 doctors in Rajasthan. International Journal of Pharmaceutical Applications. 3(2); 2012: 370-374.

4.       Kiran Kabtta Somyanshi. Drugs banned abroad may still be use in some cases. The Economic Times. www.articles.economictimes.indiatimes.com/2013-01-07/news/36192943_1_cdsco_drugs_standard_control_organization_side_effects.

5.       Francis PA. Nimesulide; The end begins. 2003. www.pharmabiz.com.

6.       Economic times. India turning affordable, quality option for medical tourists. 2010 Nov.6; Available From URL; http://www.indiahealthcare.in/index.php?option.

7.       Medic8. Nimesulide side effects online. 2010 Nov.5; Available From URL; http//www.ethow.com/facts_7312477_nimesulide_banned_html.

8.       Tripathi KD. Essentials of medical pharmacology. New Delhi: Jaypee Brother Medical Publisher (P) Ltd; 1997.

9.       Kernan WN, Viscoli CM, Brass LM. Phenylpropanolamine and the risk of hammorhagic stroke. N. Engl. J. Med. 343 (25); 2000 Dec: 1826-32.

10.     Dogra S. Banned but available. 2005 Nov. 15; Available From URL; http//www. expresspharmaonline.com/ 20051115/ marked 01.shtml

11.     Bakshi AB. Last few dose [online]. 2009 Jun 1; Available From URL; http//www.outlookindia. Com/printarticle. aspx? 240569

12.     Gautam et al. Irrational drug combinations: Needs to sensitize undergraduates. Indian J Pharmacol. Vol 38(3); June 2006: 169-70.

13.     Nutt D, King LA, Saulsbury W, Blakemore C. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet. 369 (9566); March 24, 2007: 1047-53.

14.     John J. Donohue lll, Rethinking Amerika’s illegal drug policy.www.ycsg.yale.edu/center/forms/ US-illegal drug policy-145-158.

15.     Crime reprinted in, In the name of Justice. Timothy lynch ed., 2009. pendix B at p.186

16.     http://enn.wikipedia.org/wiki/prohibition of drugs.

 

 

 

 

 

Received on 01.10.2013       Modified on 25.10.2013

Accepted on 02.11.2013      © RJPT All right reserved

Research J. Pharm. and Tech. 7(1): Jan. 2014; Page   104-109