Publication: Irrational fixed dose combinations in Nepal: Need for intervention
Date
2008
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
A large proportion of drugs available are of little importance in terms of ful lling primary healthcare needs. Combination
drugs increase the risk of side effects, lead to an ineffective dosage and liability to abuse and may also needlessly increase
the cost. Drug combinations make it more dif cult to nd the causative agent responsible for the adverse reactions. In
many cases their stability is doubtful, reducing the ef cacy of many preparations. The Fifteenth WHO model list of
essential medicines (March 2007) contains only 25 approved xed dose combinations, whereas in Nepal, there are
innumerable examples of irrational drug combinations, which are easily available and can be bought even without
a prescription. A system of screening the drug combinations that are already licensed and available in the market is
implemented in many developed and developing countries. Rational combinations can be of immense help to the health
care system. These combinations may improve the quality of life for many and increase compliance. But irrational xed
dose combination products can be equally harmful.
Key words: Adverse drug reaction, Combination drugs, Fixed dose combination, Irrational drug use, Nepal
Description
Poudel A1 , Palaian S2 , Shankar PR 3 , Jayasekera J4 , Izham MIM 5
1Hospital and Clinical Pharmacist, Drug Information and Pharmacovigilance Center, Manipal Teaching Hospital,Pokhara, Nepal, 2Assistant Professor, Department of Pharmacy/ Pharmacology, Manipal College of Medical Sciences,Pokhara, Nepal, 3Department of Pharmacology and Therapeutics, KIST Medical College, Lalitpur, Nepal, 4 Project co-ordinator, Health Action International, Colombo, Sri Lanka, 5 Associate Professor, Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia