Some popular cough syrups and common cold medicines like Sumo and Piriton may soon not be available at your local chemist.
The Centre is said to be screening Fixed Drug Combination (FDC) medicines, including common cold and cough medicines like Piriton, Grillinctus, D Cold Total, and Sumo. A report by News18 stated that “these drugs are under the scanner, as the government plans to weed out irrational combinations”.
The report also stated that the Central Drugs Standard and Control Organisation (CDSCO) has a list of 19 FDCs. An expert committee headed by Dr MS Bhatia, professor and head, Department of Psychiatry, University College of Medical Sciences, will decide which drugs to be banned.
What are FDC medicines?
FDC medicines, also known as cocktail medicines, have more than one active ingredient combined in a fixed dose to form a single drug. Such drugs have often been under government scrutiny — especially antibiotics, as their resistance can lead to diseases.
High time we revisit these drugs
Dr Ravi Mehta, a renowned pulmonologist at Apollo Hospitals in Bengaluru, who treats many patients with common cold and cough, told South First why it is “high time” and important to put some corrective measures in place.
“Because mixing medications is okay only if there is a scientifically explained allergy behind it. Before prescribing one needs to look into the drug interaction, dosing, and any precautions to take before prescribing it,” he said.
However, now that science is getting specific and mixed medications are allowed only after clinical trials, it may be time to revisit what we have done in the past and take some corrective steps, he argued.
Do not work for all
Some of these cough syrups typically contain a combination of expectorants whose job is to bring out the phlegm. Some act as phlegm thinners. Few more are cough suppressants and contain opioids that are used to relieve allergies.
So these combinations, according to Dr Mehta, may have detrimental effects and not suit everybody. For instance, if someone is looking for one particular effect — such as cough suppression — then these may not help. So, it does make sense to review these as a strategy.
Dr Vijayalakshmi, infectious disease expert at SIMS Hosptial in Chennai, told South First: “Some of these combination cough syrups have certain elements which are not suitable for health, in fact, may be detrimental for a particular subset of patients.”
Not found in most countries
Dr Mehta said cocktail drugs are unique to places like India and are not approved in many parts of the world. India boasts of more than 2,000 FDCs, unlike other countries.
“If you look at other parts of the world, most of the cough medicines are a mixture of one or two things which are carefully thought through and approved after clinical trials. It’s a reasonable idea for India to review and relook at the FDCs available here,” Dr Mehta said.
Doctors also said that these cough expectorant medicines can be misused.
“Some of these contain sleeping agents and mild opioids which are hallucinogens. They are abused and a large number of cough syrups are consumed as addictive substances,” explained Dr Bhagat Ram, physician at Victoria Hospital in Bengaluru.
Why are they so popular?
Amongst several other reasons, doctors said these medicines are cost-effective. Instead of buying two or three separate medicines to treat multiple illness symptoms, the patient can make do with just one FDC drug. Pharma companies can produce these drugs quickly as they don’t have to discover new medicines or manufacture them separately.
According to the News18 report, the medicines under the scanner include: Sumo, Nicip, D Cold Total, Vicks Action 500 Advanced, cough syrups Tedykoff, Grilinctus, Codistar, Tossex, Ascoril C, Piriton expectorant, and antibiotic ointment Clindamycin, among others.
The pharma companies manufacturing these drugs include Alkem, Cipla, Reckitt Benckiser, Procter & Gamble, Mankind Pharma, Abbott, Glenmark, and GlaxoSmithKline, among others.