Re: Analgesic combinations - Cost

[Guest guest]

Dear Friends, Analgesic combinations, not only cause adverse effects, but also add to the cost.Kindly Ref the data. Product Price(in Rupee per tablet approximate) Paracetamol 500 mg 0.40-0.60 Ibuprofen 400 mg 0.67 Diclofenac 50 mg 0.45 Nimesulide 100 mg 1.00 - 3.50 Methocarbomol 500 mg 2.65 Chlorzoxazone 500 mg 3.70 Ibuprofen 400 + Paracetamol 500 1.20 - 1.30 Diclofenac 50 + Paracetamol 500 0.70-1.60 Diclofenac 50 + Paracetamol 500 + Chlorzoxazone 500 4.50 - 5.00

Tramadol 50 + Paracetamol 500 5.00 - 6.00 DIC Goa <dicgoa@...> wrote: U.K. has withdrawn combination of Dextropropoxyphene & Paracetamol (Coproxamol) almost 2 years back, because it has been linked to suicide, misuse. Has any other country restricted its use or done something similar ? Its use in India I think is quite rampant. And often misused too. Below is from the Uk Regulators (MHRA) website : Further to renewed interest, the MHRA position on the withdrawal of co-proxamol: Co-proxamol is implicated in 300-400 deaths from overdose a year. There is growing concern prompted by UK research which shows that co-proxamol is implicated in almost one fifth of drug related suicides and is second only to tricyclic antidepressants as an agent of fatal

overdose. In response, the MHRA/Commitee on Safety of Medicines (CSM) conducted a review of the risks and benefits of co-proxamol. The CSM considered all the available data for co-proxamol and in January 2005 advised that it should be withdrawn from the market on the grounds that the benefits of taking co-proxamol are not considered to outweigh the risks:› Co-proxamol to be withdrawn from the market - January 2005 It was decided to withdraw co-proxamol over an extended period of time in order to allow long term users an opportunity to move to suitable alternatives. The withdrawal will be

phased over a period of up to 36 months. Some manufacturers have already withdrawn co-proxamol and a few will phase the withdrawal until the end of 2007. The MHRA has issued CSM pain management guidance to help doctors find the best options for individual patients. We recognise, however, that there is a small group of patients who are likely to find it very difficult to change; when alternatives appear not to be effective or suitable. For these patients, continued provision of co-proxamol through normal prescribing may continue until the cancellation of the licences at the end of 2007. After this time there is a provision for the supply of unlicensed co-proxamol, on the responsibility of the

prescriber. Patients wishing to go down this route should discuss this possibility with their doctor. The avoidable death toll from co-proxamol overdose cannot be ignored. Sometimes regulation has to balance the needs of the individual against the benefits at a population level. In this case the removal of marketing authorisations with continued use possible in exceptional circumstances is the best balance that could be achieved. The public health gain is already becoming apparent. Further information about the withdrawal of co-proxamol is available in:› Current Problems in Pharmacovigilance: Vol 31 (pages 1-12) May 2006 Raj VAidya Community Pharmacist On 3/19/08, Bharat Gajjar <gajjarbm > wrote: Dear Trupti,Very important topic.The list of 'Innovative combinations' isattractive,but they are not rational. Fixed dosecombinations of NSAIDs with NSAIDS,skeletal musclerelaxant drugs, antacids, H2 receptor blocker drugs,serratiopeptidase are irrational.Recently, DCGI has

given directive to Pharmaceuticalcompanies to surrender the product licenses of variousFixed Dose Combinations (around 251 in number)available in Indian market. Most of the drugs in this list are above saidcombinations.Dr. Bharat Gajjar. --- Trupti Swain <drtruptiswain > wrote:> Dear Friends,> > Providing few data of analgesic combinations> available in Indian market.These combination pills> have now become the largest selling 'brands' of> antiinflammatory/analgesic/antipyretic products. The> 'single' drugs have almost become redundant and 'old> fashioned'. The pharmaceutical companies compete> with one another to find out such 'innovative'> combinations.> > Trupti > Ibuprofen 400 mg +Paracetamol 325 mg or 500

mg> tablet> > Ibuprofen 100mg + Paracetamol 125mg or 162.5 mg> per > 5 ml syrup for children> Diclofenac 50 mg +Paracetamol 325 mg or 500 mg> tablet> Ibuprofen 400 mg + Methocarbamol 750 mg tablet> Diclofenac 50 mg +Paracetamol 325 or 500 mg +> Chlormezanon 100 mg tablet> Indomethacin 25 mg + Paracetamol 325 or 500 mg> tablet> Diclofenac 50 mg +Paracetamol 325 or 500 mg +> Chlorzoxazone 250 mg or 500 mg tablet> Nimesulide 100 mg + Paracetamol 500 mg> > Mefenamic acid 250 Mg + Dicyclomin10 mg> > Diclofenac 50 mg +Paracetamol 250 mg + > Dextroprophoxyphene 32.5 mg tablet> > Ibuprofen 400 mg+ Tizanidine2.28mg> > > > > > > ---------------------------------> Be a better friend, newshound, and know-it-all with> Mobile. Try it

now.__________________________________________________________Be a better friend, newshound, and know-it-all with Mobile. Try it now. http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ

Be a better friend, newshound, and know-it-all with Mobile. Try it now.

[Guest guest]

Hi Trupti,

The prices mentioned by you are what the patients pay?

Vijay

>

> > Dear Friends,

> >

> > Providing few data of analgesic combinations

> > available in Indian market.These combination pills

> > have now become the largest selling 'brands' of

> > antiinflammatory/analgesic/antipyretic products. The

> > 'single' drugs have almost become redundant and 'old

> > fashioned'. The pharmaceutical companies compete

> > with one another to find out such 'innovative'

> > combinations.

> >

> > Trupti

> > Ibuprofen 400 mg +Paracetamol 325 mg or 500 mg

> > tablet

> >

> > Ibuprofen 100mg + Paracetamol 125mg or 162.5 mg

> > per

> > 5 ml syrup for children

> > Diclofenac 50 mg +Paracetamol 325 mg or 500 mg

> > tablet

> > Ibuprofen 400 mg + Methocarbamol 750 mg tablet

> > Diclofenac 50 mg +Paracetamol 325 or 500 mg +

> > Chlormezanon 100 mg tablet

> > Indomethacin 25 mg + Paracetamol 325 or 500 mg

> > tablet

> > Diclofenac 50 mg +Paracetamol 325 or 500 mg +

> > Chlorzoxazone 250 mg or 500 mg tablet

> > Nimesulide 100 mg + Paracetamol 500 mg

> >

> > Mefenamic acid 250 Mg + Dicyclomin10 mg

> >

> > Diclofenac 50 mg +Paracetamol 250 mg +

> > Dextroprophoxyphene 32.5 mg tablet

> >

> > Ibuprofen 400 mg+ Tizanidine2.28mg

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Be a better friend, newshound, and know-it-all with

> > Mobile. Try it now.

>

>

> __________________________________________________________

> Be a better friend, newshound, and

> know-it-all with Mobile. Try it now.

http://mobile./;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ

>

>

>

>

>

>

>

>

>

>

>

>

>

> ---------------------------------

> Be a better friend, newshound, and know-it-all with

Mobile. Try it now.

>