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Fixed dose combinations.

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Dear members,

Fixed dose combinations in India.

In India a variety of combinations of drugs are available which are not included

in WHOs list of essential medicine and are irrational.

Following are examples of some.

Pediatric formulations of Nimesulide + Paracetamol can induce severe hypothermia

in small children and lead to shock. FDCs of Diclofenac + Serratiopeptidase do

not offer any particular advantage over the individual drugs despite vigorous

claims that Serratiopeptidase promotes more rapid resolution of inflammation. On

the other hand, the patient is exposed to greater risk of gastrointestinal [GI]

irritation and serious bleeding from unsuspected peptic ulceration. FDCs of

quinolones and nitroimidazoles (e.g. Norfloxacin + Metronidazole, Ciprofloxacin

+ Tinidazole, Ofloxacin + Ornidazole) have not been recommended in any standard

books, but continue to be heavily prescribed drugs in GI infections, pelvic

inflammatory disease, dental infections, etc.. Such injudicious use of

antibiotic FDCs can rapidly give rise to resistant strains of organisms, which

is a matter of serious concern to the health care situation in our country.

Regards,

Dr.Sonali Pimpalkhute,

Lecturer,Pharmacology.

GMC,Nagpur.

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