Re: Re: Problems in brand name

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Dear all, Congratulations Dr Anupama , for being the youngest moderator in this forum !! The following clinical cases may not be directly related to ur topic , but I thought of sharing with u all... I have come across three cases of dispensing errors due to confusing names , illegible prescrition (?), carelessness and negligence of so called pharmacist... 1. Folimax- Folitrax :A pregnant patient presented with complains of sev. stomatitis . It was found out that she was dispensed methotrexate instead of folic acid ... her pregnancy was adversely affected and pregnancy was terminated ... 2. A pharmacist dispensed salbutamol instead of ethambutol ( generic) 3. A private chemist shop dispensed Daonil instead of Dio-1 to a young girl She went into hypoglycemic coma,

was hospitalised , remained on IV glucose for three days .... In all these cases pharmacist is primarily responsible . This raises many questions : whether the person at the chemist shop is really qualified ? The pharmacist can always ask the patient about the primary complain , check the age of the patient, or call upon the prescriber in case he can read the prescription. Are there any surprise inspection at the chemist shop to check qualifications of the person employed ? what is the role of FDA ? Even the prescriber can ask the pt. to get the medicines confirmed by him before starting the treatment.. as the market is flooded with numerous brands and the prescriber is not aware of all of them... A list can be prepared and made available to all doctors, chemist shop, consumers to avoid the confusion.. UG students can be asked to study the market

preparartion and prepare the list (project work) to increase the awarness .... Any other suggestion ... Mira Desai anupama sukhlecha <anupama_acad@...> wrote: Respected Dr Mahadev Desai, Great work! You have done a good search and given a list of drugs where ingredients were changed in brands which were once very popular. You have also included a list of change in brand names of same drug when given by different routes (of same company) and a list of drugs with almost similar brand name but different generically. It would be nice if you could also include the name of the manufacturing company in these cases. The companies would definitely be profiting in the first case- by confusing the doctors, the pharmacists and even the patients. Some brand names get very well engraved in the minds of doctors, pharmacists that companies take advantage of this situation and simply introduce new drugs or drug combinations on same brand name and mint money.Even in OTC preparations, this strategy of companies has been observed. There should be strict rules to prevent this. There should also be strict

control on naming brands to prevent confusion. One of the drugs is called FOLIMAX (Folic acid)and the other FOLITRAX (Methotrexate, Folic Acid antagonist). What if - in a confusion, one is taken for the other? Who should be blamed? Would our senior moderators- Dr Vijay, Madam Kunda, Dr Mira.. like to comment in this regard? Senior moderators, please.. Anupama. Dr. MAHADEV DESAI'S POST Dear NetRUMiansThanks to Dr. Chetna and Dr. Gajjar for veryinformative links. Both links are indeed very usefulfor all.I) As I had earlier mentioned some companies changethe ingradients retaining their once popular brands.Few examples: Brand name Earlier ingradient Present ingradientOxalgin Analgin Diclofenac(Oxalgin SR)Suganril Oxyphenbutazone DiclofenacSpasmindon ?Analgin Dicyclomin + EthylmorphineII) Some companies have same name with differentingradients in oral and injectable

formulationsBrand Oral Injection / otherValz Valdecoxib ParecoxibValeron -do- -do-Valsafe -do- -do-Valcox -do- -do-Ecwin meloxicam piroxicam (as Gel)III)Three generic compound have common initial lettersviz. Valsartan, Valdecoxib and Valproate leadingconfusion for clinicians in remembering their brandnames, one wrong /illegible letter will change thedrug of different

class.e.g.VALTEC is Valproic acidVALTIC is ValdecoxibVALENT is ValsartanVALLET is ValdecoxibSAZO is sulfasalazine (now SAZO EN)ZASO is ZolpidemZIL is TinidazoleZILEE is LevofloxacinFOLIMAX is Folic acidFOLITRAX is Methotrexate (folic acid antagonist)I am sure there are innumerable such instances wherethere are very high chances of prescription errorsresulting into more morbidity.Thanks , have a great day!Dr Mahadev Desai Get the freedom to save as many mails as you wish. Click here to know how.

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Hello Mira madam, Thank you for the congrats. One more thing madam-When we had joined Netrum, we were told that age, nationality.. are no barriers for the membership.And you can see, all of us- from India, Malaysia, Nigeria...are in netrum, whether a member or a moderator, our goals are the same! About the posting-you have given examples, where brand confusion has lead to such serious disasters. Folimax and Folitrax confusion is the worst.In fact notices should be issued to those companies to rename their preparations About Dio-1, I would like to know the generic name. Confusion can arise with Daonil. The other one-Ethambutol and Salbutamol, the names appear different still confusion could be because of the rhyming part or suffix problem. In India, on paper,officialy, chemists are qualified while registering the pharmacies.But then, the one who sits

and dispenses the drugs that counts. Surprise checks and action on the pharmacies not following the rules can help, but then, once again India is one amongst the most corrupt countries. Yes,patients should get the dispensed medicines verified before leaving the clinic. Anupama.Mira Desai <desaimirak@...> wrote: Dear all, Congratulations Dr Anupama , for being the youngest moderator in this forum !! The following clinical cases may not be directly related to ur topic , but I thought of sharing with u all... I have come across three cases of dispensing errors due to confusing names , illegible prescrition (?), carelessness and negligence of so called pharmacist... 1. Folimax- Folitrax :A pregnant patient presented with complains of sev. stomatitis . It was found out that she was dispensed methotrexate instead of folic acid ... her pregnancy was adversely affected and pregnancy was terminated ... 2. A pharmacist dispensed salbutamol instead of ethambutol ( generic) 3. A private chemist shop dispensed

Daonil instead of Dio-1 to a young girl She went into hypoglycemic coma, was hospitalised , remained on IV glucose for three days .... In all these cases pharmacist is primarily responsible . This raises many questions : whether the person at the chemist shop is really qualified ? The pharmacist can always ask the patient about the primary complain , check the age of the patient, or call upon the prescriber in case he can read the prescription. Are there any surprise inspection at the chemist shop to check qualifications of the person employed ? what is the role of FDA ? Even the prescriber can ask the pt. to get the medicines confirmed by him before starting the treatment.. as the market is flooded with numerous brands and the prescriber is not aware of all of them... A list can be prepared and made available to all doctors,

chemist shop, consumers to avoid the confusion.. UG students can be asked to study the market preparartion and prepare the list (project work) to increase the awarness .... Any other suggestion ... Mira Desai anupama sukhlecha <anupama_acad (DOT) co.in> wrote: Respected Dr Mahadev Desai, Great work! You have done a good search and given a list of drugs where ingredients were changed in brands which were once very popular. You have also included a list of change in brand names of same drug when given by different routes (of same company) and a list of drugs with almost similar brand name but different generically. It would be nice if you could also include the name of the manufacturing company in these cases. The companies would definitely be profiting in the first case- by confusing the doctors, the pharmacists and even the patients. Some brand names get very well engraved in the minds of doctors, pharmacists that companies take advantage of this situation and simply introduce new drugs or drug combinations on same brand name and mint money.Even in OTC preparations, this strategy of companies has been observed. There should be strict rules to prevent this. There should also be strict control on naming brands to prevent confusion. One of the drugs is called FOLIMAX (Folic acid)and the other FOLITRAX (Methotrexate, Folic Acid antagonist). What if - in

a confusion, one is taken for the other? Who should be blamed? Would our senior moderators- Dr Vijay, Madam Kunda, Dr Mira.. like to comment in this regard? Senior moderators, please.. Anupama. Dr. MAHADEV DESAI'S POST Dear NetRUMiansThanks to Dr. Chetna and Dr. Gajjar for veryinformative links. Both links are indeed very

usefulfor all.I) As I had earlier mentioned some companies changethe ingradients retaining their once popular brands.Few examples: Brand name Earlier ingradient Present ingradientOxalgin Analgin Diclofenac(Oxalgin SR)Suganril Oxyphenbutazone DiclofenacSpasmindon ?Analgin Dicyclomin + EthylmorphineII) Some companies have same name with differentingradients in oral and injectable formulationsBrand Oral Injection /

otherValz Valdecoxib ParecoxibValeron -do- -do-Valsafe -do- -do-Valcox -do- -do-Ecwin meloxicam piroxicam (as Gel)III)Three generic compound have common initial lettersviz. Valsartan, Valdecoxib and Valproate leadingconfusion for clinicians in remembering their brandnames, one wrong /illegible letter will change thedrug of different class.e.g.VALTEC is Valproic acidVALTIC is ValdecoxibVALENT is ValsartanVALLET is ValdecoxibSAZO is sulfasalazine (now SAZO

EN)ZASO is ZolpidemZIL is TinidazoleZILEE is LevofloxacinFOLIMAX is Folic acidFOLITRAX is Methotrexate (folic acid antagonist)I am sure there are innumerable such instances wherethere are very high chances of prescription errorsresulting into more morbidity.Thanks , have a great day!Dr Mahadev Desai Get the freedom to save as many mails as you wish. Click here to know how. Here’s a new way to find what you're looking for - Answers

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