In a significant move aimed at safeguarding public health, the Indian Govt banned 156 FDC medicines. This decision follows extensive recommendations from an Expert Committee appointed by the Central Government, which concluded that these combinations were “irrational” and posed potential health risks. The list includes commonly used antibiotics, painkillers, and multivitamins, all of which have now been outlawed from production, marketing, and distribution in India.
What Are Fixed Dose Combination (FDC) Medicines?
Fixed Dose Combination (FDC) medicines are pharmaceutical products that contain two or more active ingredients in a fixed ratio. These combinations are designed to improve patient compliance by reducing the number of pills they need to take. However, not all FDCs are beneficial; some can be irrational, meaning that the combination of drugs either does not provide additional therapeutic benefit or, worse, can lead to increased risks and side effects.
Why Govt Banned 156 FDC medicines ?
The recent ban on 156 FDC medicines was not made lightly. The decision was based on the recommendations of the Drug Technical Advisory Board (DTAB) and an Expert Committee, both of which found these combinations to be irrational. The central government, convinced by these findings, concluded that the use of these FDCs could potentially harm patients, particularly when safer alternatives are available, that’s why Govt banned 156 FDC medicines.
The Health Ministry issued a gazette notification on August 21, stating that the Govt banned 156 FDC medicines includes antibiotics, anti-allergic drugs, analgesics, multivitamins, and combinations used to treat conditions like fever and hypertension. The notification emphasized that the decision was made in the interest of public health, with the primary goal of eliminating unnecessary health risks.
What Makes an Govt Banned 156 FDC medicines Irrational?
An FDC is deemed irrational when the combination of drugs does not have a justified therapeutic benefit or when the risks outweigh the benefits. For instance, some of the banned FDCs included combinations that had no proven additional advantage over individual drugs taken separately. In some cases, the interactions between the drugs in the combination could lead to harmful side effects or reduced efficacy.
The Expert Committee and the DTAB found that many of these banned FDCs offered no therapeutic justification. Moreover, the presence of multiple active ingredients in these combinations could increase the risk of adverse drug reactions, making their use dangerous, especially when safer alternatives exist, that’s why Govt banned 156 FDC medicines.
A Closer Look at the Banned Medicines
The list of Govt banned 156 FDC medicines include a wide range of commonly used medications. For example, the combination of Omeprazole Magnesium and Dicyclomine HCl, often used to treat stomach pain, has been prohibited. Another banned combination is Mefenamic Acid and Paracetamol, commonly used for pain and swelling. These combinations were found to be irrational, with the potential for significant health risks.
Additionally, combinations like Povidone Iodine, Metronidazole, and Aloe, used for preventing and treating skin infections, and Ursodeoxycholic Acid and Metformin HCl, used for treating fatty liver in diabetics, were also included in the banned list. The DTAB concluded that the harm to patients from these combinations far outweighed any potential benefits.
Fixed Dose Combinations: Benefits and Risks
While FDCs can offer certain benefits, such as improved patient compliance and reduced pill burden, they also come with significant risks. The primary concern with FDCs is that the fixed ratio of drugs may not be suitable for all patients. For instance, one component of the combination may be required in a higher dose than the other, but the fixed ratio does not allow for this flexibility.
Furthermore, the presence of multiple active ingredients increases the likelihood of drug interactions, which can lead to adverse effects. In some cases, one drug in the combination may reduce the effectiveness of the other, making the FDC less effective than individual drugs taken separately.
The Role of Regulatory Bodies in Ensuring Drug Safety
The Govt banned 156 FDC medicines highlights the critical role of regulatory bodies in ensuring the safety and efficacy of medicines. The Drugs Technical Advisory Board (DTAB) and the Expert Committee were instrumental in evaluating these FDCs and recommending their prohibition. Their rigorous analysis and review process ensured that only those combinations that posed significant health risks were banned.
The Drugs and Cosmetics Act, 1940, under which these bans were enforced, empowers the government to prohibit the manufacture, sale, or distribution of drugs that are found to be unsafe or lacking in therapeutic justification. This act serves as a safeguard for public health, ensuring that only safe and effective medicines are available to consumers.
The Impact of the Ban on the Pharmaceutical Industry
The ban on these FDCs is likely to have a significant impact on the pharmaceutical industry. Manufacturers of these combinations will need to halt production and distribution, potentially leading to financial losses. However, this move also presents an opportunity for the industry to innovate and develop safer, more effective drug formulations.
For pharmaceutical companies, the ban serves as a reminder of the importance of rigorous research and development. Ensuring that drug combinations are both safe and effective is crucial, not only for regulatory approval but also for maintaining public trust.
Public Reaction and Industry Response
The response to the ban has been mixed. While some in the pharmaceutical industry have expressed concerns about the financial impact, others have welcomed the move as a necessary step to protect public health. Sudarshan Jain, Secretary General of the Indian Pharmaceutical Alliance, stated that the decision is in the best interest of patients and is a result of ongoing discussions and recommendations from various expert committees.
The public, on the other hand, has largely supported the ban, with many people expressing relief that potentially harmful medicines are being removed from the market. The ban has also sparked discussions about the importance of informed decision-making when it comes to medication use.
The Legal Background: Section 26A of the Drugs and Cosmetics Act
The Govt banned 156 FDC medicines was enforced under Section 26A of the Drugs and Cosmetics Act, 1940. This section gives the central government the authority to prohibit the manufacture, sale, or distribution of any drug that is found to be unsafe or lacking in therapeutic justification. The use of this legal provision underscores the seriousness of the government’s commitment to ensuring drug safety.
The decision to ban these FDCs was not taken lightly. The Expert Committee and the DTAB conducted thorough evaluations of each combination, considering factors such as therapeutic efficacy, safety, and the availability of safer alternatives. Only after these rigorous assessments were the bans recommended and subsequently enforced.
The Future of FDCs in India
The Govt banned 156 FDC medicines raises important questions about the future of combination medicines in India. While FDCs can offer benefits, particularly in improving patient compliance, it is essential that these combinations are both safe and effective. The ban highlights the need for ongoing vigilance and regulation to ensure that only rational and beneficial combinations are approved for use.
For patients, the ban serves as a reminder of the importance of being informed about the medications they take. Patients should consult their healthcare providers before starting any new medication, especially combination therapies, to ensure that the benefits outweigh the risks.
The government’s decision to ban 156 fixed dose combination medicines is a significant step toward ensuring public health and safety. While FDCs can offer benefits in terms of convenience and compliance, it is crucial that these combinations are both safe and effective. The ban, enforced under Section 26A of the Drugs and Cosmetics Act, 1940, reflects the government’s commitment to eliminating irrational and potentially harmful drug combinations from the market.
As the pharmaceutical industry adapts to this new regulatory landscape, the focus must remain on developing safe, effective, and rational drug formulations that meet the highest standards of quality and safety. For patients, this ban serves as a reminder of the importance of informed decision-making when it comes to medication use.
Here is the complete list of Govt Banned 156 FDC medicines
FDC of Amylase + Protease + Glucoamylase + Pectinase + Alpha Galactosidase + Lactase + Beta-Gluconase + Cellulase + Lipase + Bromelain + Xylanase + Hemicellulase + Malt diastase + Invertase + Papain
FDC of Antimony Potassium Tartrate + Dried Ferrous Sulphate
FDC of Benfotiamine + Silymarin + L-Ornithine L-aspartate + Sodium Selenite + Folic acid + Pyridoxine hydrochloride
FDC of Bismuth Ammonium Citrate + Papain
FDC of Cyproheptadine HCl + Thiamine HCl + Riboflavine + Pyridoxine HCl + Niacinamide
FDC of Cyproheptadine Hydrochloride + Tricholine Citrate + Thiamine Hydrochloride + Riboflavine + Pyridoxine Hydrochloride
FDC of Rabeprazole Sodium (As enteric coated tablet) + Clidinium Bromide + Dicyclomine HCl + Chlordiazepoxide
FDC of Fungal Diastase + Papain + Nux vomica Tincture + Cardamom Tincture + Casein Hydrolysed + Alcohol
More of Govt Banned 156 FDC medicines includes
FDC of Omeprazole Omeprazole Magnesium + Dicyclomine HCl
FDC of S-adenosyl methionine + Metadoxine + Ursodeoxycholicacid BP + L-Methylfolate Calcium eq. to L-Methylfolate + Choline bitartratee + Silymarin + L-ornithine L-aspartate + Inositol + Taurine
FDC of Silymarin + Thiamine Mononitrate + Riboflavin+ Pyridoxine HCl + Niacinamide + Calcium pantothenate + Vitamin B12
FDC of Silymarin + Pyridoxine HCl + Cyanocobalamin + Niacinamide + Folic Acid
FDC of Silymarin + Vitamin B6 + Vitamin B12 + Niacinamide + Folic acid + Tricholine Citrate
FDC of Sodium Citrate + Citric Acid Monohydrate Flavored with Cardamom Oil, Caraway Oil, Cinnamon Oil, Clove Oil, Ginger Oil + Alcohol
FDC of Sucralfate + Acelofenac
FDC of Sucralfate + Domperidone + Dimethicone
FDC of Sucralfate + Domperidone
FDC of Tincture Ipecacuanha + Tincture Urgenia + Camphorated Opium Tincture + Aromatic Spirit of Ammonia + Chloroform + Alcohol
More of Govt Banned 156 FDC medicines includes
FDC of Ursodeoxycholic Acid + Metformin HCl
FDC of Weak Ginger tincture + Aromatic Spirit of Ammonia + Peppermint Spirit +Chloroform +Sodium Bicarbonate +Compound Cardamom + Alcohol
FDC of Sucralfate + Pantoprazole Sodium + Zinc Gluconate + Light Magnesium Carbonate
FDC of Aloe + Vitamin E Soap
FDC of Povidone Iodine + Metronidazole + Aloe
FDC of Azelaic acid + Tea Tree Oil + Salicylic acid + Allantoin + Zinc oxide + Aloe vera + Jojoba oil + Vitamin E + Soap noodles
FDC of Azithromycin + Adapalene
FDC of Calamine + Aloes + Allantoin
More of Govt Banned 156 FDC medicines includes
FDC of Calamine + Diphenhydramine Hydrochloride + Aloe + Glycerine + Camphor
FDC of Chlorphenesin + Zinc oxide + Starch
FDC of Clindamycin Phosphate + Zinc acetate
FDC of Gamma Benzene Hexachloride + Benzocaine
FDC of Glucosamine hydrochloride + Diacerein + Menthol + Camphor + Capsaicin
FDC of Hydroxyquinone 2.0%w/w + Octyl Methoxycinnamate 5.0% w/w + Oxybenzone 30 % w/w
FDC of Ketoconazole +Zinc Pyrithione +D-Panthenol +Tea Tree Oil +Aloes
FDC of Ketoconazole +Aloe vera+ Vitamin A Acetate
FDC of Ketoconazole +Aloes + ZPTO
FDC of Kojic Acid +Arbutin +Octinoxate +Vitamin E + Mulberry
FDC of Lornoxicam + capsaicin + menthol + camphor
More of Govt Banned 156 FDC medicines includes
FDC of Lornoxicam + Thiocolchicoside +Oleum Lini +Menthol + Methyl salicylate
FDC of Menthol + Aloe vera Topical Spray
FDC of Menthol + Lignocaine HCl+Aloe vera gel + Clotrimazole + Diphenhydramine
FDC of Miconazole nitrate + Gentamicin + Fluocinolone Acetonide +Zinc Sulphate
FDC of Miconazole +Tinidazole
FDC of Minoxidil +Aminexil + Alcohol
FDC of Minoxidil +Azelaic acid + saw palmetto
FDC of Minoxidil +Aminexil
FDC of Pine Bark extract + Kojic acid + Sodium Ascorbyl Phosphate
FDC of Povidone Iodine + Tinidazole + Zinc sulphate
FDC of Povidone Iodine + Ornidazole + Dexpanthenol
FDC of Salicyclic acid + Aloe vera + Allantoin + D-Panthenol
FDC of Silver sulphadiazine +Chlorhexidine Gluconate solution +Allantoin + Aloe vera gel +Vitamin E acetate
More of Govt Banned 156 FDC medicines includes
FDC of Sodium salicylate + Zinc gluconate + Pyridoxine HCl
FDC of Tetracycline + Colistin Sulphate
FDC of Clomiphene + Ubidecarenone
FDC of Combikit Clomiphene Citrate + Estradiol Valerate
FDC of Flavoxate HCl + Ofloxacin
FDC of Clomiphene Citrate + N-Acetylcysteine
FDC of Evening Primerose Oil +Cod liver oil
FDC of Sildenafil Citrate +Papaverine +L-Arginine
FDC of Tranexamic acid + Mefenamic acid + Vitamin K1
FDC of Divalproex Sodium +Oxcarbazepine
FDC of Divalproex Sodium +Levetiracitam
FDC of Ergotamine tartrate + Caffeine + Paracetamol + Prochlorperazine maleate
FDC of Piracetam + Ginkgo biloba extracts + Vinpocetin
FDC of Ginkgo biloba + methylcobalamin + Alpha lipoic acid + Pyridoxine HCl
FDC of Ginseng Extract + Dried extract of Ginkgo Biloba
More of Govt Banned 156 FDC medicines includes
FDC of Meclizine HCl+ Paracetamol + Caffeine
FDC of Nicergoline + Vinpocetine
FDC of Gamma Linolenic Acid + Methylcobalamin
FDC of Beclomethasone Dipropionate + Neomycin Sulphate + Clotrimazole + Lignocaine HCl
FDC of Boric acid+ Phenylephrine HCl + Naphazoline Nitrate + Menthol + Camphor
FDC of Naphazoline HCl + Chlorpheniramine Maleate + Zinc Sulphate + Hydroxy Propyl Methyl Cellulose
FDC of Chlorpheniramine Maleate + Naphazoline HCl + Zinc Sulphate + Sodium Chloride + Hydroxy Propyl Methyl Cellulose
FDC of Chlorpheniramine Maleate + Naphazoline HCl + Hydroxy Propyl Methyl Cellulose
FDC of Chlorpheniramine Maleate + Sodium Chloride + Boric Acid + Tetrahydrozoline HCl
FDC of Chlorpheniramine Maleate + Phenylephrine HCl + Antipyrine
More of Govt Banned 156 FDC medicines includes
FDC of Ketorolac Tromethamine + Chlorpheniramine Maleate + Phenylephrine HCl + Hydroxy Propyl Methyl Cellulose
FDC of Ketorolac Tromethamine + Flurometholone
FDC of Naphazoline HCl + Zinc Sulphate + Boric Acid + Sodium Chloride+ Chlorpheniramine Maleate
FDC of Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Boric Acid + Borax + Menthol + Camphor
FDC of Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate +Boric Acid + Sodium Chloride + Zinc Sulphate
FDC of Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate +Boric Acid
FDC of Naphazoline HCl + Chlorpheniramine Maleate + Methyl Cellulose
More of Govt Banned 156 FDC medicines includes
FDC of Naphazoline HCl + Hydroxy Methyl Cellulose + Boric Acid + Menthol + Camphor
FDC of Naphazoline HCl + Boric Acid+Menthol+Camphor +Methyl Cellulose + Chlorpheniramine Maleate + Zinc Sulphate + Sodium Chloride
FDC of Naphazoline HCl + Phenylephrine HCl+ HPMC + Chlorpheniramine Maleate + Menthol+ Camphor
FDC of Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate + Boric Acid + Sodium Chloride + Zinc Sulphate + Menthol + Camphor
FDC of Naphazoline HCl + Hydroxy Propyl Methyl Cellulose + Chlorpheniramine Maleate + Boric Acid +Zinc Sulphate
More of Govt Banned 156 FDC medicines includes
FDC of Naphazoline HCl + Azelastine HCl+ Sodium Carboxy Methyl Cellulose + Menthol + Camphor + Stabilized Oxychlorocomplex
FDC of Naphazoline HCl + Sodium Carboxy Methyl Cellulose + Menthol + Camphor + Stabilized Oxychlorocomplex
FDC of Naphazoline Nitrate + Chlorpheniramine Maleate + Phenylephrine HCl + Hydroxy Methyl Cellulose + Boric Acid+ Menthol+ Camphor
FDC of Naphazoline Nitrate + Chlorpheniramine Maleate + Zinc Sulphate + Boric Acid + Sodium Chloride
FDC of Norfloxacin + Tinidazole (with Betacyclodextrin) Eye ointment
More of Govt Banned 156 FDC medicines includes
FDC of Ofloxacin + Beclomethasone Dipropionate + Lignocaine HCl
FDC of Naphazoline HCl + Chlorpheniramine Maleate + Phenylephrine HCl+ Menthol+ Camphor
FDC of Phenylephrine HCl + Naphazoline HCl +Menthol+ Camphor + Hydroxy Propyl Methyl Cellulose
FDC of Phenylephrine HCl + Naphazoline HCl + Menthol + Camphor
FDC of Sulphacetamide Sodium + Zinc Sulphate + Chlorpheniramine Maleate + Boric acid + Sodium Chloride
FDC of Zinc Sulphate + Boric acid + Naphazoline HCl + Sodium Chloride + Phenyl Ethyl Alcohol
FDC of Cetirizine HCl + Paracetamol + Phenylephrine HCl
FDC of Cetirizine HCl + Phenylephrine HCl
FDC of Levocetirizine + Phenylephrine HCl
More of Govt Banned 156 FDC medicines includes
FDC of Levocetirizine + Phenylephrine HCl + Paracetamol
FDC of Phenylephrine HCl + Paracetamol + Levocetirizine HCl + Menthol
FDC of Levocetirizine HCl + Ambroxol HCl + Paracetamol
FDC of Levocetirizine HCl + Ambroxol HCl + Phenylephrine HCl
FDC of Diethylcarbamazine Citrate + Chlorpheniramine maleate
FDC of Diethylcarbamazine Citrate + Levocetirizine HCl
FDC of Ambroxol HCl + Phenylephrine HCl + Guaiphenesin
FDC of Bromhexine HCl + Phenylephrine HCl
Etofylline + Theophylline anhydrous eq. to Theophylline hydrate + Ambroxol HCl
FDC of Etofylline + Theophylline anhydrous eq. to Theophylline hydrate + Montelukast
FDC of Ambroxol HCl + Terbutaline Sulphate + Ammonium Chloride + Guaiphenesin + Menthol
FDC of Ambroxol HCl + Salbutamol Sulphate + Ammonium Chloride + Guaiphenesin + Menthol
FDC of Cetirizine HCl + Terbutaline Sulphate + Ambroxol HCl + Guaiphenesin
FDC of Dextromethorphan Hydrobromide + Chlorpheniramine Maleate + Ammonium Chloride + Sodium Citrate + Menthol
More of Govt Banned 156 FDC medicines includes
FDC of Salbutamol Sulphate + Bromhexine HCl + Guaiphenesin + Ammonium Chloride + Menthol
FDC of Terbutaline Sulphate + Bromhexine HCl + Chlorpheniramine Maleate
FDC of Chlorpheniramine Maleate + P.G Sulphonate + Ammonium Chloride + Sodium Citrate + Menthol
FDC of Aminophylline + Ammonium Chloride + Sodium Citrate
FDC of Paracetamol + Chlorpheniramine Maleate + Phenyl Propanolamine
FDC of Trithioparamethoxyphenyl Propene + Chlorpheniramine Maleate
FDC of Aceclofenac 50mg + Paracetamol 125mg oral liquid
FDC of Aceclofenac 50mg + Paracetamol 125mg tablet
FDC of Adenosine triphosphate diphosphate + Magnesium Orotate
FDC of Amoxicillin Trihydrate + Dicloxacillin Sodium + Lactobacillus
FDC of Camylofin Dihydrochloride 25 mg + Paracetamol 300mg
FDC of Cefixime + Acetyl Cysteine
FDC of Cephalexin Monohydrate + Serratiopeptidase
More of Govt Banned 156 FDC medicines includes
FDC of Cetyl Myristoleate + glucosamine Sulphate Potassium+ Methyl Sulfonyl methane
FDC of Diacerin IP + Glucosamine Sulphate Potassium Chloride USP + MSM (Methylsulphonyl Methane) + Cetyl Myristoleate
FDC of Paracetamol + Diclofenac Potassium + Caffeine Anhydrous
FDC of Diclofenac sodium + Thiocolchicoside Injection
FDC of Doxycycline + Ornidazole + Bromelain + Lactobacillus Rhamnosus + Lactobacillus Reuteri RC
FDC of Doxycycline HCl + Betacyclodextrin + Serratiopeptidase
FDC of Erythromycin stearate eq.to Erythromycin +Lactic acid Bacillus
FDC of Etodolac + Paracetamol +Serratiopeptidase
FDC of Flupirtine Maleate 400 mg + Paracetamol 325 mg tablet
More of Govt Banned 156 FDC medicines includes
FDC of Glucosamine sulphate potassium chloride 410 mg + Chondroitin Sulphate 100 mg
FDC of Glucosamine sulphate potassium chloride+ Methyl Sulphonyl Methane(MSM) + Sodium Borate+ Copper Sulphate pentahydrate+ Manganese Sulphate + Vitamin D3
FDC of Glucosamine Sulphate Sodium Chloride +Manganese +Boron + Zinc + Copper
FDC of Glucosamine sulphate + Chondroitin sulphate + Methylsulfonylmethane +Vitamin D3 + Vitamin E + Vitamin C + Selenium +Elemental Zinc +Elemental Manganese + Elemental Chromium + Elemental Copper +Elemental Boron
More of Govt Banned 156 FDC medicines includes
FDC of Glucosamine sulphate + Methyl sufonyl methane + manganese sulphate +Vit E acetate +calcium Carbonate
FDC of Glucosamine Sulphate + +Vitamin E acetate + Calcium Pantothenate + Vitamin D3
FDC of Glucosamine Sulphate Potassium chloride +Calcium Carbonate from an organic source (oyster shell) eq. to elemental Calcium+ Vitamin D3
FDC of Cetyl Myristoleate + Glucosamine Sulphate Potassium chloride + Methyl sulfonyl methane
FDC of Glucosamine Sulphate Potassium chloride + Methyl sulfonyl methane +Calcium carbonate +Vitamin E+ Manganese
More of Govt Banned 156 FDC medicines includes
FDC of Glucosamine Sulphate Potassium chloride + Calcium carbonate + Methyl sulfonyl methane +Vit D3
FDC of Glucosamine Sulphate Potassium + Methyl sulphate Sodium+ Sulphonyl Methane +Chondroitin Sulphate Sodium+ Calcium Carbonate +Vitamin D3+Sodium Borate+ Cupric Oxide+ Colloidal Silicon Dioxide+ Manganese Chloride
FDC of Methocarbamol + Diclofenac Sodium Injection
FDC of Paracetamol + Pentazocin
FDC of Sucralfate +Domperidone+ Simethicone
FDC of Sulfaquinoxaline +Diaveridine HCl+ Vitamin K
FDC of Tramadol HCl +Dicyclomine HCl + Domperidone
FDC of Tramadol HCl +Paracetamol +Caffeine +Taurine
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