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A Rational Study of
Analgesics and Antipyret
Dr. Jarnie Uhrig
Dr. Penny Dawson
Rational Drug Ceil
Medico Friend Circle
Published by
Kerala Sastra Sahitya Parishad
A Rational Study of
Analgesics and Antipyretics
'"flOMITY HEALTH CELL
Dr. Jamie Uhrig
Dr.Penny Dawson
Rational Drug Cell
Medico Friend Circle
Published by
Kerala Sastra Sahjtya Parishad
A RATIONALITY STUDY OF
ANALGESICS AND ANTIPYRETICS
Dr. Jamie Uhrig and Dr. Penny Dawson
Pain is a universal phenomenon and the development of
drugs to relieve pain must be looked upon as one of the few
real accomplishment of western medicine. The minor and major
analgesics are important drugs in any formulary and are wide
ly prescribed. Fever is another common symptom of disease
and antipyretics are also used extensively, especially for
children. In order to study what drugs are available and used
for pain and fever it is useful to study the Monthly Index of
Medical Specialities (MIMS), which contains many of the
standard preparations and the combinations currently being
promoted by the pharmaceutical industry. Before the results
of this study of the analgesics and antipyretics in MIMS are
presented, a few introductory comments are needed.
A World Health Organization Expert Committee has esta
blished a list of essential drugs for all countries. The list
includes the following analgesics and antipyretics:
Aspirin (acetylsalicylic acid, ASA)
tablets and suppositories
Paracetamol (acetaminophen)
tablets and suppositories
Codeine : Phosphate tablets,
Pethidine : Injection,
Morphine : Injection.
■5
Mjjor textbooks of medicine and surgery recommend the use
of these listed drugs almost exclusively. 6, 7.
Notably absent from this list are three drugs that are found
in MIMS. They are the widely used analgesic analgin (metamizol, dipyrone), and the opioid analgesics dextropropoxy
phene and pentazocine.
recommendations of the World Health Organization, it is
possible to classify the preparations- found in MIMS. The
fiftynine preparations listed as analgesics and antipyretics in
the July 1984 issue of MIMS India were studied; the results
were graded
A : use of the product is justified—
14 preparations.
Analgin is a minor analgesic/antipyretic that enjoys wide
spread popularity in India. It is an unnecessary and dangerous
drug for which there are safe and inexpensive substitutes.'ll
Analgin is not inexpensive; even generic preparations are
usually five items the price of aspirin and double the price of
paracetamol. It has been implicated in many cases of agranulo
cytosis and has been deleted from the formularies of most
countries.'! Analgin should also be banned in India If its
manufacture and sale continue to be allowed, then it should
only be used when no alternative is available'1 Because most
countries have banned analgin, studies have not been per
formed on combinations of analgin and other analgesics. These
combinations cannot be recommended for use.
Dextropropoxyphene is an opioid analgesic that has rela
tively low addictive potential but little analgesic activity
either. One study found it to be no better than placebo in the
relief of moderate pain'1. In combination with aspirin for the
relief of mild pain, it was found to be only as effective as
aspirin and codeine'5. The combination of dextropropoxyphene
and paracetamol has been proven to be ineffective; the combi
nation is only as effective as paracetamol alone'2.
Pentazocine is a newer opioid analgesic. It is an extremely
expensive drug that offers no advantages over the well-known
and proven major analgesics pethidine and morphine'3. Penta
zocine tablets are thirty times more expensive than pethidine
tablets. Pentazocine should be classified as a narcotic, as
there is potential for drug abuse.'10
Bearing in mind the recommendations of standard text
books, the findings of studies published in periodicals, and the
B : the combination is not proven
to be superior to single ingredient
preparation; and hence not reco
mmended—
1 6 preparations.
C : the combination has deen proven
to be inferior to single ingredient
p'reparation; and should be withdrawn—
11 preparations.
D : the preparation contains analgin;
and should be banned —
18 preparations.
Manu
facturer's
name
Cost of
Refe
treatment rences
(usually 5 days)
Grade
Ingredients
1 '
2
3
4
5
ANADEX
(Concept)
D
Analgin 250 mg
dextropropoxyph ene
-65 mg
Rs. 9.05
1, 2
Comments : This combination is of unproven efficacy.
Analgin should not be used when alternatives are available;
and dextropropoxyphene is no better than a placebo in com
binations.
7
1
2
3
APIDIN
(IDPL.)
C
aspirin 300 mg
caffeine 30 mg
codeine
phosphate 6 mg
4.5
Rs. 5.92
1,12
Addition of caffeine or a subtherapeutic dose of codeine to
Aspirin adds nothing to its effectiveness; caffeine does not
potentiate the analgesic activity of aspirin but codeine can do
so, if used in proper dosage.
AVAFORTON
(Khandelwal)
D
avapyrazone 24 mg
Rs. 5.32
metamizoltwo in
analgin
240 mg jections
per ml
avapyrazone 60 mg Rs. 16.74
metamizol 210 mg
analgin
per tab
1
This analgesic-antispsmodic combination is of unproven effec
tiveness, and should not be entered in the analgesic/antipyretic section of any formulary. Avapyrazone is a little-used drug
and analgin should never be used when substitutes are avai
lable.
AVAMOL
(Khandelwal)
B
avacan substance 50 mg Rs. 6.02
systral
5 mg fora
paracetamol
100 mg bottle
per ml
1
Like the previous preparation, this is a combination of unpro
ven value. Avacan is a little-used drug, and analgin should
never be used when substitutes are available.
1
2
BARALGAN
(Hoechst)
D
BESEROL
(Win-Medicare)
B
3
4
5
analgin 500 mg
Rs. 11.34
1
p-piperidinoethoxy-ocarbmethoxybenzophenone 5 mg
diphenyl-piperidinoethylacetamidbrom-o-methylate
: 01 mg
per tablet
analgin 500 mg
Rs. 2.17 for
second ingredient
one injecas above 2 mg;
tion
third ingredient as
above 0.02 mg.
per ml.
This is an analgesic-antispasmodic preparation of unproven
value. Analgin should never be used when substitutes are
available.
Paracetamol 450 mg Rs. 45.50
chlormezanone 100 mg
1,5
This is a very expensive unproven combination. Chlormeza
none is a minor tranquilizer that is outdated and adds nothing
to the effectiveness of paracatamol.
BETAFLAM
(Vilco)
C
Paracetamol 400 mg
dextropropoxyphene
65 mg
oxyphenbutazone
100 mg
diazepam
2 mg
Rs. 9.79
2
The combination of paracetamol and dextropropoxyphene has
been proven to be inferior to single ingredient preparation.
Oxyphenbutazone has to be used only for very specific purpo
ses and never to be included in fixed dose combination.
8
1
2
BRAL
(Microlabs)
B
9
3
______ 4
identical ingredients
to Baralgan
Rs. 11.13
5
1
2
3
1
CORBUTYL
(Roussel)
C
dextropropoxyphene
-65 mg
paracetamol 650 mg
This preparation is identical to Baralgan that has been reviewed
above.
CAFIASPIRIN
(Bayer)
B
aspirin
caffeine
300 mg
30 mg
Rs. 3.60
1,5
The addition of a small dose of caffeine to the effective analgesic/antipyretic aspirin does not add to its therapeutic effect.
CALPOL
(Wellcome)
A
paracetamol 500 mg
tabs.
paracetamol 120 mg
Rs. 8
D
analgin 500 mg
Rs. 10.26
clidinium bromide 2.5 mg
diazepam 2.5 mg
2
DOLOPAR PLUS
(Micro Labs)
C
dextropropoxyphene Rs. 22.92
-65 mg
acetaminophen (paracetamol) 400 ,,
diazepam :
2 „
2
The combination of dextropropoxyphene and paracetamol
has been proven to be not superior to individual drugs given
alone. Addition of minor tranquilizer to this combination
does not make it more effective.
Paracetamol has excellent analgesic/antipyretic activity. The
only problem with this preparation is its high price.
CODOLSIC
(FDC)
Rs. 7. 63
5
The combination of paracetamol and dextropropoxyphene
has been proven to be inferior to single ingredient prepara
tion.
1, 5,
6, 7.
Rs. 1 2.23
Rs. 48.90
for 5 days
depending
on age.
4
1
This combination is of unproven effectiveness. The addition
of an antispasmodic and a minor tranquilizer to this analgesic
does not add to its effectiveness. Analgin should never be
used when substitutes are available.
EQUAGESIC
(Wyeth)
B
ethoheptazineRs. 13.95
citrate
75 mg
meprobamate 150 mg
aspirin
250 mg
1,5
This combination is of unprove effectiveness. The addition
of the minor tranquilizer to aspirin and ethoheptazine adds
nothing to its effectiveness. The use of this minor tranqui
lizer, meprobamate, has been replaced by the use of newer
and safer ones. Meprobamate is an addicting drug hence
the use of this combination should be restricted.
10
1
2
FORTAGESIC B
(Win-Medicare)
11
3
Paracetamol 500 mg
Pentazocine 15 mg
4
Rs. 62.76
5
1,5,
10
Addition of 25 mg of pentazocine creates a more effective
combination. But addition of 15 mg has not proved to be of
any value. This is an extremely expensive combination. Penta
zocine can cause addiction.
FORTWIN
(Ranbaxy)
A
Pentazocine 30 mg
injection
Pentazocine 25 mg
tablet
Maximum
Rs. 39.84
per day
Rs. 102.40
1,3,
5,10
This extremely expensive drug is not necessary to replace the
WHO-recommended major analgesics, morphine and pethidine.
Because of its addictive potential, pentazocine shoulo be
added to the narcotic formulary. Its use should be restricted to
severe painful condition where other drugs are ineffective.
CROCIN
(Duphar)
A
paracetamol 500 mg tabs. Rs. 8.00
paracetamol 125 mg
Rs. 2.57 to
per 5 ml.
Rs. 10.30
(depending
on age)
CUREPAR
(Curewel)
a
A
paracetamol 500 mg
Rs. 7.28
etamol has excellent analgesic/antipyretic activity.
CYCLOPAN
(Indoco)
1,5,
6,7-
B
dicyclomine
paracetamol
diazepam
3
20 mg
500 mg
2.5 mg
4
5.
Rs. 4.00
1,5
This combination is of unproven effectiveness- The addition
of a minor tranquilizer and an antispasmodic adds nothing to
paracetamol's activity.
DISPIRIN
(Reckitts)
A
Aspirin
. 350 mg Rs. 7.20
calcium carbonate 105 mg
citric acid
35 mg
1,5
Buffered aspirin has no advantages over plain aspirin for the
treatment of pain and fever. However, it can be given in
patients with gastritis.
DOLOPAR
(Microlabs)
1,5
6,7
Paracetamol has excellent analgesic/antipyretic activity. Its
toxic effects are less as compared to other agents. It can be
safely given in pregnancy.
2
1
D
analgin
250 mg Rs. 14.68
paracetamol 250 mg
caffeine
25 mg
per tablet
analgin
62.5 mg Rs. 20.19
paracetamol 62.5 mg
per 5 ml.
1
This combination is of unproven effectiveness. Analgin should
never be used when substitutes are available. Analgin should
not be combined with other agents.
NORGESIC
(CIPLA)
C dextropropoxyphene 32.5 mg Rs. 9.45
paracetamol
325 mg
2
This combination of dextropropovyphene and paracetamol has
been proven to be no more advantageous as compared to
single ingredient.
12
NEOGENE
(AFD)
3_ ____________ 4____
2
1
D
13
analgin
200 mg
paracetamol
25 J mg
chloropromazine 7.5 mg
codeine phosphate ,,
caffeine
30 mg
Rs. 7.50
5
1
2
1,5
MAZETOL
(SG Pharmaceuticals)
A
This combination with 5 ingredients is totally irrational; it
mixes one useful analgesic/antipyretic drug with another,
major antipsycotic with a minor opiate; and adds a small dose
of caffeine.
NOVALGIN
(Hoechst)
D
analgin
tablets
analgin
injection
500 mg
500jng/ml
Rs. 10.88
1
Rs. 26.85 to
Rs. 42.75
This expensive minor analgesic/antipyretic should never be
used when alternatives are available.
NOVALGINE
QUININE
(Hoechst)
D
metamizol quinine
100 mg
metamizol calcium
1 50 mg
Rs. 6.95
1
The minor analgesic/antipyretic analgin should never be used
when alternatives are available. The addition of quinine adds
nothing to its effectiveness.
paracetamol 250 mg Rs. 15.15
1,5
salicylamide 250 mg
caffeine
25 mg
This combination is not proved to be superior to paracetamol
alone. This combination of two analgesic/antipyretic drugs
vxith similar actions in one tablet is not rational as it does not
increase the effectiveness of either drug. Caffeine does not
add to the combination's effectiveness. "
MADDENS
(Nicholas)
3
carbamazepine 200 mg
,
4
Rs. 8 to
Rs. 32
5
3
This drug has no intrinsic analgesic/antipyretic activity and is
only indicated for the specific treatment of trigeminal neuralgia
and some types of seizures. It should not be included with
analgesics/antipyretics in this formulary. Its indication should
be clearly spelt.
MICROPYRIN
(Nicholas)
B
microfine aspirin 350 mg Rs. 2.37
caffeine
20 mg
1,5
This is an inexpensive combination of aspirin and caffeine.
Caffeine adds nothing to the analgesic/antipyretic activity of
aspirin.
MOLIN
(Pharma
Research)
A
paracetamol 125 mg/5 ml Rs. 11.70 1,5
syrup
6.7
Paracetamol has excellent analgesic/antipyretic activity. Can
be given to infants, children and pregnant women safely.
OPTALIDON
B butabital
50 mg, Rs. 7.84 1,5
with paracetamol
aspirin
200 mg
(Sandoz)
paracetamol
caffeine
40 mg
The combination of these two analgesic/antipyretic drugs with
similar actions in one tablet is not rational, and the addition of
a minor tranquilizer and the amount of caffeine found in half a
cup of tea does not add to its effectiveness. Butabarbital
should be removed from the combination.
14
1
PAMAGIN
(Alkem)
D
15
4
2_______ 3_________
5
500 mg
5 mg
Rs. 3.27
1
500 mg
5 mg
Rs. 30.50
analgin
diazepam
tablet
analgin
diazepam
injection
:
The minor analgesic/antipyretic, analgin should never be used
when an alternative is available. The addition of a minor tran- ■
quilizer to this drug does not increase its effectiveness. The
injectible form is very costly.
A
paracetamol
500 mg
Price not 1,5
tablet
quoted
6,7
paracetamol 1 25 mg/ml.
syrup
Paracetamol has excellent analgesic/antipyretic activity.
PARACIN
(Stadmed)
PARVON
(Jagson Pal)
A
dextropropoxyphene 65 mg Rs. 9.26 ’,,2
This synthetic analgesic of relatively low addictive potential
has limited usefulness in the treatment of moderate pain. It is
three times more expensive than the WHO-recommended
major analgesic, pethidine.
dextropropoxyphene 32 mg Rs. 9.26 2
paracetamol
350 mg
diazepam
2 mg
The combination of dextropropoxyphene and paracetamol has
been proven to be no more superior than individual agents
used alone. The addition of a minor tranquilizer adds nothing
to analgesic effectiveness, and has been prohibited by Govt, of
India (see below).
PARVON-N
(Jagson Pal)
C
12
PARVON-P
(Jagson Pal)
C
3
4
dextropropoxyphene 32 mg Rs. 9.26
paracetamol
350 „
5
2
This combination has been proven to be no more superiorthan
the individual agents.
PREDIMOL
(Uniloids)
A
paracetamol
500 mg
Rs. 6.64
•
1,5
6,7
Paracetamol has excellent analgesic/antipyretic activity. This
is the least expensive of the paracetamol tablets available in
MIMS, but it is still three timesmore expensive than generic
preparations.
PROMALGIN
(Uniloids)
D
analgin
.250 mg
paracetamol 250 ,,
caffeine
25 ,,
Rs. 11.04
1,5
This combination is of unproven effectiveness. The combina
tion of two analgesics/antipyretics with similar actions in one
tablet is not rational, as it does not increase the effectiveness
of either drug.
PROXYVON
(Wockhardt)
C dextropropoxyphene 65 mg Rs.11.04 1,5
acetaminophen
paracetamol
400 mg
diazepam
2 mg
The combination of dextropropoxyphene and paracetamol has
been proven to be ineffective. The addition of a minor tranqui
lizer adds nothing to analgesic effect and such addition has
been prohibited by the Govt, of India; but the prohibition is
not’enforced.
76
2
PYRIGESIC
(East India)
A
3
17.
4
5
paracetamol 500 mg
Rs. 8.08 1,5,6,7
tablet
paracetamol 125 mg/ml Rs. 5.16
syrup
Paracetamol has excellent analgesic/antipyretic activity,
PYRISPAM
B
(Biddle Sawyer)
dicyclomine 10 mg
paracetamol 500 ,,
chlodiazepoxide 5 mg
tablet;
Rs. 10.52
dicyclomine
5 mg
paracetamol 125mg/ml
syrup
Rs. 18.90
1,5
These combinations are of unproven effectiveness. The addi
tion of an antispasmodic and a minor tranquilizer to this anal
gesic adds nothing more to the analgesic effect. Chlordiazepoxide should be removed from the combination: as per
Govt, of India decision.
RALCIDIN
(Rahis)
B paracetamol 300 mg
Rs. 3.87
, caffeine
16 mg
chlorpheniramine 1.6 mg
phenylephrine 5 mg
1,5
The analgesic/antipyretic activity of paracetamol is not enha
nced dy the addition of a vasoconstrictor, an antihistamine &
caffeine. This combination is irrational as an analgesic. Il
will be effetive in allergic cold. Phenylephrine can act locally
and not reliably absobed orally.
1
3
2
4
SEDYN-A-FORTE D analgin
375 mg Rs. 2.51
(MM Labs)
diazepam
. 2.5 rrg perinjecdiphenhydramine 20 mg
tion
5
1,5
This combination is of unproven effectiveness. The addition
of a minor tranquilizer and an antihistamine to the minor analgesic/antipyietic, analgin, does not add to its effectiveness.
Drowsiness will be added disadvantage of this combination.
The Govt, of India has banned. The combination of tranquilizer
with analgesics. But brands like Sedyn-H-Forte containing
a tranquilizer combined with an analgesic are still being sold.
SOSEGON
(Win-medicare)
A
Pentazocine
injection
30 mg
pentazocine
tablet
25 mg
maximum 1,3
Rs. 49.08 5,10
per day
Rs. 105.18
for 5 days
This extremely expensive drug is not necessary to replace the
WHO-recommended major analgesics, morphine and pethidine.
The tablets are 30 times more expensive than pethidine and
the injections are 10 times more expensive than pethidine.
Because of its addictive potential pentazocine should be added
to the narcotic formulary.
18
19
5
1
Rs. 4.93
1
homatropine methyl
bromide 2.5 mg
analgin
500 m9
phenobarbitone 10 mg
tablet'
price indeterD homatropine methylminable
bromide 2.5 mg
analgin
100 mg
phenobarbitone 5 mg
injection per ml.
0.5 mg
••
D methscop.
analgin
500 mg
injection per ml.
These are unproven combinations. The addition of an antispas
modio and a tranquilizer to the minor analgesic/antipyretic,
analgjn, does not add to its effectiveness.
TYLENOL
(Ethnox)
1
SPASMIZOL
(IDPL)
2
3
4
D
dicyclomine 10 mg
Rs. 12.57
2
SPASMOdextropropoxyphene
65
mg
PROXYWON
acetaminophen(Wockhardt)
(paracetamol)
400 mg
chlordiazepoxide
5 mg
The combination of dextropropoxyphene and paracetamol has
been proven to be ineffective. The addition of a minor tranqui
lizer and an antispasmodic adds nothing to its effectiveness.
C
TUXYNE
(Griffon)
B
noscopine
15 mg Rs. 4.77
aspirin
300 ,,
caffeine
30 „
chloropheniramine 2 ,,
1,5
Aspirin has excellent analgesic/antipyretic activity, but the
addition of an anticholinergic, an antihistamine, and caffeine
adds nothing to its effectiveness. It may add to the cost of
the preparation.
2
3
5
4
A acetaminophen—
.(paracetamol) 120 mg/5ml Rs. 4.80
syrup
(One Yr)
Rs, 16.10
(Six Yrs)
1,5
6,7
The analgesic/ antipyretic activity of paracetamol is excellent
but these are cheaper preparations of paracetamol syrup.
ULTRAGIN
(Manners)
D
analgin
250 mg Rs. 9. 72
paracetamol 200 mg
caffeine
25 mg
(same as Promalgin)
1,5
This combination is of unproven effectiveness. The combina
tion of two analgesic/antipyretic drugs with similar actions in
one tablet is not rational as it does not increase the effecti
veness of eitherdrugs. Analgin should never be used when
alternatives are available.
ULTRAGIN
Syrup
(Manners)
D
analgin 62’5 mg.
paracetamol 625 mg
per 4 ml
Rs. 6.23
(infants)
Rs. 20.55
(children)
1
/
This combination is of unproven effectiveness- The combina
tion of two analgesic/antipyretics drugs with similar actions
in one preparation is not rational as it does not increase
the effectiveness of either drug. Analgin should never be used
wfften alternatives are available.
20
2
1
SUDHINOL-N
COMPOUND
(Ranbaxy)
21
3
*5
C dextroproppxyphene 100 mg Rs. 12.86 2
paracetamol
325 mg
diazepam
2 „
This combination of dextropropoxyphene and paracetamol has
been proven to be inferior to single ingredient preparation.
The addition of a minor tranquilizer does not add to its anal
gesic effectiveness. Paracetamol alone will be cheaper and
better.
TAPAL
(Win-Medicare)
B
Aspirin ■
caffeine
500 mg
30 mg
Rs. 13.12
1,5
Aspirin has excellent analgesic/antipyretic activity ; but the.
same amout of caffeine is found in one third of a cup of tea
and adds nothing to'its analgesic/antipyretic activity. This
preparation is very expensive.
TAPAL-JUNIOR A
(Win-medicare)
aspirin
75 mg
Rs. 1.21 1,4,5
(1-2 yrs)
Rs. 9.70
(8-12 yrs)
Aspirin has excellent analgesic/antipyretic- activity, and this
preparation is in expensive and effective for young children.
TREUPEL
(German
Remedies)
B
aspirin
375 mg
Rs. 8.40
caffeine
50 mg
codeine phosphate 10 mg
1,4,5
The combination of aspirin and codeine in proper doses i.e.
60 mg of codeine, is superior to aspirin and is a safe combi
nation for fever and pain. The caffeine adds no.hing to its
effectiveness - it is about the same amount found in half a cup
of tea.-
1
2
4
5
ULTRAGIN
D analgin
' 500 mg
Rs. 2 22
1
INJECTION
lignocaine
10 mg
per injection
(Manners)
Analgin is a minor analgesic/antipyretic that should never be
used when alternatives are available. The addition of ligno
caine to analgin does not add to its analgesic/antipyretic acti
vity, and may simply cause allergic reactions in sensitive
patients. No drug should be combined with analgin.
VEGANIN
(Warner)
B
aspirin
250 mg
Rs. 8.50
1,5,
paracetamol
50 ,,
12
codeine phosphate 5 mg
This combination is not proven to be better than aspirin alone.
The combination of two analgesic/antipyretic drugs with simi
lar actions in one tablet is irrational; but aspirin can be com
bined with codeine in proper dosage to get enhanced effect.
WALAGESIC
C dextropropoxyphene 65 mg Rs/16.50
2
(Carterparacetamol
400 mg
Wallace)
diazepam
2 mg
The combination of dextropropoxyphene and paracetmol has
been proven to be no more effective than single ingredient
alone. The addition of a minor tranquilizer does not add to
its analgesic effect, and such addition has been prohibited
by Govt.
analgin
250 mg
Rs. 27.36
1
paracetamol . 250 mg
. caffeine
15 mg
codeine phosphate 5 mg.
This combination is.of unproven effectiveness. The combina
tion of two analgesic/antipyretic drugs with similar actions in
one tablet is irrational as it does not increase the effectiveness
of either drug. Analgin should not.be used when safer alter
native are available.
'
C
I Y HcA.M CiLL,
ZIMALGIN-A
(Rallis)
A
—-------- ?———— v
I--- -------- -—47)1. (fiibt rtcor) St. Marks Road,
1
'
Bangalore - 560 001.
22
23
Comparative Prices for
It should be noted that several drugs from the WHO
essential drugs list are not found at all in MIMS. Aspirin and
paracetamol suppositories are not listed. Plain aspirin tablets,
codeine tabletsand pethedineand morphine injections are also
not in the current MIMS, but are available by their generic
names in the market. One combination that is notable by its
absence in MIMS, is paracetamol and codein. Like the com
bination of aspirine and codein, paracetamol and codein is
another combination that has been shown to be mare effective
than either drug alone. Although there are serious omissions
of essential drugs from MIMS, some of the nineteen prepara
tions listed as 'justified' can be recommended for use. Aspirin
for children is available as Tapal-Junior. The least expensive
paracetamol preparations are Predimol tabs and Crocine syrupApidine and Treupel are aspirin, codeine and caffeine prepa
rations that can be recommended for mild to moderate pain.
Equivalent Quantities of Drugs
generic 300 mg
Aspirin
1
2
3
4
5
6
Ps. 2
cafiaspirin
(also has caffeine)
Micropyrin
(also has caffeine)
Dispirin (also has citric
acid, calcium carbonate)
Apidinjalso has codeine,
caffeine)
Tapal (also has caffeine)
Treupel (also has codeine,
caffeine)
Paracetamol generic 500 mg
1 Predimol
2 Curepar
3 Crocin
3 Pyrigesic
3 Calpol
6
7
10
14
19
22
—
5.50
—
—
—
—
—
16
18
20
20
20
Rs. 1.20
(enough for a One year old
baby for 3 days)
Paracetamol syrup generic 150 mg
1 Crocin
2 Pyrigesic
3 Tylenol
3 Calpol
4 Molin
.
'
—
—
—
_
—
4.12
4.13
5.00
5.00
510
Generic prices quoted above are samples only,
.cheaper:prices for generic preparations may be available.
»
A Government policy for provision of all essential analge
sics and antipyretics at low-cost and the banning of ineffective •
preparations and analgin would be a 'healthy first step' in
forming a 'Rational Drug Policy for the country.'
24
References
1—Editor Jarhes Reynolds', 'Martindale-The Extra'Pharmacopia' 28th edition-1982.
2—JH Hbpkirison et al. in Current Therap'etitic Research
(1974) 16 194'.
3—Editor GS Avery, 'Drug Treatment 2nd edition-1980.
4—AK Done, 'Antipyretics' in Pediatric Clinics' of North
America (1972) 19 167.
5—L Goodman A Gillmen, 'The Pharmacological' Basis of
Therapeutics' 4th edition-1970.
6—Behrman, Vaughn, 'Nelson Textbook of Pediatrics' 12th
edition-1983.
7—Editor Weatherall, Ledinghan Warrell, 'Oxford textbook
of Medicine'-1983.
8—MIMS India, July'84, AE Morgan Publications, 90
Nehru PI, New Delhi.
9—WHO, 'The use of essential drugs' Report of a WHO
Expert Committee, WHO Technical Report Series 685,
1983.
10—College Notes, The College of Physicians and Surgeons
of Ontario, Issue No.8, Sep '84.
11 — Mukarram Bhagat, 'Aspects of the Drug Industry in
India' Centre for ..Education and Documentation, 1982.
12—Moertel etal: Relief of oral medications, A controlled
evaluation of analgesic combinatios JAMA, July , 1974'
Vol. 229 No. 1
Kerala Sastra Sahitya Parishad Demands
—
Urgent steps for production and distribution of
Essential and life saving drugs at low cost.
—
Immediate ban on the imports and production of
non essential and hazardous drugs.
—
Strict quality control of drugs.
—
Implimentation of the Hathi committee
recommendations.
—
Implimentation of a People's Drug Policy.
All India Drug Action Network....
This Study is a part of the work of the A!I—India Drug Action
Network (AI-DAN). AI-DAN is a loosely knit network of more
than ten groups/organizations from different parts of the coun
try committed to oppose the irrationalities in the production
and use of drugs in India and to foster a Rational Drug Policy.
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