BAN ON FDC MEDICINES -HOW TB,HYPERTENSION & DIABETES WILL BE TREATED ?

BAN ON FDC MEDICINES -HOW TB,HYPERTENSION & DIABETES WILL BE TREATED ?Prof.Dr.Dram,profdrram@gmail.com,Gastro Intestinal,Liver Hiv,Hepatitis and sex diseases expert 7838059592,9434143550

We are using many fixed drug combinations medicines for many diseseas since long particularly for Diabetes,to control hypertension,to control Hepatitis  B,C and HIV ,TB fixed doses of different drugs are being used for better compliance of disease control .

            The Ministry of Health and Family Welfare, Government of India has recently prohibited the manufacture for sale, sale or distribution for human use of 328 fixed dose combinations (FDCs) with immediate effect, including FDCs in diabetes,Hypertension etc.Even closure of many combinations confuse medical specialist as those not in list,may be closed in future.So now a complicated task for Doctor to open the list and see what to prescribe or not before writing any prescription otherwise Doctor may be penalised as inspite of banning due to corruption and lack of vigilance of Drug and health department  many drugs in Indian market are often available and companies also donot stop it due to heavy sale.What to talk of drus availability so many quacks as doctor and so many pathies without any recognition practice in India and no body checks them as bribe is paid to police,general and health administration.

             Type 2 diabetes is a progressive disease, characterized by insulin resistance and β-cell dysfunction. As the disease runs its course, the initial oral hypoglycemic agent (OHA) prescribed may lose its efficacy leading to inadequate glycemic control, which requires sequential addition of a second or even a third drug belonging to a different class of OHAs, to achieve target or desired glycemic control.Combination therapy administered as separate medications may deter patient from adhering to the prescribed treatment.

Combining two or more OHAs as a single-dose fixed-dose combinations (FDCs) therefore improves treatment adherence by minimizing medication burden to the patient and also reduces costs of treatment, which is a very important consideration, given that out of pocket expenditure on health is amongst the highest in India.

A widely used FDC in diabetes is the combination of glimepiride, metformin and pioglitazone in two strengths: lower strength (7.5 mg) & higher strength (15 mg).Triple drug combinations reduced A1c to a greater extent than two drugs in a systematic review and meta-analysis of randomized controlled trials, which examined the addition of a third agent after dual therapy failure in patients inadequately controlled with two agents (predominantly metformin and a sulfonylurea or metformin and a thiazolidinedione),. In trials lasting 52 to 54 weeks, addition of thiazolidinediones, GLP-1 receptor agonists, or SGLT2 inhibitors to metformin and sulfonylurea reduced A1c to a similar extent (Diabetes Obes Metab. 2018 Apr;20(4):985-997).

              Similiarly in TB,HIV,Hepatitis B and C control multi drugs are needed and are combined as FDC for better compliance and better control of disease preventing resistance to particular one drug,Same way in hypertension many drug combined give better control than a single drug.

                As a doctor what you feel?is our Government moving in correct direction ? 

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