Though the city boasts more than 500 hospitals and medical institutions with renowned specialists who can guide patients on safe practices, it still has a large number of people flocking to pharmacies for over-the-counter (OTC) medicines.
Terming this unsafe, medical experts point out that India does not have an approved list of OTC drugs that people can go in for safely. In countries such as the U.S. and the U.K., stringent laws have ensured that there is a list of drugs that can be sold over the counter. Selling anything outside of this list attracts stringent legal action.
However, in India there is no prescribed list to mention “OTC” medication. Any drug that is not mentioned in the ‘Prescription only Drugs’ (Schedule H or Schedule X) list invariably becomes an OTC drug. But in the highly consumer driven market environment, one can get just about any sort of medicine without a prescription over the counter. In reality, any antibiotic, painkiller or a sedative, commonly sold without prescription, come under the schedule H list. Therefore, it is all the more important that these need a prescription.
S. Rajsabapathy, Director, Ganga Hospitals, says OTC medication can be accepted if it is a simple paracetamol or an antacid. However, it is essential for patients to know where to draw the line.
“Patients should by no means encourage pharmacists to become doctors, as even for a doctor it is unsafe to arrive at a diagnosis without examining the patient. Abuse of OTC medication happens when there is over dependence on any drug, be it a paracetamol, antacid, laxative or a pain killer. OTC is prohibited for children, pregnant women and senior citizens,” the doctor says.
G. Lakshmipathy, General Physician, believes that OTC is grossly abused.
“The biggest problem is though there are laws to ensure that Schedule H drugs are sold only on prescription, there is no efficient execution or enforcement. Be it a pharmacist or someone in the medical transcription profession or anyone even remotely connected to someone in the medical profession, all act as quacks,” he says.
He also warns how people with existing medical conditions should be extra cautious about the drugs they take. “Like a diabetic is highly prone to kidney related problems due to intake of painkillers, a person with hypertension can develop cardiac damage by taking painkillers beyond a level”.
R.M.P.L. Ramanathan, Head of Pulmonology, PSG Hospitals, warns of a condition of the use of single antibiotic course or frequent usage of antibiotics causing drug resistant organisms. Appropriate dosages of antibiotics at appropriate times alone will help kill bacteria and avoid drug resistance. Hence a haphazard intake of antibiotics causes serious repercussions.
The situation takes on a larger dimension with small time companies focussing on chemists for pushing drugs over the counter.
M. Ramanathan, Principal, PSG College of Pharmacy, says, that despite stringent laws about sale of Schedule H Drugs there is large scale violation by almost all pharmacies. Manoj Kumar, a pharmacist, says that every day at least 30 per cent of the customers ask for OTC drugs. If denied, they move to another pharmacy. This mindset must change if drug consumption is to be totally safe, the medical fraternity says.