RATIONALITY ASSESSMENT OF ZINC FORMULATIONS AVAILABLE IN INDIA
DOI:
https://doi.org/10.22159/ijpps.2017v9i8.19178Keywords:
Zinc preparations, Irrational prescribing, Fixed dose combinations, NutraceuticalsAbstract
Objective: To critically analyze the essentiality and irrational zinc preparations available in Indian market.
Methods: This was conducted as cross-sectional analysis by department of pharmacology of our tertiary care hospital between June and December 2016. Data regarding various formulations of zinc were retrieved from current index of medical sciences and drug India database. Rationality assessment was done using prescribed guidelines and approved formulations of zinc by Central drug standard control organisation. Essentiality was checked using National list of essential medicine India, 2013 and latest version of WHO list essential medicine bulletin. Dosage regulation was assessed using Indian pharmacopeia guidelines, National institute of nutrition, India recommendation and upper daily intake toxicity intake, United States of America (USA)
Results: Our study results showed wide variation in the number of zinc preparation. Total number of formulation available in the market is 335. Among zinc preparation, the preparation that contains 20 mg of zinc as recommended by various guidelines is 10 in number. About 325 preparations of zinc are added with one or more nutraceuticals. None of these fixed dose combination of zinc containing preparation is recommended as essential fixed regimen.
Conclusion: Zinc has lot of relevance in treating recurrent diarrhoeal illness, especially in paediatric cases; however legal, regulatory and educational measures should be followed to curtail all the irrational zinc prescription development, promotion, marketing and prescription.
Downloads
References
Roohani N, Hurrell R, Kelishadi R, Schulin R. Zinc and its importance for human health: an integrative review. J Res Med Sci 2013;18:144-57.
Plum LM, Rink L, Haase H. The essential toxin: impact of zinc on human health. Int J Environ Res Public Health 2010;7:1342-65.
Inoue K, O’Bryant Z, Xiong ZG. Zinc-permeable ion channels: effects on intracellular zinc dynamics and potential physiological/pathophysiological significance. Curr Med Chem 2015;22:1248-57.
World Health Organization. The World Health Report 2007–a Safer Future: Global Public Health Security in the 21st Century. Geneva: WHO; 2007.
Bryce J, Boschi-Pinto C, Shibuya K. WHO estimates of the causes of death in children. Lancet 2005;365:1147–52.
Kosek M, Bern C, Guerrant RL. The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. Bull World Health Organization 2003;81:197–204.
GJ Fosmire. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Med 2008;14:353-7.
Babu TA. The ideal zinc preparation in the management of acute diarrhoea in children. Indian J Pharmacol 2013;45:539.
J Thirunavukkarsau, V Krishnan. Analysis of prescription pattern of general practitioners at different pharmacies in avadi-Chennai. Int J Pharm BioSci 2015;6:1048-51.
V Krishnan, Prakash Murugaiah, Aruna Maria Bachmann. Are we too reluctant about irrational nutraceutical combinations? Int J Basic Clin Pharmacol 2016;5:2585-8.
Jadav SP, Parmar DM. Critical appraisal of irrational drug combinations: A call for awareness in undergraduate medical students. J Pharmacol Pharmacother 2011;2:45-8.
Gupta YK, Ramachandran SS. Fixed dose drug combinations: issues and challenges in India. Indian J Pharmacol 2016;48:347-9.
Sharma K, Sharma A, Singh V, Pilania D, Sharma YK. Irrational fixed dose combinations and need for intervention: understanding of dental clinicians and residents. J Clin Diagnostic Res 2014;8:49-52.
N Venkateswaramurthy, R Murali, R Sampath Kumar. The study of drug utilization pattern in pediatric patients. Int J Pharm Pharm Sci 2013;3:140-4.
