e/c NSAIDS

[Linnear]

Originally Posted by Zoggite

Just out of sheer scientific correctness, I feel I need to mention that one of the PMR-systems (that's Patient Medication Records) that we used to have, used to put the following caution on all labels for suppositories: "remove wrapper first"...
Could this be the cause of the anal ulceration?

I have actually had the "My suppositories aren't working. Have you taken the wrapper off? What wrapper?" Conversation.

In my defence the supps were OTC ones not a Rx I have always tried to mention the wrapper to Rx patients.

[Cathedral]

Originally Posted by Jeff

butapirazol = phenylbutazone - was banned for human used several years ago.
indometacin - still being used.


Jeff

Well... we sell phenylbutazone in injections and as oinment... There are also tablets in production, but fortunatelly they are very rarely prescribed. So I wouldn't beso sure about that ban.

[johnep]

Butazolidin still used to keep horses running. I remember when it was first introduced. Gave it out on every other script.
johnep

[Cathedral]

Well we still dispense them for humans. I mean in Poland. We have oinment (made by GSK) and injections produced by Polfa in Warsaw. And it doesn't seem they are going to disapear. Rather some indometacin preparations are removed from our market.
There are even tablets, fortunately almost out of use.

[johnep]

Yeah, had enquiry for 'Novalgin' the other day. Believe this phenazone derivative banned in Western Europe some fifty years ago. when we first started getting lists of 'essential' drugs for relief operations, found many UK banned drugs listed as essential in third world.

Problem with these analgesics was aganularcytosis. Is phenacetin still permitted in Poland?

johnep

[Zoggite]

Novalgine (sodium metamizole): was still available in Belgium in 2006...

[Cathedral]

Well, we've got plenty of metamizol in every preparation: tablets (OTC!), suppositories (very often dispensed for children) and powder we use to prepare liquids (if a prescription is provided, then the amount of metamizol goes up to 4 grams!)
And just last year there was at least one new product based on metamizole.
There are also several other drugs which contain metamizole and other compounds (for example hioscine).

We also have such drugs as:
Gardan P - metamizole and prophyphenazone
Pabialgin P - allobarbital and prophyphenazone
Everybody says it shouldn't be used, but nobody does anything about it.

There was also a dicsussion concerning other drugs with prophyphenazone (Saridon for example). And everybody agreed that it is not rational, and not safe to put this substance as exhancer of paracetamol. But thet are still produced, and still in use.

Have you heard about that "hydrocortisone" case in Poland? It was huge. And rather scary. In my country something bad must happen, and only than there is a chance for some changes.

As it goes to that phenylbutazone I tried to find on GSK page an information about it to show you. But... there isn't any! It looks like they are not very proud they produce it...

Phenactin isn't in use.

[johnep]

When I joined Roche in 1961 we used to carry slide packs of 10 tablets Saridone as give aways to receptionists etc. Avomine was also available in similar slide pack made of aluminium. However, if tablets rattled about a bit in the pocket then aluminium used to mark them.
johnep

[pharmacopola]

Originally Posted by mm45

yeah I relise the fact that NSAIDs inhibit PG synthesis and mucous secretion etc. But if e/c are no more benefitical then normal NSAID why are so many doctors prescribing them, surely it could save the nhs money if they just stuck to the normal coating...

1) Doctors are creatures of habit - it is very difficult to change prescribing habits of doctors who have done things one way for many years... Some bigger switches which are more cost-beneficial take precedence, for example, the switch to generic simvastatin as statin of choice, or switch from branded to generic PPI's...

2) The price of e/c pred is comparable to plain (Drug Tariff £1.88 for 30x EC 5mg cf. £1.77 for 28x plain 5mg) - wouldn't save a huge amount of money, and the NHS as a whole would save nothing as any nominal savings would simply be redistributed into the GP's pot of money - probably wouldn't even be enough to pay for a hospital admission for one patient who developed a GI bleed!

Or am i just too cynical?!