Prescribing trends of fixed dose combinations in a tertiary care teaching hospital of Bhopal district
Keywords:B complex preparations, Essential drug list, Fixed dose combinations, Prescription, Rationality, Teaching hospital
Background: Medicines are an integral part of healthcare. More than one drug is frequently used for treatment of either single ailment or multiple co-morbid conditions. Sometimes, two or more drugs are combined in a fixed ratio into a single dosage form, which is termed as fixed dose combinations (FDCs).
Methods: This prospective observational study was carried out in the patients admitted in various medical and surgical wards of Chirayu hospital associated with Chirayu medical college of Bhopal district for a period of 3 months. The prescribed FDCs were collected from the case sheet of the admitted patients. Patients of all ages and both sexes were included in the study.
Results: The total numbers of prescriptions from teaching hospital were 475, out of which 373 patients (78.52%) were prescribed FDCs. The first four most preferred FDCs were B complex preparations followed by pantoprazole + domperidone, Diclofenac+Paracetamol and Chlorpheniramine+Pseudo-ephedrine+Paracetamol.
Conclusions: In present study total 11types of FDCs were prescribed, out of 11 FDCs prescribed; only 1 type was enlisted in the essential drug list of WHO and Govt. of India. In only 4 types of FDCs there is scientific justification for combining ingredients. Most of FDCs do not have scientific justification for combining the ingredients. It is the need of the time that hospitals should constitute drugs and therapeutics review committees to promote rational prescription of FDCs.
Gupta YK, Ramachandran SS. Fixed dose drug combinations: Issues and challenges in India. Indian J Pharmacol. 2016;48:347-9.
Kadir Alam, Arjun Poudel, Subish Palaian. Fixed Dose Combination antimicrobials practices in Nepal. J Clin Diagnos Res. 2010;4:3255-60.
Amitava S. Indian market’s fixation with fixed dose combinations (Editorial). Rational Drug Bulletin. 2002;12: 1.
Anand S, Asha A.N, Uday Bhosale, Sarasija Suresh. Emergence of irrationality in fixed dose combinations. Pharma Times. 2008;40:17-21.
Dhaneria SP. Rational and irrational drug combinations. Drug bulletin. Department of pharmacology Post Graduate Institute Med Educ Res Chandigarh (India). 2010;35:2.
Renfro L, Snow JS. Ocular effects of topical and systemic steroids. Dermatol Clin. 1992;10(3):505-12.
Hindoliya M, Sharma PK, Dhaneria SP. Prescribing Trends of Fixed Dose Combinations in Teaching and Non Teaching Hospitals of Ujjain District. J Pharm Res. 2012,5(7),3503-5.
Jaina NK, Akarte AB, Deshmukhb PT, Kannojiac P, Garudc N, Akasha Y. Rationality Of Fixed Dose Combinations: An Indian Scenario. The Pharma Res. 2009;01:158-68.
The Use Of Essential Drugs. WHO Technical Report Series 825. Geneva. World Health Organization. Available at apps.who.int/medicinedocs/ documents/s16063e/s16063e.pdf. Accessed on 22 June 2018.
Angus DC, Walter T, Linde-Zwirble S, Tam W, Ghali JK, Sabolinski ML, et al. Winkelmayer, Manuel Worcel. Cost-effectiveness of fixed dose combination of isosorbide dinitrate and hydralazine therapy for blacks with heart failure. Circulation. 2005;112:3745-53.
Upadhyay D, Singh A, Joshi HS, Agarwal M, Katyal R. Study of Prescription Patterns of Fixed Dose Combinations Prescribed by Medical Interns. Int J Biomed Res. 2016;7(9):624-8.
Rayasam SP, Dudhgaonkar SS, Dakhale GN, Hire RC, Deshmukh PS, Gaikwad NN. The irrational fixed dose combinations in the Indian drug market: an evaluation of prescribing pattern using WHO guidelines. Int J Basic Clin Pharmacol. 2013;2(4):1.