The Hindu : New Delhi News : Similar medicine names a threat to patients

Online edition of India's National Newspaper
Tuesday, Apr 27, 2004

New Delhi

New Delhi

Similar medicine names a threat to patients

By Bindu Shajan Perappadan

NEW DELHI, APRIL 26. Are you at risk of consuming medicines not meant for you? If experts are to be believed, too many medicines in India are being sold under similar if not exactly same brand names, exposing patients to the danger of wrong medication if they aren't extra watchful.

"We carried out a small experiment where a prescription was written for Lona, a brand of antiepilepsy drug clonazepam marketed by Triton Healthcare Private Limited.

The `patient' was sold Lona, exactly as prescribed, but it contained low sodium salt marketed by Dabur and meant for hypertensive patients," says the Editor of the Monthly Index of Medical Specialities (MIIMS), C.M. Gulati.

According to him, even when brand names are not identical many are deceptively similar. For example, Sivoxol is a combination of salbutamol, theophylline and ambroxol, while Sivozol contains ofloxacin and tinidazole.

Tocan contains clindamycin while Tocon is a brand of ketoconazole. A quick glance at the brands of just 300 manufacturers shows that there are more than 20 similar brand names all starting with just one alphabet "A" including Adiflox/Adilox, Adlin/Adliv and Alzol/Alzot.

But why is this problem peculiar to India? There are many reasons, claim experts. For one, when there are over 17,000 pharmaceutical producers churning out more than 40,000 brands of just 450 or so basic molecules, there is bound to be shortage of unique, distinct brand names.

Secondly, producers are keen to use short, easily remembered brand names that give some indication of the ingredient.

Alzol was so named because "Al" and "zol" can be identified with albendazole while Alzot is supposed to remind the prescriber of alprazolam. Commercial companies are apparently not concerned with the havoc on healthcare caused by such branding.

"Under the laws of the land, unlike Western countries, drug regulators in India do not have a role in the determination, use and registration of brand names. The Drugs Controller-General, India (DCGI), is charged with the task of approving new medicines under their generic (chemical) names while state level Food and Drug Administrations issue manufacturing licences. None of them is supposed to keep an updated record of brand names used by various companies. In any event, in a federal set-up a Central authority is needed to monitor the registration of trade names since one State level authority cannot have jurisdiction over another State," explains Dr. Gulati.

Also, there is no Central or State law specific to the use or registration of brand names of medicines. Like other consumer items (telephones, cars, air-conditioners), brand names of medicines can be registered with the Trade Mark Registry.

The over-burdened Registrar takes years to approve or reject a trade name application. Its data bank is not updated for months and years. The bigger problem is that it is not compulsory to register trade names of any item in India be it a pen or a pill.

Even when a brand name is registered, it is applicable to one particular class of items.

The result: the trade name Lona, even if registered by one company for low sodium salt, can be used by another manufacturer for clonazepam since these two items fall under different class of products.

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