Switching medications? Consult a doctor

As per a recent study, none of the five most commonly prescribed diabetes pills in India that combine metformin with other medicines have gone through rigorous testing meeting standards laid out by the WHO. It suggests that Indian patients taking these combinations should discuss with their clinicians before making a switching to a different agent


About 8 months ago, Lekha Shah (name changed) was given medicines to control her heart beat which was unusually fast. However after many dosages, the heartbeat couldn’t be controlled. That’s when the doctor grew puzzled.

“A detailed check-up revealed that the pharmacist gave her a wrong drug by misreading the name of the medicine. This is a very unusual scenario. But it is important to understand that in the prescription itself, the doctors prescribe medicines that can be easily available. Also, I give a printed prescription so that there are no errors or misreading due to handwriting,” said Dr Hemal Shah, Senior Nephrologist and Secretary, Amar Gandhi Foundation.

Switching medicines without consulting a doctor is a major problem in the country. A study that appeared in the BMJ Global Health journal noted that the five top-selling fixed dose combination pills in India account for 500 different brands. The findings of the study reveal that clinical trials demonstrating safety and efficacy of these fixed dose combinations are neither publicly available or of low quality.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA) said, “It is imperative that the government takes strong measures to strengthen the quality assurance infrastructure to the required level so that the quality of every batch of drugs is assured. Adequate regulatory manpower should also be deployed to enforce laws regarding drugs. More than 95% of the drugs available in India are generic with no patent.”

He added, “Doctors are committed to the welfare and safety of patients. There is a need to stop over-the-counter sale of prescription drugs without a prescription.”

“The medicine has to be taken post  consultation with doctor only, as the medication needs to be taken after understanding the patients metabolism,” said Dr Mita Shah, Diabetologist at Global Hospitals, Mumbai.