About this book 3Foreword to earlier version 5Preface to earlier version 6Acknowledgments 6How to use this book 8Index of Drug Profiles 11

Annexure 1 Some Common Drug Categories and How they Work 47Annexure 2 Poisoning and its Treatment 87

Annexure 1 Criteria for Withdrawal of Irrational and Hazardous Drugs: the Bangladesh Example 115Annexure 2 Access to Medicines: How India Stands Globally? 117Annexure 3 Country Specific Approaches to Updating Essential Drugs and Formulary Lists 119Annexure 4 Right Brands; Wrong Medicines Dietary Salt Dispensed in Place of Epilepsy Drug 120

Annexure 1 Why Some Leading Drugs in the Indian Market should not be sold - but are still sold 154Annexure 2 Dubious FDCs Being Marketed in India … not Approved by DCGI and hence Illegal 160Annexure 3 List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications 162Annexure 4 Identification of Harmful, Irrational and Useless Analgesics 165Annexure 5 Irrational Combinations of Paracetamol 167Annexure 6 Rofecoxib, Heart Attacks and the FDA: Testimony of David J. Graham 169

Section 1

Chapter 1: About Drugs in General 15

Chapter 2: Essential Drugs 92

Chapter 3: Rationality of Drugs 122

1. Drug Forms and Administration2. Evaluation of Drug Profiles

1. Why We Need Only Essential Drugs?2. Why an Essential Medicines List?3. Generic/Brand Names, Innovator Products and Generics4. Implementation of Essential Drugs Idea in Two States of India

1. What is Rational Therapy?2. Causes of Irrationality3. Combination Drugs: When Drug Combinations are Rational4. Vitamins and Tonics5. Hazardous Drugs

619

9396

101112

123129

139

143

Chapter 4: Marketing of Drugs 178

1. Pharma Scenario in India2. Marketing of Top 300 Drugs in India: A Brief Analysis3. Marketing of Drugs and the Abandoning of Quality and Ethics4. Manipulating Quality

178181

188192

CONTENTS

9

5. Prevalence of Spurious Drugs

1. "Forms of Entanglement"2. Clinical Trials, Research Publications and Conflicts of Interest3. Conflicts of Interest and Codes of Marketing

1. Free Trade, WTO/TRIPS and the Pharma Industry2. India, Patents and TRIPS3. Possible Impacts4. What is to be done?

1. Need for Price Control2. Health and Political Context of Price Control3. Some Positive Initiatives and Reports4. How much do Drug Formulations Actually Cost and can Cost

1. Medicines and Women's Health2. Misuse of Drugs and its Effects on Women3. Contraceptive Drugs and Women4. Hormonal Replacement Therapy (HRT)5. Other Concerns

Profiles of 50 DrugsShort Profiles of 107 Drugs

194

208217

231

248258

271279

299311

318324

333337

341347

348

Annexure 1 Landmark Incidents in the Unethical Marketing of Drugs 201

Annexure 1 What are Clinical Trials? 235Annexure 2 Conflict of Interest: My Journey 239Annexure 3 WHO Ethical Criteria and IFPMA Code of Pharmaceutical Marketing Practices 241

Annexure 1 TRIPS in WTO: Is it Logical? 284Annexure 2 Openness Promotes Growth? 285Annexure 3 For Free Trade in Ideas 285Annexure 4 Unfairness of Free Trade: WTO, a Neutral Arbiter? 287Annexure 5 Some of the Useful Recommendations in the CIPIH Report 290

Annexure 1 Pricing and Price Control of Drugs and Pharmaceuticals 326

Primary and Secondary Information Sources on Drugs & Related Health Issues 583Glossary 593 About LOCOST 597 About All-India Drug Action Network 598

Chapter 5: Drug Promotion, Clinical Trials and Conflicts of Interest 208

Chapter 6: Patents, Trade and Availability of Medicines 247

Chapter 7: Pricing and Availability of Drugs 299

Chapter 8: Women and Medicines 333

Chapter 9: What is to be done? 356

Section 2 363Section 3 505Section 4 583

10

Activated Charcoal 507

Albendazole 507

Allopurinol 508

Aluminium Hydroxide & Magnesium 508

Aluminium Hydroxide 365

Aminophylline 509

Amitriptyline 510

Amoxycillin 367

Amphotericin - B 510

Ampicillin 369

Aspirin 372

Atenolol 511

Atropine 374

Beclomethasone 512

Benzanthine Benzyl Penicillin 513

Benzoic Acid and Salicyclic Acid 377

Benzophenones 513

Benzyl Benzoate 378

Benzyl Penicillin 514

Betamethasone 379

Bisacodyl 383

Calamine Lotion 387

Calcium Lactate 514

Carbamazepine 515

Cephalexin 516

Chloramphenicol 517

Chlorhexidene 388

Chloroquine Phosphate 389

Chlorpheniramine Maleate 393

Chlorpromazine 518

Cimetidine 519

Clofazimine 520

Clonidine 520

Clotrimazole 521

Cloxacillin 521

Page No. Page No.

Coaltar 522

Co-trimoxazole 396

Codeine Phosphate 399

Cyclosporin 522

Dapsone 401

Dexamethasone 523

Diazepam 403

Diclofenac Sodium 524

Diethyl Carbamazine 524

Digoxin 407

Diloxanide Furoate 525

Diphenhydramine 410

Domperidone 525

Doxycycline 526

Ephedrine 413

Epinephrine 527

Ergocalciferol (Vit. D2) 529

Ergometrine 530

Ergotamine 416

Erythromycin 419

Ethambutol 422

Ethionamide/Propionamide 530

Ethosuximide 531

Ferrous Sulphate 424

Flucytosine 531

Folic Acid 427

Frusemide (Furosemide) 430

Furazolidone 532

Gentamicin 532

Gentian Violet 433

Glibenclamide 434

Glucose 533

Glyceryl Trinitrate 437

Griseofulvin 534

Index of Drug Profiles

11

Haloperidol 535

Hydralazine 535

Hydrochlorthiazide 536

Hydrocortisone 537

Ibuprofen 440

Imipramine 537

Indomethacin 538

Insulin 444

Iodine 539

Ipecacuanha 540

Iron Dextran 540

Isoniazid 450

Isoniazid+Thiacetazone (INH) 541

Isosorbide Dinitrate 542

Ketoconazole 543

Levamisole 543

Levodopa + Carbidopa 545

Levothyroxine 546

Lindane(Gamma Benzene Hexachloride) 547

Lithium Carbonate 547

Loperamide 452

Mannitol 548

Mebendazole 455

Mefloquine 549

Methyldopa 457

Methylene Blue 549

Metoclopramide 551

Metronidazole 460

Miconazole 463

Morphine 551

Neomycin 552

Niclosamide 553

Nifedipine 553

Nitrofurantoin (NFT) 554

Page No. Page No.

Nitrous Oxide 555

Norethisterone 556

Nystatin 557

Oral Contraceptives/BirthControl Pills 465

ORS (Oral Rehydration Salts) 471

Paracetamol 475

Pethidine 558

Phenobarbitone 558

Phenoxymethyl Penicillin 559

Phenytoin 560

Pilocarpine 561

Piperazine Citrate 561

Podophyllin 562

Potassium Chloride 563

Praziquantel 564

Prednisolone 564

Primaquine 565

Procain Benzyl Penicillin 565

Procainamide 566

Promethazine 476

Propranolol 479

Pyrantel Pamoate 566

Pyrazinamide 567

Pyridoxine (Vit. B6) 567

Pyrimethamine & Sulfadoxine 483

Quinidine 568

Quinine 485

Ranitidine 487

Reserpine 490

Riboflavin (Vit. B2) 569

Rifampicin 493

Rifampicin + INH + Pyrazinamide 570

Salbutamol 496

Silver Nitrate 571

Silver Sulfadiazine 571

Index of Drug Profiles

12

Index of Drug Profiles

Sodium Bicarbonate 572

Sodium Chloride 573

Sodium Chloride + Dextrose (Glucose) 573

Sodium Thiosulphate 574

Streptokinase (Enzyme) 574

Sulfacetamide 575

Sulfadimidine 575

Tamoxifen 576

Tetracaine 576

Tetracycline 498

Page No. Page No.

Thiamine 577

Trihexyl Phenidyl 577

Valproic Acid 578

Verapamil Hydrochloride 579

Vinblastine 579

Vincristine 580

Vitamin A 500

Warfarin (mainly as Warfarin Sodium) 580

Zinc Oxide 581

13