Single-strength drugs are the need of the hour to avert pediatric drug overdose: Experts

Paediatricians in Hyderabad have urged CDSCO to mandate single-strength formulations for commonly used drugs like paracetamol, warning that multiple strengths confuse parents and lead to accidental overdosing in children. They emphasised adopting uniform strengths to prevent avoidable ICU admissions.

Hyderabad: Coming across a medicine with multiple strengths and formulations is a common sight these days. What if ill-informed parents unwittingly administer the right medicine but of wrong strength, leading to overdose in their toddler?

With little awareness about medicines and formulations, there is every possibility that a common medicine like paracetamol, available in multiple variations and strengths, can cause major health complications, especially among children.“In our country where the understanding about giving the right dose of medicine is very poor, there is a need for regulatory authorities to stick to one strength of medicine in the entire country. At least, for medicines that are most commonly in use,” says vocal public health advocate from Hyderabad, Dr Sivaranjani Santosh.

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A few days ago, Dr Sivaranjani Santosh, a senior pediatrician from Hyderabad reached out to the Indian drug regulatory authority Central Drugs Standard Control Organisation (CDSCO), urging it to ensure there is one strength of paracetamol in India.

We as pediatricians see many children landing up in ICUs because of overdosing with paracetamol, because of the confusion that exists due to multiple strengths being available (1ml containing 100mg, 5ml containing 120mg, 125mg,250mg,240mg, and 500mg), Dr Santosh said.

Though the dosage as per the weight is mentioned on the label, many parents do not follow the instructions and end up giving toxic doses of paracetamol to their children, thus endangering their lives. If we have a single strength of Paracetamol available like in most western countries, these dangerous mistakes can be prevented. It is extremely important that CDSCO takes cognizance of this fact and enforces only one strength of paracetamol suspension to be available in India, Dr Santosh pointed out.

In India, many medicines like paracetamol,cough and cold medicines, vomiting medicines etc are available in various concentrations, but have the same name. So, the parents end up giving incorrect doses. “Please ensure you understand the doctor’s prescription properly including the name of the medicine, the composition, and the dose, the doctor said.

 

Common mistakes that could lead to overdosing

• Administering domstal drops instead of domstal suspension multiple times a day
• Sinarest is available in drops, syrup, AF drops, AF syrup, AF New syrup etc
• Each with a different composition, which is not allowed for children
• Maxtra is available in drops and syrup- different composition.
• Ambrodil is available in the form of syrup, drops, Ambrodil S, Ambrodil D etc with different compositions
• Crocin drops, Crocin 120, Crocin 240, P500 etc have different strengths of Paracetamol
• Giving 2 to 3 cough/cold syrups on the same day with the risk of overdosing with one of the components.