May 26,2024
New Delhi: Dr Uday Ananth Pai , a Mumbai-based paediatrician, has been troubled by an ethical dilemma over the past few years. The doctor has seen an alarming rise in the use of a class of medicines that are not approved to be prescribed for infants and children. Yet, even while their reckless use is known to cause health complications, he says, there is no let-up.
A distraught Pai has finally decided to voice his views. He says doctors prescribe for children proton pump inhibitors (PPIs), medicines that are mostly used to treat heartburn or acid reflux in adults. Even among adults, these are used in worrying numbers and are not always prescribed for indications approved by regulators anywhere in the world.
PPIs are drugs that work by inhibiting acid secretions in the stomach. It brings fast relief in cases of peptic ulcers and episodes of gastroesophageal reflux disease (GERD). GERD is stomach acids flowing back into the tube connecting the mouth and the esophagus. PPIs are available as tablets, capsules and injections and are becoming as ubiquitous as a Crocin to manage fever.
The reason for the popularity of PPIs among doctors and patients is not tough to gauge. With unhealthy lifestyles and dietary habits, acidity is common among Indians. While many brands of PPIs are sold almost over-the-counter, Pan, Pantop, Omez, and Rablet fly off the chemist’s shelves.
He says pantoprazole is prescribed for children but warns that it cannot be recommended to anyone below the age of 1 year.
Pantoprazole leads in PPI categories. Amit Mookim, MD of IQVIA South Asia , which tracks prescription trends, says while many new brands have entered this segment, the top players have consolidated their positions. Pantoprazole and its combination products contribute nearly 50 per cent of the market and are growing. One of the key factors driving increased usage, he says, is co-prescription of PPI molecules with amoxicillin & clavulanate fixed dose combination and paracetamol and its fixed dose combination, which has increased significantly over the last five years. Co-prescription refers to a medicine that a doctor adds to increase or suppress the effects of a drug used to address the actual illness.
Source: Healthworld