Pharmaceutical News
Doctors worry about the risk of drug interaction following TFDA’s decision of drug reclassification

Reported by Chen Li-Ting from Taipei


The TFDA plans to reclassify 13 prescription drugs as instruction drugs.  Doctors raised their concerns that the reclassification may increase the risk of complications.  For example, patients may not know that aspirin is effective in preventing cardiovascular problems only in cases of blocked blood vessels.  Without this knowledge, taking aspirins as a preventive treatment may not only be ineffective, but also cause stomach pain or even gastrorhagia.  Doctors also mentioned that the use of anti-histamine has to be strictly controlled and recorded so as to prevent adverse effect due to the high risk of drug interaction. 


Dr. Wang Tsung-Dau, Secretary General of the Taiwan Hypertension Society and a cardiologist of the NTUH, expressed that low-strength aspirins can be used to treat cardiovascular problems.  The cardiology society has confirmed that the use of aspirins in patients with heart stents or blocked blood vessels can reduce the death rate by 20-25% and prevent the relapse of cardiovascular problems.


Dr. Wang stated that aspirins are less effective in preventing cardiovascular problems for patients with high blood pressure or high cholesterol.  Clinical data showed that 10% of the patients had stomach pain after taking aspirins, and 1% had gastrorhagia.  The reclassification of some prescription drugs as instruction drugs will make them easier for patients to access; however, pharmacies have to strictly control the use and ensure that patients have obtained the accurate knowledge about their medication in order to reduce the risk of side effects and complications.


Anti-histamine is also on the list of reclassification. It is a common treatment for cold relief and skin irritation.  Dr. Yao Chien-An of the NTUH expressed that there is a major concern of drug interaction between anti-histamine and drugs for chronic diseases.  For example, the concomitant use of anti-histamine and anti-coagulant may either prolong or shorten the effect of anti-coagulant.  A prolonged effect my cause bleeding; and a shortened effect may cause blocked vessels.  The reclassification will make it easier for patients to access anti-histamine; however, it also increases the risk of drug interaction if patients are not properly informed of the risk. 


Mr. Chen Bi-Li, Deputy Director of the Pharmacy Department of the Taipei Medical University Hospital, expressed that he disagreed with the TFDA’s decision to reclassify two vaginal preparations as instruction drugs because the causes of vaginal infection are complicated and self-medication may delay proper treatments.


Mr. Chen said he also did not understand the rationale behind the TFDA’s decision of reclassifying Omeprazole and Pantoprazole as instruction drugs.  At present, the use of these two drugs is strictly for patients with ulcer or gastroesophageal reflux disease.

Dr. Lin Ying-Rang, a general practitioner, expressed that the reason why instruction drugs are popular in the US is that seeing a doctor is very expensive.  There were reports about illegal sales of prescription drugs in pharmacies in the US.

Ke Min-Dao, a community pharmacist, expressed that those 13 drugs on the TFDA’s reclassification list are comparatively safe.  A qualified pharmacist should have the ability to provide necessary information on medicines and protect patients’ medication safety.


【2015-01-18/ United Daily News】