Pioglitazone a controversial drug

Pioglitazone is an oral drug prescribed to patients who suffer from type 2 diabetes mellitus. It reduces the volume of sugar level in blood. Insulin is a hormone that stimulates cells to remove glucose from the blood. People suffering from type 2 diabetes cannot make enough insulin due to which level of blood glucose remains more than normal & the body’s cells respond less to the insulin that gets produced in the body. Pioglitazone acts as an insulin sensitizer & enables cells to become more sensitive to insulin. This helps in discarding more volume of glucose from blood & this drug also lowers the glucose level in blood.

It’s believed that people who consume this drug have increased risk of heart failure, blood cancer & osteoporosis. India had suspended this drug on 18^th June 2013; however this suspension was only temporarily & soon revoked on 31^st July 2013.

Ambrish Mithal, an expert & head of the endocrinology & diabetes department at the Medanta hospital in Gurgaon had said ‘It's grossly overused in this country.’ Chandra Gulhati, editor of MIMS India, states ‘The sales data show that fixed-dose combinations of pioglitazone with other antidiabetics are top-selling in the country. That indicates the drug is being overused & is being used as first-line treatment,’

Annual sales of fixed-dose combinations of pioglitazone with metformin & glimepiride are around INR5 billion. An article published in Times of India by Rupali Mukherjee dated  Jun 27, 2013, 05.16AM IST shares that pioglitazone & its combinational drugs have Rs. 700 crore market in India.

France has already put a stop for selling this drug.

Currently this drug is sole with warnings that the drug cannot be used as a first-line treatment for type 2 diabetes.

Reflections: -

In my opinion Indian Government just wants the health industry that includes hospitals, pharmaceutical industry to boom. Pioglitazone in combination with other anti-glucose drugs has a very big market around Rs. 700 crores that’s why the suspension was revoked. It may sound pessimistic however I don’t hesitate to state that the Government just wants diabetic patients to suffer more from bladder cancer, heart failure & osteoporosis. If people will suffer due to these diseases then they’ll consume more medicines for bladder cancer or heart problems or osteoporosis. This will help the pharmaceutical industry to sell more drugs & eventually boom. If pharmaceutical industry will boom then Government will get more value added tax which it collects from medicines. This will also help people to visit hospitals more times & will help the hospitals to grow. Most of the hospitals are owned by business corporations & thus their business will grow & thus government will eventually make more money from taxes. Many people may die due to bladder cancer & heart failure & that will improve the death rate.

As a Pharmacist I’ve found that most of the diabetic patients consume piaglitazone drug in combination with other drugs. In India due to illiteracy & unawareness most of the people don’t do any survey, search & research about the medicines that they consume. Majority of Indians understand medicine by its brand name & its ingredients or composition remains unknown to them as they never read it. In India onetime doctor consultancy fee is high & due to that patients just get the medicines prescribed from doctors once & keep consuming those medicines without further follow up. In this way doctors don’t get proper feedback from their patients & they continue to prescribe the same medicines.

Many times Pharmacist isn’t the person that dispenses the prescribed medicines. Most of the time medicines get dispensed by normal people who work under pharmacists & these people have little awareness about the toxic effects of this drug & hence they don’t discuss it with the consumers.

Diabetes can’t be treated however it can be controlled & for controlling it one has to consume medicines regularly. Indians have awareness about Homeopathic & Unani medicines. India’s Ayurvedic medicine formulation is also very rich. In case medicines have to be taken throughout life then one should rely on alternative medicines like Ayurveda or Homeopathy or Unani. These formulations have very mild side effects. One should also follow a healthy life style that includes eating a healthy diet, doing yoga daily, exercising regularly, meditating regularly & taking proper rest & sleep.

References: -

1. Mukherjee, Rupali. Govt bans popular diabetes drug and analgin. June 27, 2013. http://timesofindia.indiatimes.com/india/Govt-bans-popular-diabetes-drug-and-analgin/articleshow/20789831.cms (accessed November 14, 2014).

2. Omudhome Ogbru (PharmD). pioglitazone, Actos. http://www.medicinenet.com/pioglitazone/article.htm (accessed November 14, 2014).

3. Sachan, Dinsa. Indian U-turn on diabetes drug ban. August 16, 2013. http://www.rsc.org/chemistryworld/2013/08/india-u-turn-diabetes-pioglitazone-drug-ban (accessed November 14, 2014).