E-DRUG: Diclofenac and the WHO Essential Medicines List (3)
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Dear All
Since we had a very dreadful experience with injectable Diclofenac in Iran I
wish to warn all of you to be very cautious about use of this medicine. We
have published our experience as a paper titled *Injectable diclofenac: A
painful shot into Iran’s health system, Social Science & Medicine 63 (2006)
1597–1601*.
I would be glad to send a copy of the paper for fair use to anyone
interested. I include the abstract as following:
Despite high accessibility to medicines irrational prescribing of injections
is a characteristic of Iran’s health system and it has been reported that
more than 40% of patients who visited a doctor receive at least one
injection. The injectable dosage form of Diclofenac was introduced into the
Iran drug market in 1993. However, its use rapidly increased shortly post
commercialization and this medicine was prescribed by many doctors and its
sale increased to 85,520,000 ampoules in 1998. Therefore, not unexpectedly
the Iran pharmacovigilance center received substantial number or reports
indicating ADRs following use of injections and specifically with that of
Diclofenac injection. A total number of 176 ADR reports major problems
following intramuscular administration of Diclofenac were reported to Iran
pharmacovigilance center in the period of 1996-2002. Although a multi
interventional policy including educational, regulatory and managerial
interventions was able to bring adverse drug reactions due to Diclofenac
injection under control, unfortunately statistics shows that prescribers are
trying to substitute Diclofenac injection by other injectable medicines.
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Professor Majid Cheraghali
Tehran- Iran
Fax: (9821) 88601580
Tel: (9821) 88601582
cheraghali@ibto.ir