E-drug: Re: Phenylbutazone availability (cont)
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Dear E-druggers,
The persisting availability of phenylbutazone on the market is one of
these crazy irrational consequences of drug registration policy.
Novartis still continues marketing the drug in some countries (UK)
for Bechterew and Reiter's disease, though there is good trial
evidence that the drug is no better or worse than naproxen. In other
countries Novartis (inheriting Geigy's patent) has withdrawn it from
the market, but it is still available as generic (i.e., Holland, with the
approval of the official formulary of the pharmacists' association).
Ox(y)phenbutazone ("Tanderil") is one of the metabolites of
phenylbutazone, and it was revealed by the late Olle Hansson that
the incidence of agranulocytosis was high, with a high mortality - on
the basis of Geigy's own data, prematurely released by a Norwegian
representative. Shortly thereafter the drug was withdrawn world-
wide. But the parent drug phenylbutazone was there to stay, even
though Bill Inman showed in his 1977 study that there was no
statistically nor clinically relevant difference between the risk of
adverse reactions caused by these two drugs. Clinical
pharmacological ratio would command that both drugs should have
been treated in the same manner, but that has never been the case.
No European registration authority ever took the appropriate action.
It is quite obvious that with the plethora of much better NSAIDs we
have now there is no longer any need for these old dangerous
drugs. Novartis knows this better than anybody else....
So apparently it is there to stay together with a number of old
"skeletons in the cupboard" to quote Andrew Herxheimer - at least
until somebody wakes up and starts cleaning the cupboard.
Good luck - get rid of the "weakest link".
Dr.L.Offerhaus
Koedijklaan 1a, NL-1406KW Bussum, The Netherlands
Phone: +31-35-6923288. Fax: +31-35-6923290
E-mail: LO@EURONET.NL CompuServe disconnected from 1/3/2001
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