E-DRUG: Irrational formulations

[Sunitha Srinivas <sunithasrinivas@kspcdic.org>]

E-DRUG: Irrational formulations
-------------------------------

This mail is to take your help in finding the literature for the
following query.

1. With respect to a review of rationality of iron tonics and enzyme
preparations, the iron tonic preparations with amino acids or vitamins
other than folic acid & Vit C is being questioned .

2. Addition of Zinc in Iron preparation is being questioned in India.

3. Vitamins or minerals is not to be added to enzyme preparations.

I am looking for references as to on what basis these combinations are
to be called irrational. Kindly inform me where I will get this
information -whether in the internet or in journals, etc. I am
interested in reference materials regarding irrationals formulations in
general. Kindly suggest this as well.

Thanks in advance.
Anticipating your earliest reply.

Ms. Sunitha Srinivas
Deputy Director
Drug Information Centre
Bangalore, India

Email: sunithasrinivas@kspcdic.org

[dear Sunitha, 

Proving rationality is much easier than proving irrationality!

Rationality can be 'proven' by doing randomised controlled trials. It is,
however, unethical to try and do a clinical trial if you want to 'prove' that a product
is irrational. You will therefore have to rely on independent opinions from experts or
drug bulletins.

I think you should turn the question: ask the manufacturer of the 
irrational tonic to document that his product is effective and rational.
If the evidence provided is poor, draw your conclusions and consider the
product ineffective and irrational.

Anything that is called a 'tonic' sounds suspicious to me. What is the indication? If
the anaemia due to iron-deficiency, it is rational to provide iron tablets or
iron-containing food. For children, iron syrups could be made, but be careful with iron
therapy in children.

In tonics, the dose of iron is often too low to be really useful in iron-
deficiency. That is probably not very cost-effective.

Folic acid has its own indication - it is, however, for a different kind 
of anaemia. Combined with iron it is being used in pregnancy for profylaxis.

Zinc, vitamine C, amino-acids sound like placebo's to me. Normal food sounds a better
idea to me: cheaper and more rational...  

But maybe some E-druggers can email you some nice literature references.
Please send them direct to  sunithasrinivas@kspcdic.org

WB]




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