It is not uncommon to see a pharmacist selling a 'Schedule H - Drug' without asking for the doctor's prescription. Few pay heed to the warning: ' To be sold by retail on prescription of a registered medical practitioners only'. Yet this seemingly small act of negligence can result in even lives being lost.
The Directorate of Drugs Control is facing criticism from several departments, including the police, for not initiating action against drug stores, which violate the Drugs and Cosmetics Act. In the recent past, at least in two cases, one suicide and another attempted suicide; persons have consumed several strips of Schedule H tablets.
One such is Jayalakshmi, a nurse. She told doctors at M S Ramaiah Memorial Hospital, Bangalore, that she swallowed two strips (20 tablets) of Gardenal (phenobarbitone), an anti-epilepsy drug. She had sent her driver to procure them from a neighborhood medical store. Earlier, a medical student Rashmi consumed several strips of the same drug because she didn't get a seat in the specialty of her choice.
Says drug controller Sripathy:"We do run surprise checks and inspection on drugs stores to watch for violators."These violations usually happen when drug stores don't have a registered pharmacist," he adds. Last year, the department suspended the licenses of 181 drug stores.
In this category, there are around 530 drugs. The drugs inspectors report rampant sale of drugs such as Nimusulide (non-steroidal anti-inflammatory drug) prescribed for arthritic pain and sometimes by gynecologists for dysmenorrhoea. These can cause serious problems if they are not prescribed. Other drugs include some lifesaving drugs such as insulin. Worse, even drugs that need to be given under medical supervision are given without a prescription.
Yet, drug store owners try to justify this. "If I don't, my neighbor will sell it. It's cutthroat competition, with at least three drug stores in each lane. What do you expect us to do?" says one in Indiranagar, Bangalore.
There are many too who sell these drugs because they don't want their customers to switch loyalty. "I know every diabetic who visits me. They need insulin to live. Doctors give them prescriptions for just one month. It's unfair to tell them to visit doctors for the same prescription,'' says a pharmacist in Jayanagar.
Doctors beg to differ. "We don't write prescriptions without applying our mind," says Dr Mala Dharmalingam. "Every diabetic should have his sugar levels checked. Many take prescriptions for a month and never return for a refill. I see them after a year with high sugar levels and complications such as kidney failure," she adds.
Most of her fraternity would agree to that. "This happens only in India. Abroad, they insist on prescription for many drugs including those branded as 'over the counter' here," says consultant physician Dr Ramana Rao.
Says a volunteer of Lawyer's Collective: "We are sitting on a time bomb. Something needs to be done before it explodes. That could be catastrophic."