Drugs and Cosmetics Rules - Schedule H & Schedule H1 Drugs

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Drugs and Cosmetics Act

The Drugs and cosmetic act, 1940 was passed in British India to regulate the manufacture, distribution, and sale of drugs in the colony. This act also governed the import of the drugs in the country. A related Drugs Rules was passed in 1945. Later on, after Indian independence, the act underwent various amendments from time to time and is now known as the Drugs and Cosmetics Act, 1940.

The important amendments in the act were as follows:
  • The Drugs (Amendment) Act, 1955 (11 of 1955)
  • The Drugs (Amendment) Act, 1960 (35 of 1960)
  • The Drugs (Amendment) Act, 1962 (21 of 1962)
  • The Drugs and Cosmetics (Amendment) Act, 1964 (13 of 1964)
  • The Drugs and Cosmetics (Amendment) Act, 1955 (19 of 1972)
  • The Drugs and Cosmetics (Amendment) Act, 1982 (68 of 1982)
  • The Drugs and Cosmetics (Amendment) Act, 1986
  • h) The Drugs and Cosmetics (Amendment) Act, 1995 (71 of 1995)
However, the primary objective of this act remains constant. The act clarifies that the drugs and cosmetics that are sold in India should always be safe, effective and meet stringent quality standards.

Drugs and Cosmetic Act Schedules

The drug sales have increased over the years and new drugs are constantly being added to the drug formulary. To ensure safety of end consumer the drug regulatory body schedules the drugs according to their therapeutic effect.

Drugs and Cosmetics Act differentiates prescription drugs, narcotic and psychotropic substances, over the counter drugs and medical devices, with a view to promote safety in public health.

This scheduling system helps law makers, law enforcers, and healthcare professionals identify the nature of existing as well as new drugs.

Drugs and Cosmetics Rules, 1945

The Drugs and Cosmetic Rules of 1945 allocated provisions for the classification of the drugs under various given schedules including details regarding the storage, display, sale and the prescription of an individual schedule.

The prominent schedules included Schedule G, H, X, J.

Other schedules included A,B,C,E,F,K,M,N,O,P,Q,R,S,T,U,V,Y. Schedule F has sub-categories of F -I, F-II,F-III and F-F while schedule P has a sub category called P-I.

What are Schedule H Drugs?

This schedule contains a list of drugs that can be sold only against the prescription of a registered medical practitioner. Another provision needs to be followed is that, only the required amount of medications mentioned in the prescription can be dispensed. These drugs can be supplied only to the licensed parties.

The drug label must exhibit the text “Rx” and Schedule H drug warning: To be sold by retails on the prescription of a Registered Medical Practioner only.

As per the notification on 16th March 2006 released by the Department of Health under the Ministry of Health and family welfare there are 536 Schedule H drugs.

The original list contained 510 drugs but this has been revised by the Drugs Technical

Advisory Board, and the present list includes about 536 drugs.

List of Schedule H Drugs

  1. Abacavir
  2. Abciximab
  3. Acamprosate Calcium
  4. Acebutolol Hydrochloride
  5. Aclarubicin
  6. Albendazole
  7. Alclometasone Dipropionate
  8. Actilyse
  9. Acyclovir
  10. Adenosine
  11. Adrenocorticotrophic Hormone (Acth)
  12. Alendronate Sodium
  13. Allopurinol
  14. Alpha chymotrypsin
  15. Alprazolam
  16. Alprostadil
  17. Amantadine Hydrochloride
  18. Amifostine
  19. Amikacin Sulphate
  20. Amiloride Hydrochloride

Why was Schedule H1 Introduced

The schedule H1 drugs were mainly allocated to restrict the selling of antibiotics through over the counter (OTC) sales, after it was noted that any number of these drugs could be bought from pharmacies across India without any limitations.

Irrational prescribing of antibiotics and other drugs by doctors and chemists lacking a registered pharmacist has contributed to the increasing antibiotics resistance and tolerance of psychotropics. In response to these serious issues, antibiotic forums, scientific meetings and symposiums were conducted by medical fraternity and various educational institutions.

As a result, the Government of India issued a gazette notification, GSR 588 (E) dated on 30. 08. 2013 regarding schedule H1 Drugs which shows the importance of this schedule.

Schedule H1 Drugs:

The schedule H1 drug includes 3rd & 4th generation antibiotics, anti-tuberculosis drugs and certain habit-forming drugs like psychotropic drugs.

To dispense these drugs two main criteria have to be followed strictly.

1) The drug supplied under the schedule H1 specification should be recorded in a separate register at the time of supply, mentioning the name and address of the prescriber, name of the patient, and the name of the drug along with the quantity supplied. This register has to be maintained confidentially up to three years and should be open for inspection.

2) The schedule H1 drugs should be labeled with the symbol Rx in red, clearly displayed on the left top corner of the drug label. The label should also bear the following words in a box with a red border.

"Schedule H1 Drug-Warning:

-It is dangerous to take this preparation except in accordance with the medical advice.

-Not to be sold by retail without the prescription of a Registered Medical Practitioner."

List of Schedule H1 Drugs

  1. Alprazolam
  2. Balofloxacin
  3. Buprenorphine
  4. Capreomycin
  5. Cefdinir
  6. Cefditoren
  7. Cefepime
  8. Cefetamet
  9. Cefexime
  10. Cefoperazone
  11. Cefotaxime
  12. Cefpirome
  13. Cefpodoxime
  14. Ceftazidime
  15. Ceftibuten
  16. Ceftizoxime
  17. Ceftriaxone
  18. Chlordiazepoxide
  19. Clofazimine
  20. Codeine
  21. Cycloserine
  22. Diazepam
  23. Diphenoxylate
  24. Doripenem
  25. Ertapenem
  26. Etambutol HCl
  27. Ethinamide
  28. Feropenem
  29. Gemifloxacin
  30. Imipenem
  31. Isoniazid
  32. Levofloxacin
  33. Meropenem
  34. Midazolam
  35. Moxifloxacin
  36. Nitrazepam
  37. Pentazocine
  38. Prulifloxacin
  39. Pyrazinamide
  40. Ribabutin
  41. Rafampicin
  42. Sodium Para-aminosalicylate
  43. Sparfloxacin
  44. Thiacetazone
  45. Tramadol
  46. Zolpidem
The schedule H1 drug list, however, shows no limitation of using the drugs as topicals or for external use such as in ophthalmic, ear or nose preparations.

It is a known fact that a gazette notification alone will not help. Apart from this several measures have to be executed by the respective authorities at all levels.

They are as follows:

a) Surveillance of OTC sales

b) Studying patterns of antibiotic sensitivity and resistance

c) Launching of appropriate antibiotic and psychotrophic policies in a healthcare facility

d) Creating awareness about rational use of antibiotics in all levels of medical setups including teaching medical institutions

e) Conducting frequent pharmacy inspections

Conduct Frequent Pharmacy Inspections

Illegal drug trafficking activities can be eliminated by categorizing drugs as scheduled drugs; this ensures patient health and safety. Ultimately, the registered pharmacists should firmly understand their responsibility in adequately managing drugs being sold through their pharmacy under the drugs regulatory law.

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