more-in Mumbai: The Food and Drug Administration (FDA) has sent out a circular alerting chemists in the State that antiviral drugs Oseltamivir and Zanamivir have been withdrawn from Schedule X and moved to Schedule H1. Available under several brand names, both drugs are prescribed to H1N1 patients. While drugs under Schedule X require a copy each of the prescription for the doctor, patient and chemist and can be sold by a chemist who holds a Schedule X license, drugs in Schedule H1 require only one prescription copy of and can be sold by all chemists. Oseltamivir and Zanamivir are antiviral medication that block the actions of influenza virus types A and B. While Oseltamivir is available in the form of tablets, Zanamivir comes in a powder form for oral inhalation. The FDA circular, issued on Thursday, stated that a gazette notification to this effect was issued in February 2017 by the Drug Controller General of India. However, there is lack of awareness about the same among patients, chemists and doctors. “We are still getting patients who are given three copies of prescriptions by the doctors. And there are many chemists who insist on a copy too as they are unaware about the change in rules,” said Hakim Kapasi, a chemist from Andheri and senior member of the Andheri Chemists Association. In Maharashtra, there are around 50,000 chemists, of which nearly 6,500 are in Mumbai. However, only 1% of these chemists have the Schedule X license for highly controlled drugs. “Many patients face problems in getting access to the drug. Given that there are so many cases of H1N1, the government must have thought about public convenience,” said Mr. Kapasi. Misuse fears With relaxation in availability norms, there is a strong concern that the drugs may be misused, eventually leading to drug resistance. Dr. Om Shrivastav, an infectious diseases specialist, said, “Misuse and overuse of drugs are always concerns. In this case, it is a good thing that doctors will be able to provide medication to patients easily, but everyone has to behave responsibly.” Dr. Shrivastav, who is seeing a rise in H1N1 cases this season, added, “I’m trying to keep people out of hospital as much as possible. Timely medication and home isolation works perfectly in H1N1 cases. Many doctors are still writing three prescriptions, unaware about the changed norms. This year, the State has recorded approximately 1,800 cases of H1N1 and more than 260 deaths. In Mumbai, 490 cases and 16 deaths have been reported so far. An analysis of the city’s H1N1 cases carried out by the BMC’s Health Department earlier this week has shown that the median time between onset of symptoms to the start of antiviral drug Oseltamivir is four to five days, which is dangerously late. While the delay could be by patients in going for treatment or by the doctor in diagnosing symptoms and starting medication, many patients are finding it difficult to get medication easily.

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