Background: The hypertension is the most common chronic disease, therefore treatment should be affordable. The antihypertensive drugs of same strength are available in market at different costs. This study was undertaken to create awareness among health care workers and patients, about cost difference among different brands of same antihypertensive drug. So that whenever possible, a cheaper effective brand can be prescribed to ensure better patient adherence.Methods: Maximum retail price (MRP) of various antihypertensive drugs of same strength, manufactured by different pharmaceutical companies was obtained from various offline and online sources. The minimum and maximum cost of 10 tablets/capsules noted. The cost ratio and percentage cost variation was calculated for single drug and fixed dose combinations. The ceiling price (as per DPCO) of essential antihypertensives (as per national list of essential medicines) was compared with their maximum cost.Results: The formulations of single antihypertensive drugs (41) and fixed dose combinations of two drugs (19) and three drugs (9) were included in the study. Among the single antihypertensives analyzed the highest cost difference was of eplerenone (50 mg) and high cost ratio and cost variation percentage was of amlodipine (5 mg). Among fixed dose combination of two drugs analyzed highest cost difference was found that of hydrochlorothazide (12.5 mg)+olmesartan (40 mg) combination and highest cost ratio and percentage cost variation was of amlodipine (5 mg)+telmisartan (40 mg).Conclusions: There was a huge price variation among the antihypertensive drugs manufactured by various companies. Some measures must be taken by the government to bring the uniformity in the price that will help to reduce the economic burden on the patients.
Background: There is association of deranged thyroid hormone levels with various co-morbidities. Drugs for comorbidity may interact with each other and affect the outcome of treatment. So, this study was planned to find out comorbidities with deranged thyroid hormone levels and various possible drug interactions.Methods: It was a prospective, observational study carried out at tertiary care hospital from November 2017 to June 2018. Thyroid hormonal levels reports were followed in OPD and online information system facility. Drugs interactions were checked by referring standard pharmacology textbooks, review articles and Medscape drug interaction checker. Approval from the Institutional Ethics Committee was taken before initiation of the study. Patients with deranged thyroid hormone levels were included in the study.Results: Study was conducted in 111 patients of thyroid disorders. Spondylitis, asthma, acne cases were seen in hypothyroid patients whereas hypokalemic periodic paralysis, thyroid ophthalmopathy statistically significantly seen in hyperthyroid patients. Various concurrent medications such as calcium, carbamazepine decreases the effects of levothyroxine. For management of comorbidities various drugs are given which also interact among themselves significantly.Conclusions: Diabetes mellites, obesity, spondylitis, lichen planus were more common in hypothyroidism while comorbidities like hypertension, hypokalemic periodic paralysis, thyroid ophthalmopathy were found to be more in hyperthyroidism. Incidence of drug interactions is found to be more with increased use of medications for comorbidities, so physicians should be careful while prescribing them. Due to drug interactions desired effects of drugs given for thyroid disorders may not be observed.
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