11 Oct 2011
By: POON CHIAN HUI
WHEN a retiree bought some black pills from her relatives earlier this year, she thought they would cure her arthritis.
Instead, the pills, called Tian Ma Tu Chung Seven Leave Ginseng, caused her to hallucinate.
Her family took her to a hospital, where doctors diagnosed her with Cushing’s syndrome, a hormonal disorder. This was found to be caused by the presence of two potent Western ingredients in the pills, including a steroid.
More patients are reporting bad side effects from taking medicine and health products.
The number of adverse drug reaction reports has shot up in the past decade, from 439 in 2000 to 24,300 last year, the Health Sciences Authority (HSA) told The Straits Times.
The spike has been particularly sharp in recent years. In 2008, 17,200 reports were filed. In 2009, the number went up to 18,600, and last year, it hit 24,300.
The reports are filed with HSA by doctors whom these patients consult. More than 90 per cent of the reports are filed by doctors from polyclinics and public hospitals.
Adverse reactions to drugs vary, ranging from minor skin allergies to life-threatening heart abnormalities to hallucinations.
Skin problems were the most common adverse reaction last year, featuring in more than 6,200 reports. Ms Dorothy Toh, director of HSA’s vigilance branch, said this is because they are the most visible.
The spike in reports is largely due to doctors being more aware about the harmful reactions that drugs can cause.
Technology has also made it easier for doctors to report such incidents.
In the past, doctors could only fill paper forms and mail them to HSA. Since 2004, reports can be filed through an online portal. And since 2006, public hospitals and polyclinics have also been allowed to submit reports using patients’ electronic medical records.
Adverse reactions to a drug or health product do not necessarily mean it is harmful.
All medicines can cause adverse reactions, but many are considered safe as the benefits they bring outweigh the health risks.
For example, chemotherapy drugs cause undesirable side effects such as vomiting. But as the drugs can save the person’s life – which is more important than the discomfort they cause – they are still cleared for use.
Ms Toh said most of the products reported were not found to be harmful.
However, some were harmful as well as illegal, and she noted that more such products have been uncovered through the reporting system.
As of August, 15 illegal products have been detected this year, compared with five for the whole of last year, and six in 2009.
These illegal products are usually traditional or alternative medicines that contain Western ingredients such as steroids, which are not allowed here.
Of the 15 illegal products, about 10 are not approved for sale here and were bought overseas.
In August, for example, HSA sent out alerts when four people fell ill after taking three herbal remedies used for relieving pain.
These were found to contain potent Western ingredients. One of them, Pao Ni Kang, had repaglinide, a Western anti-diabetic medication that can lead to brain damage.
Dr Sueziani Zainudin of Singapore General Hospital’s endocrinology department recounted how she sensed something was amiss when a diabetic man’s blood sugar level remained low after he had missed his lunch.
“If he had been taking normal diabetic medication, his blood sugar wouldn’t have dropped so low – and it should readjust back to normal on its own,” said Dr Sueziani, who saw the patient in July.
The patient, who was dazed and confused, was later hospitalised for three days. He admitted taking Pao Ni Kang, which he had bought from Malaysia.
Dr Sueziani filed a report with HSA with a sample of the product. HSA conducted tests on it and found that it was indeed the cause of the adverse reaction as it contained repaglinide.
Dr Sueziani noted that the man, who is in his 30s, could have ended up in a more serious condition if he had continued taking the drug.
Ms Toh said it is important that people avoid buying drugs from sources that cannot be held accountable, such as over the Internet.
She urged patients to report adverse reactions to their doctors, even if they had bought the medicine overseas. She gave the assurance that they will not be penalised even if the medicine was not meant to be sold here.
“By informing us, you can help to protect your friends and family, who may also be taking the same product,” she said.
Email: chpoon@sph.com.sg
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