Objective: The present study is aimed to evaluate the medication safety of fixed dose combination drugs at a tertiary care hospital.
Methodology: It is a prospective observational study conducted in inpatient setting. The data collected in pre design data collection form for 200 patients, who are assessed for the period of six months. Hospitalized patients who were taking at least one fixed dose combination drugs and had a hospital stay of 48 hours were considered for this study. The collected data included demographics, fixed dose combination drugs usage pattern and safety analysis data. The data was compiled in excel and analyzed using Micromedex.
Result: A total of 200 patients were included in this study. Majority of patients were male (51.5%). Hypertension (14.5%) and diabetes mellitus (10%) were major co-morbidity. Out of 200 prescriptions analyzed, 322 drugs were fixed dose combination. The average number of FDCs prescribed was (1.62±0.78). Equal distribution of adult and geriatric FDCs prescribing was observed. As per category analysis, a higher number of fixed dose combination were related to antibiotics (18.01%) followed by antihypertensive (12.73%). The fixed dose prescribed from WHO EML was 20 (6.21%), from National Essential Medicine Lists were 296 (91.92%) and from hospital formulary of tertiary hospital were 317 (98.44%). Most commonly prescribed FDCs were aspirin/atorvastatin (7.45%) and rabeprazole/domperidone (7.45%) in the 200 prescription analyzed. drugs and fixed dose combinations was obtained from CIMS, IDR and Drug today. Of the 29 FDCs analyzed, 65% were found to be more cost effective than their total cost of individual components. The incidence of FDCs drug interaction was 21%. Among antibiotic 40 FDC were irrational followed by 22 in antihypertensive. Among the analyzed prescription, five banned drugs were observed that combination of paracetamol with tramadol in which paracetamol is 500 mg.
Conclusion: It was observed that hospital physicians prescribed fixed dose combination drugs from essential drug lists. Most of the fixed dose combination drug was cost effective. This study concluded that the pharmacists can play significant role in assessing and controlling drug related problem of FDCs.
