Are the mediations you are taking really safe?

By Rita A. Widiadana

JAKARTA (JP): With the country still in the throes of the economic crisis, most people cannot afford to visit the doctor. The cost of medical treatment and prescription drugs has risen by 100 percent to 300 percent over the past few months, prompting more and more people to look for alternative medication, nonprescription drugs and traditional herbs.

Thanks to the free market of hundreds of nonprescription medicines and natural remedies, people have ample choices in taking care of their health.

Nani, a 27-year-old factory worker, prefers to buy various medicines like Bodrex, Paramex, Oskadon or other brands available at small stores near her workplace when she gets one of her chronic headaches.

She takes Feminax pills to reduce the discomfort of menstrual cramps.

"For me, such inexpensive medicines are enough to cure my ailment," said Nani. She knows about various medicines from advertisements on the radio, television and in printed media.

"Every night, I watch television to see a large variety of commercials, especially on medicines. It is good to get information from these ads rather than spending money on doctors fees," she asserted.

Today, one can obtain a variety of free samples of medicines, traditional herbs, vitamins, minerals and food supplements at drug stores, supermarkets, by mail order, from multilevel marketing distributors and even on websites.

Medicines claiming to cure influenza, coughs and more serious illnesses like high-blood pressure, diabetes, kidney failure and heart-related diseases are sold freely.

Other products such as natural vitamins and food supplements to revitalize the body and to stave off various diseases are now replacing prescription medicines.

Due to budget constraints and other reasons, consumers buy these products as a preventive measure to stay healthy.

The frantic expansion of the market and promotional campaigns for free samples of medicines, traditional herbs and other supplements come at some risk to consumers because a large number of such products have not been registered with the government. Some have been proven safe and effective, many have not.

Sampurno, director general of drug and food control of the Ministry of Health, said the government was aware of the problem and had issued numerous regulations on the subject, but violations still occurred.

Sampurno referred to a study conducted by his office during the l997/l998 period. He mentioned that the office monitored 1,129 commercials promoting free medicines, food supplements, traditional herbs and cosmetics. The study found 395 ads violated the regulation.

"We should not let producers cheat consumers by promoting unsafe medicines. This is very dangerous since it deals with the lives of human beings," Sampurno explained.

The government is now taking steps to ensure that consumers are better informed. It has also issued guidelines on advertisements for nonprescription drugs, traditional herbs, food supplements, cosmetics and health equipment.

"Commercials must not mislead potential buyers. And producers must be able to back up their claims," Sampurno asserted.

The rapid growth of the advertising industry since the l970s has contributed to the rise in the sales of nonprescription medicines and alternative remedies.

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"Many advertisements for such products contain inadequate information on their ingredients," he said.

Iwan Darmansyah, professor at the University of Indonesia's School of Medicine, added that he had found a lot of discrepancies in marketing and campaigning for nonprescription drugs.

"Many commercials often use words like, 'safe, potent, effective and curing' and other deceptive descriptions, while at the same time hiding the products' ineffectiveness and hazardous side-effects," said Darmansyah.

The World Health Organization's Ethical Criteria for Medicinal Drug Promotion, he said, stipulates that commercials on free medicines must be truthful and informative.

These medicines are allowed to be marketed because they are considered safe and effective. However, producers must provide accurate information on ingredients and the usage because they sell the products to common people who have inadequate knowledge of complicated medical terms.

"Some medicines which use Parasetamol claim that they can cure influenza and coughs. This is misleading. Parasetamol can only treat fever temporarily. Further medical treatment is needed," Darmansyah explained.

The growing consumption of traditional and natural medicines has also caused concerns medical circles.

There may be some ingredients not listed. "You don't know how many active ingredients there are in each tablet. They can make all kinds of claims that may not be accurate," he said.

"When you open a bottle of nutritional supplements, you have no idea what is inside," the professor said.

He went on to say that herbs, vitamins, minerals and food supplements cannot be promoted as a cure for an ailment without scientific proof.

He said some vitamin C preparations had been widely promoted as protection against infection and bruises, while vitamin E improves circulation and helps lower blood pressure. But megadoses of these vitamins have dangerous side-effects.

Overuse of vitamin D, a substance that promotes bone and teeth growth in children, can be particularly toxic, as can overuse of iron by the elderly, Darmansyah claimed.

More general claims, for instance claiming that one herb is good for bones or blood circulation, are permitted as long as the claims are accompanied by a warning such as "this product is not intended to diagnose, treat, cure, or prevent any disease", he maintained.

Darmansyah added that the absence of tight control had allowed manufacturers of herbal products to flourish.

He mentioned that a woman died after consuming Daxen to treat her diabetes. She had Steven Johnson reaction, a serious side- effect from a drug. Another Daxen consumer suffered temporary blindness and was treated at Cipto Mangunkusumo General Hospital in Central Jakarta.

"This medicine and many other vitamins and minerals are sold through multilevel marketing without proper supervision from the government," he said.

The professor said such marketing systems were very dangerous when it came to selling medicines, vitamins and minerals.

"People tend to continually buy and consume the products just to get their incentive bonuses," he said.

He said that not all products from natural herbs were safe and a lot of medicines had not been adequately studied.

Loebby Loeqman, professor of law at the University of Indonesia, asserted that regulations should be strictly imposed.

Commercials are important to both producers and consumers as long as they are clear, informative and honest and are in line with the code of ethics, Loebby said.

Under the criminal law, anyone, including the government, can take drug manufacturers to court if their products are found to be harmful.