LAHORE, Dec 31: Punjab Health Director-General Nisar Ahmad Cheema claimed on Monday that dextromethorphan, an active ingredient imported from India in the form of raw material, was initially found responsible for syrup-related deaths in Lahore and Gujranwala districts.

Another top-ranking official of the World Health Organization (WHO) Syed Khalid Saeed Bukhari has also indicated the same reason behind syrup-related two tragedies.

“Samples taken from victims at Lahore showed very high concentration -- 4.1 to 7.8mg/ml -- of dextromethorphan (lethal concentration 3mg/ml)”, quoting Khalid Bukhari a senior official told Dawn seeking anonymity.

He said the use of the said ingredient by victims more than the minimum limits set internationally for its consumption might be the major factor behind deaths.The official quoted Mr Bukhari as having said: “In case of Recko Pharma, the dextromethorphan was taken from two sources. The dextromethorphan taken from the first source has fully complied with all tests performed but the one taken from the second source has not complied with the standard optical rotation and melting point.”

While recently in case of Ethical Pharma, the dextromethorphan was taken from one source only but it also showed variation in optical rotation and melting point, he said.

The ‘identical’ claim by the two top officials triggered a new controversy at a time when investigations into the syrup-related two tragedies and several lab reports were still under process.

Even no report by any foreign lab has been performed so far in the syrup-related deaths that took place in November and December.

Pakistan Pharmaceutical Manufacturers Association (PPMA) vice-chairman Nasir Qureshi termed this claim a ‘ridiculous’ saying over 65 local and multinational pharmaceutical companies were using the same active ingredient (dextromethorphan) in their cough syrups which were available in abundance in the market everywhere in Pakistan.

He said if their claim was accepted as true then the deaths, after taking these syrups, should have been hundred times more than those reported in Lahore and Gujranwala.

“Why only drug addicts are dying and that too in particular areas,” Mr Qureshi questioned while talking to Dawn.

He said it was a matter of grave concern that officials working for the highly sensitive health department had little knowledge in the field. “They are making public announcements without completing investigation which will adversely leave drastic impact on the pharmaceutical industry,” he said.

Mr Qureshi claimed that dextromethorphan-related deaths in the US and other European countries were many times more compared to those occurred in Lahore and Gujranwala.

He said drug addicts in the developed countries were also using cough syrups of various brands which carried dextromethorphan as addiction. But the authorities in those countries always took steps to ensure the sale of drugs to patients in accordance with the prescription of doctors.

Apart from this, they also made regulations to stop its ‘misuse’ rather than lodging criminal cases against manufacturers, arresting them and sealing their firms.

Earlier talking to the media on Monday, Nisar Cheema said two local pharmaceutical firms, Reko Pharma and Ethical Laboratories, were using the said raw material -- dextromethorphan -- in manufacturing cough syrups.

He said initially it had been established that the excessive dose of dextromethorphan was the cause of 19 deaths in Shahdara area of Lahore in November and over 30 others in December, mostly in Gujranwala.

He said the investigations into these deaths so far revolved around the single source of the ingredient purchased by the two pharmaceutical companies from India which they used in manufacturing cough syrups.

Mr Cheema held dextromethorphan responsible for deaths on the basis of reports issued by the Drug Testing Laboratory (DTL).The Health DG said the government had also dispatched samples abroad for analysis.

He said the Drug Regulator Authority in Islamabad had also been conveyed about the defected destromethorphan raw material imported from India for taking action against the officials involved.

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