LAHORE: The Punjab government has banned the production and sale of five “toxic” cough syrups in response to a World Health Organisation (WHO) alert, a development that marks the second major drug-related scandal in the province within just two months.

The implicated cough syrups, manufactured by a Lahore-based pharmaceutical company, were found to contain high alcohol levels. These syrups are Muco­rid, Ulcofin, Alergo, Emi­done Suspen­sion and Zincell.

The alarming discovery was made following a WHO investigation prompted by complaints from the Maldives, as these syrups had also been exported to other countries in the region.

The provincial government has ordered health authorities to immediately dispatch teams, seize the entire stocks of the drugs in question from the markets, and initiate proceedings against the manufacturer.

This incident brings to mind a previous case in Septem­ber, where an adulterated injectable drug compromised the vision of over 80 eye patients in Punjab.

It exposed significant flaws in the health authorities’ oversight of drug manufacturing and distribution process, particularly the informal transportation used to deliver these medicines. The firm was supplying medicines on motorbikes within Lahore city and on passenger buses in the rest of the province.

Dr Jamal Nasir, caretaker Punjab’s minister for primary and secondary healthcare, said the government has immediately banned the sale of cough syrups on the Drug Regulatory Authority Pakistan (Drap) recommendations.

“On the recommendation by Drap, the Punjab government has not only stopped the sale of these five syrups in the province but also decided to seal the manufacturing factory,” he said.

A preliminary inquiry report, seen by Dawn, said Drap has issued a recall for specific batches of these cough syrups due to suspected contamination with harmful substances like diethylene glycol (DEG) and ethylene glycol (EG).

The report said the WHO has also identified the suspected presence of DEG and EG impurities in Batch No. B220 of Alergo syrup, identified in the Maldives and manufactured by Lahore-based Pharmix Laboratories (Pvt) Ltd.

A preliminary investigation by the Drap’s Lahore unit suspected these impurities might also be present in other batches and products.

“This recall is a precautionary measure taken to safeguard public health against the potential harmful effects of these impurities,” the report said.

The manufacturing company has been directed to immediately recall the defective batches of the above-mentioned products from the market.

The report advised all pharmacists and chemists working at distributions and pharmacies to immediately check their stocks and stop supplying these batches of suspected products.

The remaining stock should be quarantined and returned to the supplier or the company, it said, adding that regulatory teams of Drap and provincial health departments are briefed on the matter and directed to increase surveillance in the market to ensure the effective recall of defective products.

Drap also suggested increased vigilance within the supply chains of institutions, pharmacies and healthcare facilities likely to be affected by these products in question.

“Adverse reactions or quality problems experienced with the use of this product may be reported to Drap’s National Pharmacovigilance Centre, using the Adverse Event Reporting Form or online through the given links,” the report said.

It also advised consumers to stop using the product bearing the affected batch numbers and contact their physicians or healthcare providers if they have experienced any problems that may be related to taking or using the drugs in question.

Published in Dawn, November 18th, 2023