Recommended reading list: counterfeit medicines

SecuringPharma.com presents a round-up of papers published in the peer review literature, including prevalence data on counterfeit antiparasitic drugs in Cambodia, the impact of falsified drugs in the developing world and new analytical techniques.

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Prevalence of counterfeit antihelminthic medicines: a cross-sectional survey in Cambodia.

Over 4 per cent of a sample of antihelminthic medicines collected at drug stores in Cambodia were counterfeit, according to a study carried out by researchers at Kanazawa University in Japan. The team sampled 196 products used to treat parasitic worms, of which nearly 16 per cent were unregistered. A subsample of 165 samples were tested for authenticity and seven were identified as counterfeit. "The results of our survey urge strict implementation of drug registration and vigilance on the availability of unregistered medicines to combat counterfeit medicines in Cambodia," say the authors.

Trop Med Int Health. 2010 Mar 1. (Epub ahead of print)

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Watching internet pharmacies

The number of illegal internet pharmacies selling prescription-only medicines without a prescription is increasing, writes Hamid Ghodse, Director of the International Centre for Drug Policy, St George’s, University of London, UK, in the British Journal of Psychiatry (March 2010). Large quantities of drugs are dispensed, making drugs of abuse readily available, and further risks are posed by counterfeit medication. Urgent national and international action is required to stop further proliferation of illegal pharmacies.

Br J Psychiatry. 2010 Mar;196:169-70.

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Impact of poor quality medicines in the 'developing' world

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients in 'developing' countries. Poor-quality drugs are a vital (but neglected) public health problem. They contribute to a 'crevasse' between the enormous effort in therapeutic research and policy decisions and implementation of good-quality medicines.

Trends Pharmacol Sci. 2010 Mar;31(3):99-101.

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The identification of (-)-trans-tadalafil, tadalafil, and sildenafil in counterfeit Cialis and the optical purity of tadalafil stereoisomers

Researchers from the National Institute for Public Health and the Environment in the Netherlands describe what they say is the first reported case of a counterfeit version of Eli Lilly's erectile dysfunction drug Cialis which contained the normal stereoisomer of the active ingredient tadalafil but also another optical isomer known as (-)-trans-tadalafil which could represent a health risk. "The optical purity of tadalafil needs to be taken into account when calculating the dosage in illegal medicines," they conclude.

J Pharm Biomed Anal. 2010 Feb 5;51(3):723-7

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Small molecule ambient mass spectrometry imaging by infrared laser ablation metastable-induced chemical ionization

Researchers from Georgia Institute of Technology and Louisiana State University in the USA have developed a novel mass spectrometry technique suitable for use in counterfeit medicine screening. The technique, known as infrared laser ablation metastable-induced chemical ionization (IR-LAMICI) is an imaging approach that can identify active pharmaceutical ingredients down to the pictogram level. The team is led by GIT's Professor Facundo Fernandez, who has also worked on the use of MS technologies based on Direct Analysis in Real Time (DART) and Desorption Electrospray Ionization (DESI) in the area of counterfeit medicines analysis.

Anal Chem. 2010 Mar 15;82(6):2178-81

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