Oral or Parenteral Paracetamol as a Substitute for Banned Dipyrone-Based Analgesics/ Antipyretics

Abstract

The National Agency for Food and Drugs Administration and Control (NAFDAC) banned the sale and use of dipyronecontaining drugs on 31st December 2005 in Nigeria. This ought to bring about a change in prescription patterns of antipyretic agents and thus promote rational use of these drugs in Nigeria. This was a retrospective study which objectives were to (a) determine the degree of compliance with the dipyrone ban and (b) to determine the pattern of antipyretics prescription before and after the ban in the Paediatrics Department of the University of Nigeria Teaching Hospital, Enugu, Nigeria. Over 500 prescription cards in the children emergency and children out-patient units of the hospital were screened in the trimesters before and after the banning of dipyrone. Only prescription cards containing antipyretics were selected for analysis. Patients' maximal temperatures were noted. The following prescribing patterns were observed 3 months before and 3 months after the dipyrone ban. In October 2004 there were 103 prescriptions which included Analgin IM (5), ibuprofen (6), oral paracetamol (102). In April 2005, there were 218 prescriptions for antipyretics and non-steroidal anti-inflammatory drugs (NSAIDs) which included piroxicam (11), ibuprofen (9), oral paracetamol (176), parenteral paracetamol (4). The prescribing of dipyrone-containing drugs effectively stopped after the regulatory ban. However, there was increased use of NSAIDS for pyrexia rather than the expected reliance on paracetamol (oral or parenteral) for this purpose.

Keywords: Dipyrone, prescriptions, NSAIDs, parenteral paracetamol, retrospective.