TPW_May-June 2022

Nephrology ENDORSED BY
& Urology
DGDA

MAJOR GENERAL
MOHAMMAD
YOUSUF JOINS
AS DIRECTOR
GENERAL OF DGDA
ASIA PHARMA EXPO
2022 ENDS
SUCCESSFULLY!





CONTENTS

News Did You Know 35 Innovation 97

New Arrivals 5, News 29, DGDA News 34 In Depth 50 Gleanings From Local Press 99
FIP News 34, EMA News 37
AMR 57 Facts on Finger Tips 100

Interview Pharmacovigilance 58 Glossary of Nephrology Term 100

Prof. Dr. Harun-Ur-Rashid 39 Research Update 68 Health Tips 101

Prof. M.A. Salam 43 Concern 70 FDA Update 102

Prof. Dr. Mizanur Rahman 53 Focus 75 Forecast 105

Prof. Dr. Md Kamrul Islam 61 Corona Update 79 Registration Rules 106

Prof. Dr. Sarwar Iqbal 65 Nephrology update 80 Post Event 109

Prof. Dr. Muhammad Nazrul Islam 73 Brain Teaser 87 Asia Pharma Expo ’22 in Pictures 111

Prof. Dr. Isteaq Ahmed Shameem 77

Prof. Dr. Md. Nazrul Islam 83 Drug Safety 91 Appointments And Promotions 112

Prof. Dr. A.K.M. Shahadat Hossain 89 Worth Knowing About 92 Fast Fact 113

Face to Face Red Alert 95 Doctor’s Diary 114

Nazmul Hossain 54 Technology 96 Upcoming Event 115

National Prof. Brig. (Rtd.) Abdul Malik board of Advisors Prof. Dr. ABM Abdullah
Founder & President UGC Professor, BSMMU
National Heart Foundation, Dhaka Prof. Dr. TA Chowdhury Personal Physician to Hon’ble Prime Minister
Professor, Dept. of Obstetrics & Gynaecology
National Prof. Dr. A K Azad Khan BIRDEM, Dhaka Prof. Dr. Mohammod Shahidullah
President Department of Neonatology
Diabetic Association of Bangladesh & Prof. Dr. Abdul Ghani BSMMU, Dhaka
Chairman Board of Trustees Ex-Chairman
Bangladesh University of Health Dept. of Pharmacy, University of Dhaka Prof. M.A. Salam
Sciences (BUHS), Dhaka Founder President & CEO
Prof. Dr. Harun-Ur-Rashid Urology & Transplant Foundation of Bangladesh
Advisor, International Affairs Founder & Chief Consultant Dhaka
Prof. Dr. Moshe Szyf Kidney Fundation Hospital &
GlaxoSmithKline & James McGill Professor Research Institute, Dhaka head of marketing
Dept. of Pharmacology & Therapeutics Faisal Ahmmed
McGill University Medical School Editor Marketing
Montreal, Quebec Canada Muhammad Masud Md. Shohag Hossen
Pharmaceutical Advisor Executive Editor Circulation
Abu Nayeem Saifur Rahman S A Nadeem Md. Sikander
Medical Advisor managing editor Md. Bashar
Dr. R. M. Samiul Hasan Sandip Kumar Saha Computer Graphics
Media Advisor Associate Editor Md. Aftabul Islam
Dr. Sajal Ashfaque Humayera Kabir Hana Production
Dr. SMG Saklayen Russel Business Editor Mati Ar Manush
Dr. Saleh Mahmood Tusher Md. Shahjahan Editorial/Business Office
Research Editor 51, Kalabagan 1st Lane (Ground floor)
Prof. Dr. Md. Moklesur Rahman Sarker Dhaka-1205, Bangladesh
graphics Designer E-mail: [email protected]
Munir Hussein

Volume 13 n No. 2 n may-june 2022 Published by Muhammad Masud. 51, Kalabagan 1st Lane (Ground floor) Dhaka-1205,
Bangladesh, Tel/Fax: +88 02 58155677 n Printing: Image Printing & Packaging
3 Purana Paltan, Dhaka.

IMPORTANT: Every care is taken to ensure the accuracy of the information given in
this journal but no responsibility is accepted for any error and/or omissions. Editor/
publisher is not responsible in any way for views/comments expressed herein.





ACME NEW ARRIVALS

Brand Name: Alodia
Generic Name: Alogliptin INN
Strength: 12.5 mg
Dosage Form: Film Coated Tablets
Indications: Type 2 Diabetes Mellitus

Brand Name: Barinix Brand Name: Cortimax
Generic Name: Baricitinib INN Generic Name: Deflazacort INN
Strength: 2 mg Strength: 6 mg/5 ml (60 ml)
Dosage Form: Tablet Dosage Form: Suspension
Indications: Rheumatoid arthritis Indications: Allergic & inflam-
matory disorder
Brand Name: Egolix
Generic Name: Elagolix (as
Sodium) INN
Strength: 150 mg, 200 mg
Dosage Form: Tablet
Indications: Moderate to severe
stages of endometriosis

Brand Name: Emlino Brand Name: Defrol OS
Generic Name: Linagliptin INN + Empa- Generic Name: Cholecalciferol BP
gliflozin INN Tablet Strength: 2000 IU/ml
Strength: 5+10 mg, 5+25 mg Dosage Form: Oral solution
Dosage Form: Tablet Indications: Osteoporosis, rick-
Indications: Type 2 Diabetes Mellitus ets, osteomalacia, preeclampsia
and prediabetes.
Brand Name: Famodin
Generic Name: Famotidine USP
Strength: 40 mg/5 ml
Dosage Form: Powder For Suspension
Indications: FD (Functional Dyspepsia),
GERD, peptic ulcer, heartburn & reduc-
tion of NSAIDs-associated gastrointesti-
nal effects (Off-label indication).

THE PHARMA WORLD 7

Brand Name: LM Brand Name: Liptor EZ
Generic Name: Levamlo- Generic Name: Atorvastatin + Ezetimibe
dipine Maleate INN Strength: 10 mg + 10 mg, 20 mg + 10 mg
Strength: 2.5 & 5 mg Dosage Form: Tablet
Dosage Form: Tablet Indications: Elevated total-C, LDL-C, Apo B,
Indications: Hypertension TG, and non-HDL-C, and to increase HDL-C

Brand Name: Neugalin XR Brand Name: Orthogen
Generic Name: Pregabalin Generic Name: Undenatured Type II collagen+ Glucos-
USP amine sulfate+Boswellia serrate+ Boron (Calcium fructo-
Strength: 82.5 mg & 165 mg borate).
Dosage Form: Extended Strength: 20 mg+ 750 mg+ 50 mg + 0.75 mg.
Release Tablet Dosage Form: Tablet
Indications: Diabetic Periph- Indications: Osteoarthritis & rheumatoid arthritis •
eral Neuropathy (DPN) & Post Difficulties in flexibility & mobility • Joint pain & inflam-
Herpetic Neuralgia (PHN) mation • Joint discomfort & stiffness (knee extension) •
Impaired joint function.

Brand Name: Trihale
Generic Name: Fluticasone Furoate + Umeclidinium
Bromide + Vilanterol Trifenatate
Strength: 100 mcg + 62.5 mcg + 25 mcg & 200 mcg +
62.5 mcg + 25 mcg
Dosage Form: Dry Powder Inhaler (RotaCap)
Indications: Long term maintenance treatment of,
Asthma, COPD

Brand Name: Pink Pill Brand Name: Verigat
Generic Name: Flibanserin Generic Name: Vericiguat
INN Strength: 2.5, 5 & 10 mg
Strength: 100 mg Dosage Form: Tablet
Dosage Form: Tablet Indications: Chronic heart failure, heart failure
Indications: HSDD (Hypoac- with reduced ejection fraction, hospitalization
tive Sexual Desire Disorder) for heart failure.
in Premenopausal Women

8 THE PHARMA WORLD

Aristopharma

Brand Name: Aristobet-N
Generic Name: Betamethasone (as Valerate) & Neomycin
Sulphate
Strength: 0.1% & 0.5%
Dosage Form: Cream
Indications: Eczema, contact dermatitis, otitis externa,
dyshydrosis, exfoliative dermatitis, intertrigo, neuroder-
matitis, pruritus, psoriasis, seborrheic dermatitis etc.

Brand Name: Aricarb
Generic Name: Carboplatin
Strength: 150 mg & 450 mg
Dosage Form: Injection
Indications: Advanced and
recurrent ovarian carcino-
ma, small-cell lung cancer

Brand Name: Ariplat Brand Name: Ariscon Brand Name: Optimox Brand Name: Lotepred DS
Generic Name: Cisplatin Generic Name: Sodium Al- Generic Name: Moxifloxacin Generic Name: Lotepred-
Strength: 10 g & 50 g ginate + Sodium Bicarbon- Strength: 400 mg/250 ml nol Etabonate
Dosage Form: Injection ate + Calcium Carbonate Dosage Form: IV Infusion Strength: 1%
Indications: Metastatic tes- Strength: (500 mg + 267 mg Indications: Community Dosage Form: Ophthalmic
ticular tumors, metastatic + 160 mg)/ 10 ml acquired pneumonia (CAP), Suspension
ovarian tumors, advanced Dosage Form: Suspension acute bacterial sinusitis Indications: Steroid
bladder cancer Indications: Gastric reflux, (ABS), acute bacterial exac- responsive inflammatory
Heartburn, Indigestion, erbation of chronic bron- ocular conditions & post
Flatulence associated with chitis (AECB), complicated operative inflammation
gastric reflux, Heartburn of intra-abdominal infections
pregnancy. (CIAIs), complicated skin
& skin structure infections
(CSSSIs)

Brand Name: Budison Brand Name: Goodbac-SB
Generic Name: Budesonide Generic Name: Saccharo-
Strength: 0.5 mg/2 ml myces boulardii
Dosage Form: Nebuliser Strength: 5 billion CFU
Suspension Dosage Form: Capsule
Indications: Asthma Indications: Diarrhoea, IBS,
digestive problems.

THE PHARMA WORLD 9



Beximco

Brand Name: Empalina® Brand Name: Progavi®
Generic Name: Empagliflozin+Linagliptin Generic Name: Sodium alginate BP, Sodi-
Strength: 10 mg + 5 mg, 25 mg + 5 mg um bicarbonate BP, Calcium carbonate BP
Dosage Form: Tablet Strength: 500 mg, 213 mg, 325 mg per 10 ml
Indications: as an adjunct to diet and exercise DosageForm: Oral Suspension
to improve glycemic control in adults with type Indications:  Treatment of symptoms re-
2 diabetes mellitus, in adults with type 2 diabe- sulting from the reflux of acid, bile and
tes who have known cardiovascular disease when pepsin into the esophagus such as acid
both empagliflozin and linagliptin is appropriate regurgitation, heartburn and indigestion,
and empagliflozin is needed to reduce the risk of for example following meals or during
cardiovascular death. pregnancy, and for symptoms of excess
stomach acid (hyperacidity).
Brand Name: Nervalin®
Generic Name: Pregabalin Brand Name: Buratuss®
Generic Name: Butamirate Citrate
Strength: 20mg/ml Strength: 50 mg
Dosage Form: Oral Dosage Form: SR Tablet
Solution Indications:  Dry cough,  acute cough due to lower respiratory
Indications: Diabetic tract infections, For pre- & post-operative cough sedation in pa-
tients who will undergo surgical procedures and bronchoscopy
peripheral neuropathy,
adjuvant therapy
on partial seizure,
fibromyalgia, postherpetic
neuralgia

Brand Name: Nervalin® CR Brand Name: Buratuss® Brand Name: Buratuss®
Generic Name: Pregabalin Generic Name: Butamirate Generic Name: Butamirate
Strength: 82.5 mg, 165 mg & 330 mg Citrate Citrate
Dosage Form: Pregabalin Extended Release Tablet Strength: 7.5mg/5ml Strength: 5mg/ml
Indications:  Diabetic peripheral neuropathy & Dosage Form: Syrup Dosage Form: Pediatric Drop
postherpetic neuralgia Indications: Dry cough,  acute Indications:  Dry cough, acute
cough due to lower res- cough due to lower res-
piratory tract infections,  For piratory tract infections, For
pre- & post-operative cough pre- & post-operative cough
sedation in patients who will sedation in patients who will
undergo surgical procedures undergo surgical procedures
and bronchoscopy and bronchoscopy.

THE PHARMA WORLD 11

Brand Name: Informet XR 500 Brand Name: Vesinac® Brand Name: Atova EZ®
Generic Name: Metformin Generic Name: Solifenacin Succinate Generic Name: Atorvastatin + Ezetimibe
Hydrochloride Strength: 5 mg & 10 mg Strength:  10 mg + 10 mg, 20 mg +10 mg
Strength: 500 mg Dosage Form: Film Coated Tablets Dosage Form:  Tablet
Dosage Form: Extended Release Indications: Treatment of Overactive Indications:   Primary Hyperlipidemia
Tablets Bladder (OAB) with symptoms of urge & Homozygous Familial
Indications: First line treatment urinary incontinence, urgency, and Hypercholesterolemia (HoFH)
option for type 2 diabetes mellitus urinary frequency.
and pre-diabetes
Biopharma

Brand Name: Bestcef
Generic Name: Cefixime
Strength: 21 ml
Dosage Form: Powder for Paediatric Drops
Indications: Typhoid fever, upper and lower respiratory
tract infections, urinary tract infections, gonococcal ure-
thritis & cervicitis, acute otitis media.

Brand Name: Informet XR Brand Name: Rixoban Brand Name: Enoma
Generic Name: Metformin Generic Name: Rivaroxaban Generic Name: Enoxaparin So-
Hydrochloride Extended Release Strength: 2.5 mg & 10 mg dium
Tablets Dosage Form: Tablet Strength: 40 mg & 60 mg
Strength: 750 mg Indications: Acute coronary Dosage Form: Injection
Dosage Form: Extended Release syndrome (ACS), stroke and Indications: Prophylaxis of venous
Tablets systemic embolism, deep vein thromboembolism, stroke, unsta-
Indications: First line treatment thrombosis (DVT) & pulmonary ble angina, deep vein thrombosis
option for type 2 diabetes mellitus embolism (PE). & pulmonary embolism.
and pre-diabetes

12 THE PHARMA WORLD

Brand Name: Empavic Brand Name: Famoloc Brand Name: Mexclav Brand Name: Amotid CL
Generic Name: Empa- Generic Name: Famotidine Generic Name: Cefuroxime Generic Name: Amoxicillin
gliflozin Strength: 40 mg/5 ml (50 ml) + Clavulanic Acid + Clavulanic Acid
Strength: 10 mg & 25 mg Dosage Form: Powder for Strength: (125 mg+31.25 mg Strength: (125 mg+31.25 mg
Dosage Form: Tablet Suspension )/5 ml (70 ml) )/5 ml (100 ml)
Indications: Type-2 diabetes. Indications: Heartburn, Dosage Form: Powder for Dosage Form: Powder for
peptic ulcer, dyspepsia & Suspension Suspension
urticaria. Indications: ENT infec- Indications: Community-
tions, dental infections, acquired pneumonia, acute
post-surgical infections, bacterial rhinosinusitis,
gynaecological infections, UTI, acute otitis media &
RTI, SSTI & UTI. dental infection.

Brand Name: Vcand Brand Name: Ortho-D3
Generic Name: Voriconazole Generic Name: Cholecalciferol
Strength: 200 mg Strength: 1000 IU, 2000 IU & 1000 IU/5 ml (100 ml)
Dosage Form: Tablet Dosage Form: Tablet & Oral Solution
Indications: Dermatophy- Indications: Cholecalciferol (Vitamin D3) deficiency
tosis, invasive aspergillo- states & inadequate absorption of calcium, osteopo-
sis, deep tissue infections rosis, hypoparathyroidism, rickets & osteomalacia.
& esophageal candidiasis.
Eskayef

Brand Name: Moxif 400 Brand Name: ENORIN Brand Name: Emazid L Brand Name: Glunor OD
Generic Name: Moxifloxacin Generic Name: Enoxaparin Generic Name: Empa- Generic Name: Metformin
Strength: 400 mg Sodium gliflozin + Linagliptin Hydrochloride
Dosage Form: Tablet Strength: 4000 Anti-Xa IU/0.4 Strength: 10mg + 5 mg Strength: 500mg
Indications: Adjuvant ther- ml, 6000 Anti-Xa IU/0.6 ml, Dosage Form: Tablet Dosage Form: CR Tablet
apy of Covid-19, COVID-19 8000 Anti-Xa IU/0.8 ml Indications: Type 2 Indications: Type 2 dia-
associated pneumonia, Dosage Form: Injectable diabetes betes
acute chronic bronchitis & Indications: Acute Coronary
typhoid fever. Syndrome, Deep Vein Throm-
bosis, Pulmonary Embolism,
Unstable Angina, non-ST-ele-
vated myocardial infarction, ST-
elevated myocardial infarction

THE PHARMA WORLD 13



Euro

Brand Name: Nasogurd Brand Name: Olmetor Brand Name: Olmetor AM
Generic Name: Fluticasone Generic Name: Olmesartan Medoxomil Generic Name: Amlodipine BP + Olmes-
Furoate USP artan Medoxomil BP
Strength: 27.5 mcg/Spray Strength: 10, 20 & 40 mg Strength: 5 mg+ 20 mg, 5mg+ 40 mg
Dosage Form: Nasal Spray Dosage Form: Tablet Dosage Form: Tablet
Indications: Seasonal & Indication: Hypertension. Indication: Hypertension.
perennial allergic rhinitis,
Urticaria associated with Brand Name: Olmetor Plus
allergic rhinitis. Generic Name: Olmesartan
Medoxomil USP + Hydrochloro-
thiazide BP
Strength: 20 mg+ 12.5mg,
40mg+12.5 mg
Dosage Form: Tablet
Indication: Hypertension.

Everest

Brand Name: Metanase Brand Name: Serofit 25 Brand Name: Serofit 50
Generic Name: Mometa- Generic Name: Sertraline Hydrochloride Generic Name: Sertraline Hydrochloride
sone Furoate USP USP
Strength: 50 mcg/Spray Strength: 25 mg Strength: 50 mg
Dosage Form: Nasal Spray Dosage Form: Tablet Dosage Form: Tablet
Indications: Prophylactic Indications: Depressive illness, Obses- Indications: Depressive Illness, Obses-
treatment of seasonal sive-compulsive Disorder, Post-Trau- sive-Compulsive Disorder, Post-Trau-
allergic rhinitis, Allergic matic Stress Disorder, Panic Disorder. matic Stress Disorder, Panic Disorder.
rhinitis, Nasal polyps, Ad-
enoiditis & Deviated nasal
septum (DNS).

THE PHARMA WORLD 15

Brand Name: Conloss Goodman
Generic Name: Lactulose
Strength: 3.35 gm/5 ml Brand Name: Cefivic
Dosage Form: Concentrated Generic Name: Cefixime USP
Oral Solution Strength: 200 mg, 400 mg, 100 mg/5 ml &
Indications: Constipation, 200 mg/5 ml
Intestinal Flora Disturbance, Dosage Form: Capsule & PFS
Hepatic Encephalopathy. Indications: Pneumonia, typhoid fever, sinus-
itis, tonsillitis, pharyngitis, otitis media, acute
exacerbation of chronic bronchitis, respira-
tory tract infections, acute bronchitis, skin &
soft tissue infections, gonococal urethritis.

Brand Name: Kidpred Brand Name:Qutanex Brand Name:Ozil
Generic Name: Prednisolone Generic Name:Quetiapine Fumarate USP Generic Name:Olanzapine USP
Strength: 5 mg/5 ml Strength: 25 mg & 100 mg Strength: 5 mg & 10 mg
Dosage Form: Oral Solution Dosage Form: Tablet Dosage Form: Tablet
Indications: Allergy & Indications: Schizophrenia, bipolar dis- Indications: Schizophrenia, bipolar dis-
anaphylaxis, respiratory order, major depressive disorder. order, agitation, mania.
disorders, rheumatic disor-
ders, skin disorders, blood Brand Name:Clavimax-CV
disorders, cardiovascular Generic Name:Cefuroxime USP+Clavulanic Acid BP
disorders, endocrine disor- Strength: 250 mg + 62.5 mg & 500 mg+ 125mg.
ders, gastrointestinal dis- Dosage Form: Tablet
orders, infections, muscu- Indications:Pneumonia, typhoid fever, sinusitis,
lar disorders, neurological tonsillitis, pharyngitis, otitis media, lyme disease,
disorders, ocular disease, acute exacerbation of bronchitis, respiratory tract
renal disorders. infections, urinary tract infections, acute bron-
chitis, skin & soft structure infections, surgical
Ibn Sina prophylaxis.

Brand Name: Migron
Generic Name: Mirabegron INN
Strength: 25mg & 50 mg
Dosage Form: ER Tablet
Indications: Treatment of overactive bladder (OAB) with symptoms of urge urinary
incontinence, urgency, and urinary frequency.

16 THE PHARMA WORLD

Brand Name: Cordef Indications: Treatment of Anaphylaxis, asthma, severe
Generic Name: Deflazacort INN hypersensitivity reactions, rheumatoid arthritis, juve-
Strength: 6 mg & 24 mg nile chronic arthritis, polymyalgia rheumatic, systemic
Dosage Form: Tablet lupus erythematosus, dermatomyositis, mixed con-
nective tissue disease (other than systemic sclerosis),
Brand Name: Oxyfer polyartritisnodosa, sarcoidosis, Pemphigus, bullous
Generic Name: Ferric Car- pemphigoid, pyodermagangrenosum, minimal change
boxymaltose nephrotic syndrome, acute interstitial nephritis,
Strength: 500 mg/10 ml rheumatic carditis, ulcerative colitis, Crohn’s disease,
Dosage Form: Injection uveitis, optic neuritis, autoimmune haemolyticanae-
Indications: Treatment of mia, idiopathic thrombocytopenic purpura, acute and
iron deficiency anemia in lymphatic leukaemia, malignant lymphoma, multiple
adult patients: with intoler- myeloma and immune suppression in transplantation.
ance to oral iron or have
had unsatisfactory response Brand Name: Cilmedip
to oral iron and who have Generic Name: Cilnidipine
non-dialysis-dependent Strength: 5mg & 10 mg
chronic kidney disease. Dosage Form: Tablet
Indication: Hypertension

Brand Name: Sporagin Brand Name: Opcet Brand Name: Sporagin
Generic Name: Itraconazole Generic Name: Ceterizine Hy- Generic Name: Itraconazole
USP drochloride USP
Strength: 100 mg Strength: 0.24% Strength: 10 mg/ml
Dosage From: Capsule Dosage Form: Eye Drops Dosage From: Oral Solution
Indications: Treatment of Indication: Ocular itching as- Indications: Different
oropharyngeal candidiasis, sociated with allergic conjunc- fungal infection of children
vulvovaginal candidiasis, tivitis. e.g. oropharyngealcandi-
pityriasis versicolor, tinea diasis, pityriasis versicolor,
pedis, tinea cruris, tinea Brand Name: Xorel tinea capitis, tinea pedis,
corporis, tinea manuum, Generic Name: Rabepra- tineamanuum, tinea cor-
onychomycosis, histoplas- zole Sodium USP poris, tinea cruris, onycho-
mosis, systemic candi- Strength: 10 mg mycosis. It is also used for
diasis, aspergillosis, and Dosage Form: Tablet the treatment of oropha-
cryptococcosis (including Indication: Treatment of ryngeal and esophageal
cryptococcal meningitis). hyperacidity & GERD in candidiasis.
Also used for maintenance pediatric patients.
therapy in AIDS patients to
prevent relapse of underly- Brand Name: Terbinox Indications: Treatment of onychomycosis of the toenail
ing fungal infections and Generic Name: Terbinafine or fingernail due to dermatophytes (tinea unguium).
in the prevention of fungal Hydrochloride BP Fungal infection of the skin caused by Trichophyton
infection during prolonged Strength: 250 mg (e.g. T. rubrum, T. mentagrophytes, T. verrucosum, T.
neutropenia. Dosage Form: Tablet violaceum), Microsporumcanis, and Epidermophyton-
floccosum. Yeast infections of the skin, principally
those caused by the genus Candida (e.g. C. albicans).
Pityriasis (tinea) versicolor due to Pityrosporumorbicu-
lare (also known as Malassezia furfur).

THE PHARMA WORLD 17



Brand Name: Anodyne Indications: Local treatment of traumatic inflammation of
Generic Name: Diclofenac Sodium tendons, ligaments, muscles and joints, e.g. due to sprains,
Strength: 1% (20 gm) strains and bruises and in localized forms of soft tissue
Dosage Form: Gel rheumatism, e.g. tenosynovitis shoulder-hand syndrome
and bursitis. Also indicated in localized rheumatic disease
e.g. osteoarthrosis of peripheral joints and of the vertebral
column periarthropathy.

Brand Name: Olmetab Plus Brand Name: Azopres Br Brand Name: Combofresh
Generic Name: Olmesartan Medoxomil Generic Name: Brinzolamide + Generic Name: Glycerin+
USP + Hydrochlorothiazide USP Brimonidine Hypromellose+Polyethyle
Strength: 20mg+12.5mg, & 40mg+12.5mg Strength: 1% + 0.2% ne Glycol+Tetrahydrozoline
Dosage Form: Tablet Dosage Form: Eye Suspension Hydrochloride+Zinc Sulfate.
Indications: Treatment of hyperten- Indication: Indicated for the Strength: 0.2%+0.36%+1% +0.05% + 0.25%
sion. In patients whose blood pres- reduction of elevated intra- Dosage Form: Eye Drops
sure is not adequately controlled on ocular Pressure in patients with Indications: Indicated for temporary
Olmesartan alone. It is not indicated open-angle glaucoma or ocular relief discomfort and redness of the
for initial therapy. hypertension. eye due to minor eye irritations, for
relieves dryness of the eye, for tem-
Brand Name: Terbinox Navana porary relief of burning and irritation
Generic Name: Terbinafine Hydrochlo- due to exposure to wind or sun, for
ride BP 1% protection against further irritation.
Strength: 1% (10 gm)
Dosage Form: Cream Brand Name: Pregan ER Brand Name: Loxodol
Indications: Fungal infection of the Generic Name: Pregabalin BP Generic Name: Lornoxicam INN
skin caused by Trichophyton (e.g. T. Strength: 82.5 mg & 165 mg. Strength: 4 mg.
rubrum, T. mentagrophytes, T. ver- Dosage Form: Tablet Dosage Form: Tablet
rucosum, T. violaceum), Microsporum- Indications: Diabetic neuropathy Indications: Indicated for the treat-
canis, and Epidermophytonfloccosum. and Postherpetic neuralgia. ment of mild to moderate pain in
Yeast infections of the skin, principally osteoarthritis, surgery, sciatica and
those caused by the genus Candida other inflammations.
(e.g. C. albicans). Pityriasis (tinea) ver-
sicolor due to Pityrosporumorbiculare
(also known as Malassezia furfur).

THE PHARMA WORLD 19

Brand Name: Naviscon Oral Brand Name: Ezitor
Suspension Generic Name: Ezetimibe USP + Atorvastatin USP
Generic Name: Sodium Strength: 10 mg + 20 mg.
Alginate BP, Sodium Bi- Dosage Form: Tablet
carbonate BP + Calcium Indications: Indicated as an adjunct therapy to:
Carbonate USP ●Reduce elevated total-C, LDL-C, Apo B, TG, and
Strength: 500 mg+267 mg + non-HDL-C, and to increase HDL-C in patients with
160 mg. primary (heterozygous familial and non-familial)
Dosage Form: Oral Suspen- hyperlipidemia or mixed hyperlipidemia. ●Reduce
sion elevated total-C and LDL-C in patients with homo-
Indications: Treatment zygous familial hypercholesterolemia (HoFH), as an
of heartburn, heartburn adjunct to other lipid-lowering treatments (HSDD).
in pregnancy, dyspepsia
associated with gastric Brand Name: Methebac
reflux, hiatus hernia, reflux Generic Name: Methenamine Hippurate USP
esophagitis, regurgitation Strength: 1 g.
and all cases of epigastric Dosage Form: Tablet
and retrosternal distress Indications: Prophylactic or suppressive
where the underlying treatment of frequently recurring urinary
cause is gastric reflux. tract infections when long-term therapy is
considered necessary. This drug should only
Brand Name: Fevigra be used after eradication of the infection by
Generic Name: Flibanserin other appropriate antimicrobial agents.
INN
Strength: 100 mg. Nipro JMI
Dosage Form: Tablet
Indications: Treatment of Brand Name: Lyrinex CR Brand Name: Emjenta Brand Name: Molnuva
premenopausal women Generic Name: Pregabalin Generic Name: Empa- Generic Name: Molnupi-
with acquired or general- Strength: 82.5 mg & 165 mg gliflozin INN + Linagliptin ravir INN
ized hypoactive sexual Dosage form: Extended- INN Strength: 200 mg
desire disorder (HSDD). Release Tablet Strength: 10mg+5 mg Dosage form: Capsule
Indication: Neuropathic Pain Dosage form: Tablet Indication: Recommend-
Indication: Type 2 Diabe- ed for emergency use in
tes Mellitus case of mild to moderate
COVID-19 patients.

Brand Name: Apiban
Generic Name: Apixaban INN
Strength: 2.5 mg & 5 mg
Dosage form: Tablet
Indication: Reduce the risk of stroke and systemic em-
bolism in patients with nonvalvular atrial fibrillation.
Risk reduction, prophylaxis, and treatment of deep
vein thrombosis (DVT). Risk reduction, prophylaxis,
and treatment of pulmonary embolism (PE).

20 THE PHARMA WORLD

Organic

Brand Name: Esogel
Generic Name: Esomeprazole
Strength: 20 mg & 40 mg
Dosage Form: Tablet
Indications: Healing of erosive esophagitis, maintenance of healing of erosive
esophagitis, symptomatic gastroesophageal reflux disease (GERD), H. pylori
eradication to reduce the duodenal ulcer recurrence, Zollinger-Ellison syndrome,
acid-related dyspepsia, duodenal and gastric ulcer, risk reduction of NSAID-
associated gastric ulcer.

Brand Name: Orcerin Brand Name: Dexnova Brand Name: Novetor
Generic Name: Glucosamine Generic Name: Dexlansoprazole Generic Name: Doxophylline
Sulphate+Diacerein Strength: 30 mg & 60 mg Strength: 200 mg & 400 mg
Strength: 750 mg+50 mg Dosage Form: Capsule Dosage Form: Tablet
Dosage Form: Tablet Indications: Healing of all grades Indications: Treatment and
Indications: Osteoarthritis, rheuma- of erosive esophagitis, mainte- management of asthma,
toid arthritis, bone and joint injuries. nance of healed erosive esopha- chronic obstructive pulmonary
gitis and relief of heartburn, disease (COPD), and broncho-
Orion symptomatic non-erosive gastro- spasm.
esophageal reflux disease (GERD)

Brand Name: Cilnior
Generic Name: Cilnidipine
Strength: 5mg, 10mg
Dosage Form: Tablet
Indication: Hypertension.

Brand Name: Arovent®-4 ODT Brand Name: Novelta Power
Generic Name: Montelukast Generic Name: Sodium Alginate + Sodium Bicarbonate
Strength: 4 mg + Calcium Carbonate
Dosage Form: Oro-dispersible tablet Strength: (500mg+267mg+160mg)/10ml
Indications: Prophylaxis and chronic Dosage Form: Oral Suspension
asthma, acute prevention of exercise- Indications: GERD, heartburn, flatulence associated
induced bronchoconstriction (EIB) & with gastric reflux, heartburn of pregnancy, all cases
relief symptoms of allergic rhinitis (AR) of epigastric and retrosternal distress where the un-
like seasonal & perennial allergic rhinitis. derlying cause is gastric reflux.

THE PHARMA WORLD 21



Popular

Brand Name: Candicon Brand Name: Glyxam Brand Name: FSH Brand Name: HMG
Generic Name: Voriconazole Generic Name: Linagliptin Generic Name: Follicle Generic Name: Human
Strength: 100 mg + Empagliflozin Stimulating Hormone Menopausal Gonadotropin
Dosage Form: Tablet Strength: 5 mg+10 mg & 5 Strength: 150 IU Strength: 150 IU
Indications: Tinea infec- mg+25 mg Dosage Form: Injectable Dosage Form: Injection
tions, candidiasis, invasive Dosage Form: Tablet Indications: Male & female Indications: In women: To
aspergillosis. Indication: Type 2 Diabetes infertility. treat infertility who are
Mellitus. not ovulating (producing
Brand Name: Delcyst Brand Name: Zemicef Max an egg) properly (stimu-
Generic Name: D-chiro-Inositol Generic Name: Cefixime late follicle growth) and in
Strength: 500 mg Strength: 100 mg/ml male: To treat male hypo-
Dosage Form: Capsule Dosage Form: Paediatric gonadism in combination
Indications: Polycystic drops with HCG to stimulate sper-
Ovarian Syndrome (PCOS) Indications: Bacterial infec- matogenesis.
and gestational diabetes. tions (RTI, Typhoid Fever,
UTI).

Renata

Brand Name: Laxopic Brand Name: Maxpro MUPS
Generic Name: Sodium Generic: Esomeprazole Magnesium USP
Picosulfate Strength: 40mg
Strength: 10 mg, 5 mg/5 ml Dosage Form: Tablet
Dosage Form: Tablet & oral Indications: Treatment of Gastroesophageal Reflux Disease
solution (GERD), risk reduction in NSAID associated gastric ulcer.
Indication: Constipation
of any etiology.

Brand Name: Pegalin ER Brand Name: Opexa Brand Name: Ursoren Brand Name: Nexolid
Generic Name: Pregabalin Generic Name: Bilastine Generic Name: Ursodeoxy- Generic Name: Tedizolid
Extended Release Tablet Strength: 20mg cholic Acid BP Phosphate INN
Strength: 82.5mg, 165mg Dosage Form: Tablet Strength: 150mg, 300mg Strength: 200 mg
& 330mg Indications: Symptom- Dosage Form: Tablet Dosage Form: Tablet
Dosage form: Tablet atic treatment of allergic Indications: Cholestasis Indications: Acute bacte-
Indication: Diabetic rhino-conjunctivitis (sea- (jaundice), viral hepatitis, rial skin and skin structure
Peripheral Neuropathy & sonal and perennial) and alcoholic fatty liver, Primary infections (ABSSSI)
Post Herpetic Neuralgia. urticaria. Billiary Cirrhosis (PBC), Pri-
mary Sclerosing Cholangitis
(PSC), dissolution of gall-
stones and Non-Alcoholic
Steato Hepatitis (NASH).

THE PHARMA WORLD 23



Brand Name: Laxana Brand Name: Epicet
Generic Name: Lubiprostone INN Generic Name:  Levetiracetam
Strength: 8 mcg, 24 mcg Strength: 250 mg & 500 mg and
Dosage Form: Soft Gelatin Capsule 500 mg/ 5ml (100 ml)
Indications: Irritable Bowel Syndrome with Dosage Form: Tablet & Oral Solution
Constipation (IBS-C), Chronic Idiopathic Indication: Epilepsy (Generalized
Constipation (CIC), in adults, Opioid-In- & Partial onset of Seizure.
duced Constipation (OIC) in adult patients
with chronic- non-cancer pain.

Brand Name: Oragon Brand Name: Epicet XR & Epicet Injection Brand Name: Benazin
Generic Name: Elagolix Sodium INN Generic Name:  Levetiracetam Generic Name: Tetrabenazine
Strength: 150 mg Strength: 500 mg, 750 mg & 1000 mg Strength: 12.5 mg & 25 mg
Dosage Form: Tablet and 500 mg/ 5ml (5 ml Ampoule) Dosage Form: Tablet
Indications: Indicated for the man- Dosage Form: Extended Release Tab- Indication: Hyperkinetic Movement
agement of moderate to severe pain let & Injection Disorder; Chorea Coupled with Hun-
associated with endometriosis. Indication: Epilepsy (Generalized & tington’s disease, Tardive Dystonia
Partial onset of Seizure) (TD), Idiopathic Dystonia, Tourette
Syndrome.

Brand Name: Relupros
Generic Name: Relugolix
Strengths: 120mg
Dosage Form: Tablet
Indication: Prostate Cancer.

Brand Name: Renapine XR Brand Name: Temixil Brand Name: Bricet
Generic Name:  Quetiapine Generic Name: Temazepam Generic Name: Brivaracetam INN
Strength: 50 mg, 200 mg & 300 mg Strength: 10 mg Strength: 25mg, 50 mg, 100 mg.
Dosage Form: Extended Release Tablet Dosage Form: Tablet Dosage Form: Tablet
Indication: Bipolar Disorder (Bipolar Indication: Insomnia Severe Anxiety Indication: Epilepsy
Mania) & Schizophrenia & Depression

Brand Name: Sperid Brand Name: Renapine Brand Name: Migesic
Generic Name:  Risperidone Generic Name:  Quetiapine Generic Name: Talfenamic Acid BP
Strength: 1mg, 2mg, 4mg & 1mg/1ml Strength: 25 mg, 100 mg Strength: 200mg
(100ml Syrup) Dosage Form: Tablet Dosage Form: Tablet
Dosage Form: Tablet & Syrup Indication: Bipolar Disorder (Bipolar Indications: Acute migraine headache,
Indication: Schizophrenia & Bipolar Mania) & Schizophrenia primary dysmenorrhea.
Disorder

THE PHARMA WORLD 25

Brand Name: Matadin
Generic Name: Amantadine
hydrochloride
Strength: 100 mg
Dosage Form: Capsule
Indications: Parkinson’s disease,
LID (Levodopa induced dyskinesia)

Brand Name: Reluren Brand Name: Rivaren Brand Name: Denixil
Generic Name: Relugolix + Estradiol + Generic Name: Rivastigmine Generic Name:  Clonazepam
Norethindrone Acetate Tartrate USP Strength: 0.25 mg
Strength: 40mg + 1 mg + 0.5 mg Strength: 1.5mg & 3 mg Dosage Form: Tablet
Dosage Form: Tablet Dosage Form: Capsule Indications: Panic Disorder (Panic At-
Indications: Heavy menstrual bleed- Indications: All types of demen- tack), Anxiety Disorders, Insomnia
ing associated with fibroids. tia, alzheimer’s disease. Burning Mouth Syndrome, GAD.

Brand Name: Escilex Brand Name: Betatin
Generic Name:  Escitalopram Generic Name: betahistine Dihy-
Strength: 5 mg & 10 mg drochloride
Dosage Form: Tablet Strength: 8 mg & 16 mg
Indications: Major Depressive dis- Dosage From: Tablet
order, Generalized Anxiety Disorder, Indication: Perpheral vetigo.
Obsessive Compulsive Disorder, Panic
Disorder & Social Anxiety Disorder Brand Name: Mitapro
(Social phobia). Generic Name: Mirtazapine
Strength: 7.5mg, 15 mg, 30 mg
Brand Name: Valporin CR Dosage Form: Tablet
Generic Name: Sodium Valproate BP+ Indications: Major depressivedisorder
Valproic Acid BP (MDD), depression with insomnia.
Strength: 200mg+300mg & 500mg +
200mg/5ml (100ml). Sharif
Dosage Form: Tablet & Syrup
Indications: Epilepsy, migraine head- Brand Name: Travelit
ache, bipolar disorder. Generic Name: Cyclizine Hydro-
chloride BP.
26 THE PHARMA WORLD Strength: 50 mg
Dosage Form: Oral Tablet
Indications: Prevention and
treatment of travelers’ nausea
and vomiting motion sickness.
Also used in PONV (Postop-
erative Nausea & Vomiting),
Meniere’s disease etc.

Square

Brand Name: Frabex Indications: Haemorrhage or risk of haemor- Brand Name: Deflacort 18
Generic Name: rhage in increased fibrinolysis or fibrinoge- Generic Name: Deazacort
Tranexamic Acid nolysis that may occur in conditions: Prosta- Strength: 18 mg
Strength: 500 mg tectomy and bladder surgery, menorrhagia, Dosage Form: Tablet
Dosage Form: epistaxis, conisation of the cervix, manage- Indications: Anaphylaxis,
Tablet ment of dental extraction in patients with asthma, severe hypersensi-
coagulopathies, ulcerative colitis, haematu- tivity reactions, rheumatoid
Brand Name: Ace ria, gastrointestinal haemorrhage etc. arthritis, juvenile chronic
Generic Name: Paracetamol arthritis, polymyalgia rheu-
Strength: 100 ml/1000 mg Brand Name: Fliban matic, systemic lupus erythe-
Dosage Form: IV infusion Generic Name: Flibanserin matosus, dermatomyositis,
Indication: Analgesic and Strength: 100 mg sarcoidosis, rheumatic cardi-
antipyretic. Dosage Form: Tablet tis, ulcerative colitis, crohn’s
Indications: For the treatment disease, uveitis, optic neuritis,
Brand Name: Glympa of premenopausal women with autoimmune haemolytic
Generic Name: Empa- acquired, generalized hypoactive anaemia, idiopathic thrombo-
gliflozin + Linagliptin sexual desire disorder (HSDD). cytopenic purpura, multiple
Strength: 10 mg+5 mg, 25 myeloma, immune suppres-
mg+5 mg Brand Name: Sopilax Brand Name: Mirader sion in transplantation.
Dosage Form: Tablet Generic Name: Sodium Generic Name: Mirabegron
Indication: Type 2 diabetes Picosulfate Strength: 25 mg Brand Name: Aclitol
mellitus Dosage Form: Tablet Generic Name: Aclidinium
Indications: Overac- Bromide + Formoterol Fuma-
tive bladder (OAB) with rate Dihydrate
symptoms of urge urinary Strength: 400 mcg + 12 mcg
incontinence, urgency and Dosage Form: Cozycap
urinary frequency. Indication: Chronic Obstruc-
tive Pulmonary Disease
Strength: 10mg, 5mg/5 ml (COPD)
Dosage Form: Tablet, Oral
Solution
Indications: Constipation
of any etiology, relief from
prolonged & recurrent con-
stipation, bowel clearance
before surgery, radiological
investigations etc.

Hamdard

Brand Name: Hamdard Basak
Generic Name: Vasakarista
Dosage From: 100 ml Syrup
Composition: Each 5 ml contains as extract- Adhatoda vasica 0.68 g, Piper longum 0.14 g, Vitis
vinifera 0.14 g, Honey 3.47 g, Woodfordia fruticosa 1.14 g, Terminalia chebula 73.24 mg, Glycyr-
rhiza glabra 6.78 mg, Saussurea hypoleuca 6.78 mg, Acorus calamus 6.78 mg, Zingiber officinale
6.78 mg, Piper nigrum 6.78 mg, Syzygium aromaticum 6.78 mg, Elettaria cardamomum 6.78 mg,
Cinnamomum tamala 6.78 mg, Cinnamomum zeylanicum 6.78 mg, Rhus succedanea 6.78 mg &
Myrica nagi 6.78 mg.
Indications: Dry irritable cough, Allergic & Smoker’s cough, Hoarseness of voice & Sore throat,
Asthma and Respiratory tract infection.

THE PHARMA WORLD 27



Brand Name: Hamdard Bhringaraj
Generic Name: Mahabhringaraj Taila
Dosage From: 130 ml Hair Oil
Composition: Each 5 ml oil contains- Sesamum indicum 5.63
g, Eclipta alba 22.54 ml, Rubia cordifolia 0.17 g, Prunus cera-
soides 0.17 g, Symplocos racemosa 0.17 g, Pterocarpus santa-
linus 0.17 g, Red Ochre 0.17 g, Sida cordifolia 0.17 g, Curcuma
longa 0.17 g, Berberis aristata 0.17 g, Mesua ferrea 0.17 g, Cal-
licarpa macrophylla 0.17 g, Hibiscus mutabilis 0.17 g and Ich-
nocarpus frutescens 0.17 g.
Indications: Hair fall, Premature graying of hair, Dandruff,
Headache and Insomnia.

Brand Name: Amlasia Brand Name: Kulzam Brand Name: Hamdard Balm
Generic Name: Amalaki Ra- Generic Name: Aab-e-Hayat Generic Name: Marham Ajeeb
sayan Dosage From: 15 ml Drop Dosage From: 20 g Ointment
Dosage From: 450 ml Syrup Composition: Each 5 ml contains- Cam- Composition: Each gram ointment con-
Composition: Each 5 ml con- phor 1.61 g, Thymol 0.81 g, Menthol 0.40 tains- Cinnamomum camphora 200 mg,
tains as extract- Phyllanthus g, Eucalyptus oil 0.52 ml, Pine oil 0.26 ml, Menthol 200 mg & Thymol 100 mg.
emblica Juice) 3.03 ml, Piper Caraway oil 0.26 ml, Anisi oil 0.19 ml and Indications: Headache, Pain, Backache,
longum 0.12 g & Honey 0.36 g. Tincture of ginger 0.19 ml. Sprain, Sciatica, Insect bites & Cuts.
Indications: Hyperacidity, Indications: Respiratory tract & lung infec-
Dyspepsia, Flatulence, Heart- tion, Pneumonia, Catarrh, Cough & Cold,
burn, Anorexia, Anaemia, Headache, Cuts, Insect’s bite and different
Heart disease & Jaundice. type of pains & Rheumatism.

Brand Name: Neement Paracelsus Medicine is not only a
Generic Name: Marham Swiss Alchemist And Physician science; it is also an art.
Neem It does not consist of
Dosage From: 20g Ointment compounding pills and
Composition: Each gram plasters; it deals with the
ointment contains – Azadi- very processes of life, which
rachta indica 88.88 mg, Del- must be understood before
phinium denudatum 5.55 they may be guided.
mg, Pinus longifolia 22.22
mg, Curcuma longa 44.44
mg, Cedrus deodara 44.44
mg, Glycyrrhiza glabra 44.44
mg, Lawsonia inermis 44.44
mg, Lamp-black 44.44 mg,
Acacia arabica 88.88 mg,
Onosma echioides 88.88
mg and Sesamum indicum
oil 0.89 ml.
Indications: Skin infection,
Minor cuts, Infected ulcers
as wounds, Inflammation &
Skin diseases.

THE PHARMA WORLD 29



ACI to ship drugs to US market NEWS
directly from Bangladesh

The Advanced Chemical Industries (ACI) recently the US FDA, the Europe, Middle East and Africa,
got approval from the US Food and Drug Admin- the World Health Organisation’s Current Good
istration (FDA) to export its product directly from Manufacturing Practices and other relevant
Bangladesh to the United States of America. agencies of that nature.

ACI Healthcare Ltd, one of the subsidiaries of It had received approval of nine Abbreviated
ACI Ltd, obtained the FDA approval for its health- New Drug Application by the US FDA and com-
care establishment at Tripordi in Narayanganj’s mercial supply of some of these products started
Sonargaon for the manufacturing of Gabapentin by toll manufacturing arrangement with contract
capsules, which will be exported to US market. manufacturing companies in India and in the USA.

The listed conglomerate disclosed the infor- Pharma export of ACI Ltd achieved 100 per
mation today through a posting on the website cent growth in business volume despite the
of the Dhaka Stock Exchange. Covid-19 pandemic and problems in supply and
logistics in 2020-21, the company said in its latest
The healthcare site is primarily dedicated for annual report.
export and this will positively impact pharma-
ceutical export of the company, according to the Ten new export destinations were added in its list
web posting. during the year, it said, adding the ACI has received
marketing authorisation of 190 products from differ-
ACI HealthCare was incorporated in 2013 with ent regulatory authorities in different countries.
an objective to manufacture and market phar-
maceutical products for regulated markets, es- During the pandemic, ACI has tried to extend
pecially for the US market. its support to the severely Covid-19 affected
countries with its coronavirus drugs and was
To serve the local market also, a state-of-the- able to contribute to save lives and improve the
art pharmaceutical factory of the company has quality of life of people, it added.
been built at its own land in full compliance with

Renata introduces the first USFDA approved Oral Congrats
medicine for Prostate Cancer Treatment in country
Eminent Professor in the field
Renata Limited introduces “Relu- be more efficacious, easy once-daily of Gynaecology T A Chowd-
pros 120mg Tablet”, a preparation of dose, and more importantly afford- hury has been awarded The
Relugolix 120mg for the first time in able to all classes of patients. With Asia & Oceania Federation
Bangladesh. Prostate cancer is the the launching of Relupros (relugolix), of Obstetrics & Gynaecology
most common cancer in men and its Renata once again proved its com- (AOFOG) Fellowship in AOFOG
incidence increases with age. Globally, mitment to offering modern, better 2022.
more than 1,400,000 new cases and quality, and affordable medicines for
more than 375,000 deaths occur annu- patient care. Considering the purchase THE PHARMA WORLD 31
ally, it is the third most common ma- ability of all classes of patients, Renata
lignancy diagnosed and is the eighth fixed the maximum retail price of each
cause of cancer death in the world. Relupros 120mg tablet at Taka 250.

So far, Androgen deprivation thera- The company will happily deliver
py (ADT) is essentially needed for the this medicine to the patients’ door-
management of prostate cancer. Relu- steps with its own distribution chan-
golix is the first oral gonadotropin- nel without transportation costs.
releasing hormone (GnRH) receptor
antagonist which is approved by the
United States Food and Drug Adminis-
tration (USFDA) on December 18, 2020.
Prior to the availability of relugolix,
only injectable medicines were avail-
able for prostate cancer treatment.

Relupros  (relugolix) is found to

ESKAYEF – first in the world to get contract
manufacturing of NOVO Nordisk Penfill Insulin

Inauguration of modern Penfil In- Modern Penfill Insulin was planned to right for diabetic patients, he hoped
sulin manufacturing Plant following be manufactured outside of Denmark that Eskayef would provide insulin to
historic technology transfer between in Bangladesh and Eskayef would be the millions of diabetic patients in
Eskayef and Novo Nordisk was a its first contract manufacturer for need.
milestone in the joint collaboration Penfill Insulin in the world.
between the above-mentioned local Major General Mohammad Yousuf,
and global giants which dates back to To mark this historic event, Simeen Director-General of the DGDA, appre-
2006 starting with distribution of in- Rahman, Group CEO of Transcom & ciated the collaboration and empha-
sulin products in Bangladesh. MD and CEO of Eskayef said that since sised the role of the DGDA in ensur-
inception, Eskayef always stood by ing compliance in the pharmaceutical
With the inauguration of the state- principles and ethical values in all sector.
of-the-art modern insulin manufac- its business operations following the
turing facility with Penfill presenta- footprint of late Latifur Rahman, the Winnie Estrup Petersen, Ambas-
tion at Eskayef, Tongi Plant a new legendary industrialist and founder sador of Denmark to Bangladesh,
golden era ushered. of Transcom Group which owns the praised the initiative of Eskayef and
Eskayef. Novo Nordisk, highlighted the com-
Since 2012, Eskayef Pharmaceu- mitment of Denmark towards Bangla-
ticals started manufacturing insulin Addressing the inauguration at the desh and put focus on sustainability
vials for Novo Nordisk. Following a plant, AK Azad, National Professor and and green transformation as well.
successful journey together, the rela- president of the Diabetic Association
tionship between Novo Nordisk and of Bangladesh, said, “In case of insu- In his presentation, Rajarshi Dey
Eskayef transformed into a historic lin production, Eskayef is a pioneer in Sarkar, vice president and general
technology transfer agreement in the country. So, we [the Diabetic As- manager of Novo Nordisk Bangla-
2018 to manufacture modern Penfill sociation of Bangladesh] should have desh, said around five million diabet-
Insulins. Under that agreement, first more collaborations.” ic patients in Bangladesh use insulin
time in the Novo Nordisk history, produced by their company, which
Terming access to insulin a human meets half the country’s demand.

32 THE PHARMA WORLD

Incepta Congrats
Introduces a
Breakthrough Prof. Dr. ABM Abdullah nominated for
medicine Davidson’s advisory council
in Diabetes
Management Emeritus Professor Dr ABM Abdullah has been nominated as the mem-
ber of International Advisory Council of Davidson’s Principles and Prac-
Incepta Pharmaceuticals has launched tices of Medicine which is called the Bible for medicine.
a new medicine in the Brand Name
of ‘’Linatab E’’ (Generic: Linagliptin+ This advisory council has been formed for the 24th international edi-
Empagliflozin) that combines the two tion of the textbook. Every four years a new international edition of the
most remarkable and safe therapeutic book is published for the curriculum of different countries. An interna-
class of modern time for controlling tional advisory council does this.
diabetes. Globally this combination
medicine has brought a breakthrough This year, the council has been formed with a total of 22 specialist
in diabetes management because it is doctors including ABM Abdullah. Prof ABM Abdullah, also the personal
remarkably safe for diabetic patients physician of Prime Minister Sheikh Hasina, said he has been nominated
with cardiac disorders. Also, this med- as an advisor of this year’s board for the medicine textbook.
icine has no chance of sudden glucose
fall that is a frequent phenomenon in Expressing his feelings regarding the nomination, Prof Abdullah said,
case of diabetic patients. “This is a very respectable position. I am very happy and proud to be
a member of its advisory board.” Dedicating this international honor
Incepta has introduced the medi- to physicians, the eminent physician said, “This honor is due to all my
cine in a more affordable for all class teachers, colleagues and students.” Davidson’s policy and practice of
of people- Linatab E 5/10 tablet at 30 medicine is a guide to more than two million medical students, physi-
taka and Linatab E 5/25 tablet at 40 cians and other health professionals worldwide.
taka only. For diabetic patients it will
reduce the pill burden as only one THE PHARMA WORLD 33
tablet per day can serve the purpose
of two tablets that patients are sup-
posed to take.

Incepta arranged a scientific semi-
nar and a mega launching program
of ‘’Linatab E’’ at Hotel Pan pacific
Sonargaon in the presence of Na-
tional Professor A K Azad Khan as the
chief guest. Prof. Md. Faruque Pathan,
Director, BIRDEM academy and Prof. S
M Ashrafuzzaman, Ex-head, Dept. of
Endocrinology and Diabetology, has
chaired the seminar.

The panel of experts included Prof.
Dr. Zafar Ahmed Latif, Ex-DG, BIRDEM;
Prof. Dr M A Hasnat, Head, Dept. of En-
docrinology, BSMMU; Prof. Dr. Hafizur
Rahman, Senior Consultant, United
Hospital; Prof. Dr. Md Feroz Amin,
Head, Dept. of Endocrinology, BIRDEM
and Prof. Dr. Indrajit Prasad, Head,
Dept. of Endocrinology, DMCH.



Acme launches a timely combination of
anti-diabetic drugs in Bangladesh

Acme Laboratories has organized a flozin and linagliptin has started with diac Hospital and Research Institute,
scientific discussion meeting called the help of Acme Laboratories. Professor Dr. Md. Firoz Amin, Head
“Diabetes Breakthrough” courtesy of of the Department of Endocrinology
Emlino which they have marketed for President of Bangladesh Diabetic and Diabetology at Birdem Hospital,
the first time in Bangladesh. Association National Professor AK Dr. Sultana Rehena Akter, Associate
Azad Khan was present as the chief Professor Dr. Faria Afsana, Assistant
According to the American Heart guest in the scientific discussion Professor Dr. Rushda Sharmin Binte
Association, diabetes is one of the meeting and Professor Md. Faruk Pa- Rauf, Chief Medical Officer Dr. Shaha-
seven major risks to heart disease. In than, Director of Birdem Academy was na Parveen, Registrar Dr. Kazi Nazmul
addition, about 40% of diabetic pa- present as special guest. Hossain and Mohammad Ziauddin,
tients suffer from kidney problems. General Manager (Marketing) of The
Empagliflozin and Linagliptin control Also present at the time were, Acme Laboratories Ltd.
diabetes as well as weight and blood among others, Prof. SM Ashrafuzza-
pressure which reduce the risk of man, Senior Consultant, Ibrahim Car-
heart disease as well as protect the
kidneys. As a result, the risk of kid-
ney problems and heart disease in
patients with diabetes is greatly re-
duced.

The unique combination of empa-
gliflozin and linagliptin is a boon for
diabetics and its efficacy has been
proven through worldwide clinical
trials. And in its continuation, for the
first time in Bangladesh, the journey
of unique combination of empagli-

Eli Lilly and Company to assist With the assistance of company Eli
Centeon Pharma in producing Lilly and Company, US, world stand-
insulin in Bangladesh ard insulin will be made in the plant
of Centeon Pharma Ltd, sister concern
of International Agencies (Bd) Ltd, lo-
cal partner of Eli Lilly and Company,
said a press release.

Major General Mohammad Yousuf,
Director General of the DGDA, Dhaka
laid the foundation stone of insulin
manufacturing plant of Centeon Phar-
ma Ltd.

World standard insulin will be pro-
duced by importing raw materials of
insulin from the US, which will con-
tribute a lot to control diabetes of
diabetic patients in our country.

In this ceremony, Swapan Kumar
Modak, managing director and CEO
of Centeon Pharma Ltd, Md Harun Ur
Rashid, deputy director of Drug Ad-
ministration, Gazipur and top man-
agement executives of the company
were present.

THE PHARMA WORLD 35

DGDA NEWS To reduce the self medication of
antibiotic and build awareness:
Antibiotic packaging to be flagged red

The Directorate General of Drug Administration (DGDA) entation at the dissemination pro-
has decided to have the packaging of antibiotics marked gramme and she said “Manufacturers
red to increase their rational use. will put the red identification mark
with the text ‘Antibiotic’ and the mes-
A study of IEDCR has found an average of 31%-67% of sage ‘Do not use without a prescrip-
bacteria in Bangladesh are resistant to antibiotics. tion of a registered physician”.

Director General of DGDA Major General Mohammad Directorate General of Drug Ad-
Yousuf said at a dissemination programme of CAPTURA ministration is the National Center
in Dhaka on Wednesday, “Antibiotic packaging labels will for Antimicrobial consumption (AMC)
be changed to make it easier for vendors to identify an- surveillance in Bangladesh. They have
tibiotic drugs”. conducted the AMC surveillance every
year and as per the surveillance data
DGDA Director General, Major General Mohammad Yu- they have found that the consump-
suf, said a Tk 20,000 fine has already been proposed if any tion of antimicrobial drugs is increas-
vendor sells antibiotics without a prescription. ing from 2016 to 2020 and the height
consumed antibiotics are “WATCH”
Assistant Director S. M. Sabrina Yesmin gave a pres- group antibiotics in Bangladesh.

We need to reduce the use of
“WATCH” group antibiotics and need
to increase the “ACCESS” group anti-
biotics, she added.

Implementation of an antimicro-
bial stewardship program, establish-
ing the culture sensitivity test and to
control the prescription of village cork
doctors is essential.

In that workshop the initiatives of
DGDA were well accepted and praised
by all.

36 THE PHARMA WORLD

Major General  Seniors who regularly did household chores such as
Mohammad Yousuf washing dishes, dusting, ironing, cooking. Vacuuming and
joins as Director mopping had a higher cognitive function, especially bet-
General of DGDA ter memory and attention span, and stronger legs, which
helps prevent fall, according to BMJ open.
Major General Mohammad Yousuf was
born on June 30, 1964 at Sitakunda,  Long term use of acetaminophen (paracetamol) can in-
Chattagram. He is a medical doctor crease systolic and diastolic blood pressure in people
having Fellowship of the Bangladesh with hypertension, which could increase the risk of car-
College of Physician and Surgeons diovascular diseases like stroke and heart attack, accord-
(FCPS) on Physical Medicine.  He ob- ing to circulation.
tained his MBBS degree from Chit-
tagong Medical College in 1988. He  Your Take-Out coffee cup shed trillions of plastic ‘Nano-
also did his FCPS course from Bang- particles’. Single-use paper coffee cups are lined with a
ladesh College of Physician and sur- thin plastic film that releases more than 5 trillion plastic
geon in 2004. He also obtained Fellow nanoparticles per liter when hot liquid is poured into a
in Pain Management (Delhi) and Post 12-ounce single-use cup. The researchers estimated that
fellow training on Neurorehab from by the time you’ve downed 13 paper cups of hot coffee or
the National University Hospital, Sin- tea, you’ve consumed the equivalent of one nanoplastic
gapore. particle for every seven cells in your own body.

The General joined the Bangladesh  Kidney Stones Don’t Usually Cause Kidney Disease. While
Army on 23 May, 1989. He was ap- it’s true that kidney stones can contribute to kidney dis-
pointed at the United Nations peace- ease, it rarely occurs. This is because kidney stones cause
keeping mission in Liberia. He was extreme discomfort, which leads most people to seek
promoted to Brigadier General on 05 medical attention for them right away. You can also pre-
May, 2015 and served as the professor vent the development of kidney stones by drinking lots of
at AFMC, Dhaka Cantonment, Dhaka. water and cutting back on sodium.
He was also the head of the depart-
ment, Physical Medicine Department,  Stress can heighten your risk of allergies and make  the
CMH, Dhaka Cantonment from 20 Au- symptoms  worse. In a new study, subjects with hay fe-
gust 2020 to 26 February 2022. ver had significantly more severe cutaneous allergic re-
actions in stressful situations compared to non-stressful
He was promoted to the rank of situations. During the stressful scenarios, subjects had
Major General on 27 February, 2022 higher levels of IL-6, an interleukin that is part of the in-
and assumed the appointment of flammatory allergic response to an allergen.
Director General, Directorate General
of Drug Administration on 27 Febru- THE PHARMA WORLD 37
ary, 2022. He is the Chairman of the
National Clinical Trial Advisory Com-
mittee and Technical Committee of
the Drug Control Committee of Bang-
ladesh and the Task force to monitor
AMC/AMU Bangladesh.

NEWS FIP commits to advocating pharmacists’
role in addressing vaccine hesitancy

Vaccination strategies will not be universal and fully successful until the global challenge of
vaccine hesitancy is adequately addressed, FIP said at the start of World Immunisation Week.
It added that pharmacists’ accessibility, expert knowledge, trust by populations and frequent
interactions with patients make them uniquely positioned to engage in meaningful conversa-
tions and tackle vaccine hesitancy. The federation has today committed to advocate the wide-
spread utilisation of pharmacists to build vaccine confidence and address vaccine hesitancy
and complacency, disinformation and misinformation around the world. The commitment fol-
lows the publication last year of FIP’s toolkit for pharmacists “Building vaccine confidence and
communicating vaccine value”.

World Pharmacist Day 2022 FIP launches course
to underline importance to address gaps
of professional unity in digital health
education
FIP announced the theme of World Phar-
macists Day on 25 September this year as The “Train the trainer online course
“Pharmacy united in action for a healthier on digital health” has been designed
world”. The campaign is led by FIP every year to take forward some of the recom-
and provides an opportunity to promote the mendations in FIP’s 2021 report “Digi-
pharmacy profession. The theme is chosen by tal health in pharmacy education:
the FIP Bureau, and this year aims to showcase Developing a digitally enabled phar-
pharmacy’s positive impact on health around maceutical workforce”, which found
the world and to further strengthen solidarity that a large proportion of pharmacy
among the profession. “The core duty of every schools and faculties did not offer dig-
pharmacist is to apply the full measure of their ital health education or training and
knowledge and abilities to support health and lacked experts and resources needed
well-being. I invite all colleagues to take part for digital health education. The FIP
in the campaign this year and show the world course consists of three modules cov-
how our profession is united for health, re- ering the integration of digital health
gardless of and overcoming conflict, different in pharmacy education and digital
politics and cultures, and economic disparity,” health curriculum development.
said FIP president Dominique Jordan.

FIP emphasises A wider scope of practice for phar- to maximise medication adherence.
pharmacists’ wider macists in reducing medication risks Medication review encompasses this
medication review and errors is reflected in an update person-centred approach but is also
roles in update of of FIP’s 2020 publication “Medicines an opportunity for the healthcare
its medicines use use review: A toolkit for pharmacists” team to evaluate a patient’s current
review toolkit has been released.  The updated re- medication in light of the clinical sit-
source, renamed “Medication review uation. This revised toolkit places the
38 THE PHARMA WORLD and medicines use review: A toolkit pharmacist firmly within this health-
for pharmacists”, presents medicines care team and calls on pharmacists
use review (MUR) as a subtype of to lead these services to improve
medication review. “When undertak- patient safety and minimise medica-
ing an MUR, the pharmacist consid- tion harm,” explained co-editor Filipa
ers patients’ beliefs, preferences and Alves da Costa, of the Faculty of Phar-
concerns, and reaches agreement macy, University of Lisbon, Portugal.

EMA NEWS Keeping
patients
Before a medicine is authorised
for use, evidence of its safety safe
and efficacy is limited to the results
from clinical trials, where Ifosfamide solutions: Update of the product information to pro-
patients are selected carefully and vide further details on the characteristics and risk factors of
followed up very closely under ifosfamide-induced encephalopathy, as well as highlighting the
controlled conditions. This means need to closely monitor patients receiving ifosfamide solutions.
that at the time of a medicine’s Immune checkpoint inhibitors : Update of the product informa-
authorisation, it has been tested in a tion to include a class effect of immune-mediated non-infec-
relatively small number of selected tious cystitis.
patients for a limited length of time.
Infliximab (Remicade and biosimilars): Update the product in-
Monitoring in  Once a medicine has been formation and EU reminder card of infliximab to include stricter
real-life – opti- authorised, EMA and the recommendations on the administration of live vaccines to in-
mizing safe and EU Member States continu- fants breastfed by mothers receiving infliximab due to infant ex-
effective use ously monitor the quality, posure via breast feeding.
safety and the benefit-risk
Important new balance of the medicine Invanz (Ertapenem): Update of the product information to con-
safety advice used in clinical practice. sider discontinuation of treatment if Invanz-induced encepha-
issued in 2021 This is to optimise how lopathy is suspected (e.g. myoclonus, seizures, altered mental
included the medicine is used by status, depressed levewl of consciousness). Patients with renal
patients to achieve its full impairment are at higher risk and the resolution may be pro-
benefit and to protect pa- longed.
tients from avoidable side
effects. Kadcyla (Trastuzumab emtansine): Update of product informa-
Regulatory measures tion to include new recommendations and measures to closely
range from a change to the monitor the infusion site for possible subcutaneous infiltration
product information to the during drug administration, as cases of delayed epidermal in-
suspension or withdrawal jury or necrosis following extravasation have been observed.
of a medicine or recall of a
limited number of batches. Ilaris  (canakinumab) and Kineret  (anakinra): Update of the
product information with recommendations and warnings on
 Alkindi (Hydrocortisone): adverse drug reactions with eosinophilia and systemic symp-
Recommended actions toms (DRESS) predominantly in patients with systemic juvenile
to minimise the risk of idiopathic arthritis (sJIA).
acute adrenal insufficiency
in children that may oc- Venclyxto (Venetoclax): Update of the product information to in-
cur when switching from clude new recommendations and measures for the mitigation of
conventional oral hydro- the risk of tumour lysis syndrome (a serious complication with
cortisone formulations to rapid break down of cancer cells).
Alkindi granules, due to
potential inaccurate dosing Xeljanz (tofacitinib): New recommendation to only use in pa-
with other oral hydrocorti- tients over 65 years of age, patients who are current or past
sone formulations. smokers, patients with other cardiovascular risk factors, and pa-
tients with other malignancy risk factors when no suitable treat-
ment alternative is available.

THE PHARMA WORLD 39



“During the last 18 years, INTERVIEW
Kidney Foundation has offered
more than 4.2 lac dialysis
sessions for ESKD patients”

Prof. Dr. Harun-Ur-Rashid As a pioneer nephrologist of our country, could
Professor and Chief Consultant you please, tell us in brief about the types of
Kidney Foundation Hospital and kidney disease prevalent in Bangladesh?
Research Institute
Founder president There are various types of kidney disease prevalent in our
Kidney Foundation of Bangladesh country. The commonest disease are-

In view of high a. Acute kidney injury, (AKI) means sudden deteriora-
public demand and tion of kidney function within 2 days to few weeks.
increasing number The disease usually occurs with diarrhea like ill-
of kidney disease ness, severe vomiting, road-traffic accident with
patients, Kidney differentmuscle and bone injury, pregnancy related
Foundation is disorder, muscle injury during fighting each other
committed to enhance (Rhabdomyolysis), inadvertent use of plant medi-
services. cine, pain killer, analgesic drug, use of antibiotic etc.

There are 13 million people suffering from acute
kidney injury in the world and most of them are
from low and low middle income countries. In Bang-
ladesh 15-25% of hospitalized patients are found to
suffer from AKI.

b. The other kidney disease is chronic kidney disease
(CKD). There are three most important cause of CKD.
They are Diabetes mellitus, High blood pressure and
Glomerulonephritis. Other causes are obstructive
uropathy, kidney stone, enlarge prostate, polycystic
kidney disease, heredo-familial kidney disease.

There are 850 million people are suffering from CKD
in the world. In Bangladesh, about 20 million people
are suffering, that means one in 7 people has CKD in
our country.

Early Chronic kidney disease has no signs or symptoms.
What is your message to the common people to avoid
renal complications and keeping their kidneys healthy?

CKD has no signs or symptoms unless 80-90% of kid-
ney function is lost. It is therefore very important for eve-
ry patients who has been suffering from Diabetes, (DM)
Hypertension (HTN) and Glomerulonephritis (GN) or Ne-
phrotic syndrome (NS) to do Kidney test as soon as this
diseases are there.

If you suffer from Diabetes, your first job is to examine
your Urine for R/E to find out any abnormality particular-
ly urine for albumin. If albumin is nil or trace, check ACR
means presence of micro albumin. If you notice, there is
presence of micro albumin, consult your doctor and start
medicine. Blood test for serum creatinine and cholesterol
is also to be checked for patients with Diabetes mellitus.

Similarly,if you are suffering from high blood pres-

THE PHARMA WORLD 41

sure, Kidney test is also done .Normal pital started from October 2003 with patients, Kidney Foundation is com-
blood pressure in adults is 120/80 mm meager capital investment of US$ mitted to enhance services. It has
of Hg.If blood pressure is >140/90 for 1000.00 only. Started in a hired build- constructed three extension block of
consecutively for 2 days ,you are hy- ing with only seven staffs,service the hospital building which expanded
pertensive .You have to change your provided with 6 dialysis machines on hospital beds from 150 to 300 along
life style ,do regular walking for 30-45 loan, a small diagnostic facility and with more facilities for OPD, haemodi-
minutes,reduce intake of salt,and fi- outpatient service. All services pro- alysis and kidney transplantation.
nally drugs. vided with non-profit and affordable
price.With dedication and hard work Academic activities have also been
Glomerulonephritis is also a com- of people involve in Kidney Founda- increased and training programs has
mon disease in our county. This dis- tion, it has now become the largest been started for renal nursesand re-
ease is much easier to diagnose, hospital and Institute in Bangladesh nal dietitians.In collaboration with
because in most cases they have for treatment of Kidney disease and Wayne State University, USA, we are
symptoms of puffiness of face and kidney failure.People with little or no organizing training for renaldietitians
edema of legs. Once you do rou- money can get free treatment. and conducting research on haemodi-
tine urine test, and check serum alysis patients. Kidney Foundation is
creatinine,urea ,electrolytes ,one can For other patients with kidney dis- doing excellent as an ISN sister center
diagnose GN/NS ease and kidney failure, treatment is program of Royal London Hospital
affordable. and has now promoted fromlevel C to
If you do not have any Diabetes, level B and now working from label B
Hypertension or GN but have strong Activities of kidney foundation: to A. We are expecting to be promot-
family history of kidney disease, even Kidney Foundation Hospital runs a ed from level B to level A by next
than you have to check your kidney modern outpatient facility, which can year that means we will give training
function after the age of 40.Fifty per accommodate 250-300 patientsper to other countries as well.In order to
cent of people do not know that they day. Outpatient consultation fee per start deceased transplantation we are
have DM or HTN until and unless they patient per visit is only US$ 1.25(100.00 working with The Transplantation So-
test for it. taka) when seen by an outpatient ciety (TTS) and Korea University Anam
medical officer-and-only US$ 5.00- Hospital.
What dialysis-related factors 6.00(400-500 taka) when consulted by
patients should be aware of that a specialist Nephrologist. Dialysis and We have MoU with Royal London
may influence recovery of kidney transplant patients are seen with US$ Hospital and also with Korea Univer-
function in Acute Kidney Injury? 1.25.00(100 taka) per patient per visit. sity Anam Hospital to carry academic
Outpatient service is open six days a activities on Kidney disease,Diabetic
In AKI, there are three important week. disease ,Kidney histology and train-
cause you have to remember. ing program and research. We have
During the last 18 years, Kidney organized regular conference with
- Your urine output will decrease Foundation has offered more than Bangladesh-Korea Friendship confer-
by 24 hours from normal 4.2 lac dialysis sessions for ESKD pa- ence and Korea universityAnam Hos-
amount of urine to less than 500 tients, performed 625 kidney trans- pital for deceased donor transplanta-
cc in a day & then no urine in 24 plantations, about 3 lacs 67 thousand tion for last 5 years.
hours. laboratory investigations and more
than 4 lac OPD consultations. All these Hospital record system:
- Your serum creatinine rising services are offered on a non-profit Since 2010, Kidney Foundation has
every 48hours from normal lev- basis. There are now more than 1000 the facility for online data storage. We
el. patients doing outpatient dialysis and have a web-based hospital manage-
556 patients are doing home dialysis ment where data from both in-pa-
- If your serum creatinine rises in the form of CAPD. For the last one tients and outpatients are uploaded
from normal value to more than year we have successfully treated and arereadily available to use.
400µmol/L despitedrug treat- 342 cases of acute kidney failure and
ment, You have to prepare for more than 1315 cases were treated Services for rural population:
dialysis. If creatinine is more with renal replacement therapy in In order to decentralize and make
than 500µmol/L, one has to the hospital. Surgical procedures are kidney health services available to
start dialysis.You also have to regularly performed even in 2020 due the rural population of Bangladesh,
notice 24 hour urine output, vol- to COVID infection. Kidney Foundation has launched
ume overload and other symp- threebranches which are successfully
toms as well. Over the last one year (Oct 2020 to running at Pabna, Sirajgang and Syl-
Sep 2021),Kidney Foundation success- het districts. All these branches are
As the founder president would you fully performed 1357 AV fistulas,1315 offering services likeOPD, laboratory
please introduce Kidney Foundation jugular catheters, 167 kidney biopsies, investigations and dialysis for ESKD
of Bangladesh to our readers? 30 CAPD catheter insertion. patients. The construction of Rajshahi
What are the services provided? branch will be started soon.
In view of high public demand and
Kidney Foundation officially was increasing number of kidney disease
formed in June 2002. Activity of hos-

42 THE PHARMA WORLD

Recognition from ISN: Many candidates from different In order to do transplant you need
Kidney Foundation hospital was vis- private universities are working in KF a healthy donor of a close relative.
ited by Professor John Feehally, Pro- for thesis work as well. Despite presence of close relative,
gram director and Ex-President of they do not always come forward to
International Society of Nephrology What are the challenges in healthcare donate kidney to their relation. We
(ISN)on 13th January, 2018 who was for people with kidney diseases in have seen, only mother comes forward
impressed with our services andcom- Bangladesh? What role does the to donate her son or daughter.
mented as below… kidney foundation play in prevention,
early detection, and treatment of Father donate less number think-
“I was deeply impressed by all kidney diseases in our country? ing that it might obstruct him to do
that the Foundation has done since work.
it began in 2003. In less than 15 years Chronic kidney disease will be the 5th
you have been able to establish a causes of death among non-commu- There are no legal problems for
high quality specialist kidney hospi- nicable disease by 2040. husband and wife to donate to each
tal which delivers first-rate care, and other. Here again neither wife nor
makes that care available even for the We have to work hard in order to husband come forward to donate, al-
most disadvantaged of Bangladeshi prevent this disease at primary, sec- though wife usually come forward to
people. To do this with a sustain- ondary as well as tertiary level. donate more than husband.
able financial model based entirely
on public donation is an extraordi- The most important thing for pre- In abroad, the organ act law accept
nary achievement. Your approach and vention of CKD is early detection. In emotional donor. Emotional donor
achievementsuccessfully aligned to Bangladesh we have infrastructure means you can donate if you have
the philanthropic vision of the Inter- to prevent CKD.There are 14000 com- a close friendship even with your
national Society of Nephrology: ‘a fu- munity clinics in Bangladesh for every friend, other than close relatives.
ture where all people have equitable 6000 people.
access to sustainable kidney health’. Some transplant patients accept
The ISN congratulates you and all If we can utilize the community this opportunity and they find out a
your team, and wishes your continu- clinic and check BMI, BP and urine for donor known or unrelated as their
ing success.” albumin, random blood sugar during close relation and travel to other
per people visit at clinic we can de- country called transplant tourism.
Could you please walk us through tect three most important cause of
the various research projects being CKD i.e. diabetes, hypertension and However, transplant trafficking is
conducted in your institute? proteinuria and importantly we can illegal, against the organ act law (Is-
take measures for early detection and tanbul declaration of 1988). We know
Kidney foundation hospital is always prevention. there are other South Asian country
engaged in research from the very who are doing this unlawful activity
beginning.The research as a part and In Kidney Foundation, we are con- for a long time.
parcel of our doctors working in Kid- ducting epidemiological study in dif-
ney Foundation.There are various col- ferent areas in Bangladesh for detec- In order to prevent organ tourisms,
laborative research with other insti- tion and treatment of CKD. we have to restrict patients going
tute at home and abroad. abroad and restrict Visa more tightly
We have completed study in ru- and make medical board to find out
We have research projects related ral population of Bonogram, Pabna, the type of donor they are accompa-
to clinical, observational epidemio- Zaidebpur of Savar in Dhaka,05 com- nying.
logical and randomized control trial. munity clinics in Sylhet.
There are pilot studies as well.We give We also have to start deceased
preference on clinical research on AKI, We are now planning screening donation as well. If we can start de-
CKD, Diabetic kidney disease, kidney programme in Cumilla in arsenic and ceased donation, we can transplant
failure. non-arsenic area. Our target is to patient more with a donor who do not
cover Rajshahi, Rangpur and Barisal need to be a close relative.
In the collaborative research with in future.
other institute, there are now two At the present moment, we are
Ph.D. offered one with Jadhavpur Uni- Cost of kidney transplantation trying hard to start deceased donor
versity, India and other with Wayne in Bangladesh is almost 10 times in our country.Organ Act law in 2018,
state university, USA. Both the candi- lower than overseas hospitals. also given stress to do deceased do-
date work in kidney foundation. The Still patients are going abroad nationin. Every ICU should declare
3rd student is doing Ph.D. in Royal spending huge amount of money. “Brain Death” for every patients when
London Hospital in UK and she is Why this is so? What can be done die. Transplant coordinator give all
from kidney foundation. One MPhil for the transplant procedure to get assistance to find out wheather this
candidate of Dhaka University worked more recognition in our country? patient relations are agree to donate
in Kidneys Foundation and offered, organs after death.. We should make
MPhil in nutrition under Dhaka Uni- You are very right that the cost of kid- all effort to utilize two kidney, liver
versity. ney transplantation is very minimal and other organ with permission from
in Bangladesh despite minimal cost the close relative of donor.If we can
where patients are going abroad. do that travel to other country will
decrease day by day.
Kidney transplant is the best form
of treatment for kidney failure.

THE PHARMA WORLD 43



“UTFB was established with INTERVIEW
a mission to create a world
standard urology institution for
urological treatment, education,
training and research”

Prof. M.A. Salam As a pioneer urologist of our country, could
Uro-Oncologist you please, tell us in brief about the types of
Founder president and CEO, urological cancers prevalent in Bangladesh?
Urology and transplant foundation
of Bangladesh Urological cancers represent a major public problem as-
Founder Chairman sociated with high mortality and morbidity. The pattern
Department of Urology of these cancers varies markedly according to era, region
BSMMU, Dhaka and ethnic groups, but increasing incidence trends over-
all. Cancers of the urinary tract (or urologic cancers) may
Data suggests that be linked to environmental, lifestyle, genetic and other
patients are deferring factors.
treatment because
of high out-of-pocket Kidney, prostate, and bladder cancers increase with
costs. We need to age and are influenced partly by modifiable risk factors.
find the best ways Some cancers of the urinary tract can occur in both men
to manage costs and women:
effectively while
maintaining the same, if l Bladder cancer
not better, quality of life l Kidney (renal) cancer
among our patients.
Others are specific to men:
l Prostate cancer
l Testicular cancer
l Penile cancer

Tobacco use is an important risk factor for all urologic cancers.
Prostate cancer is the most common GU Cancer in this

country occur in men with a family history of the disease,
and/or are older. More than 70 percent of prostate cancer
cases are diagnosed in men older than 65.

By contrast, penile cancer is very rare, accounting for
less than one percent of cancers in men. It’s also related to
older age, as well as to human papillomavirus (HPV) infec-
tion, lack of circumcision and poor genital hygiene.

The Testicular cancer—which usually develops in
younger men, between the ages 15 and 35—is on the rise.
Although in most cases it’s not clear what causes testicu-
lar cancer, other medical conditions can be risk factors,
such as polycystic kidney disease for kidney cancer and
chronic inflammation for bladder cancer. A small percent-
age of these cancers are inherited.

What are the risk factors associated
with Urological Cancer?

The most common general risk factors for cancer include
aging, tobacco, radiation exposure, chemicals, and other
substances, some viruses and bacteria, certain hormones,
family history of cancer, alcohol, poor diet, lack of physical
activity, or being overweight.

THE PHARMA WORLD 45

Kidney cancer: The risk factors may be extremely painful condition Selection of initial therapy: Systemic
include increased age; male sex; may demand an urgent hospital ad- therapy is usually given as a combi-
smoking; cadmium, benzene, trichlo- mission and emergency intervention nation of agents from the following
roethylene, and asbestos exposure; to evacuate the clots. classes [3]:
excessive weight; chronic dialysis use;
and several genetic syndromes (famil- Any cancer patient can experi- l Programmed cell death 1 pro-
ial RCC, hereditary papillary RCC, von ence weight loss and fatigue. Many tein (PD-1) checkpoint inhibitors
Hippel-Lindau syndrome, and tuber- advanced Prostate cancers may pre- (nivolumab and pembrolizum-
ous sclerosis). sent with Low back pain from bone ab)
metastasis. More often, these cancers
Bladder cancer: Smoking causes are detected during a routine physical l Programmed cell death ligand
about half of all bladder cancers. exam of the abdomen or genitals. 1 (PD-L1) checkpoint inhibitors
People who smoke are at least 3 (avelumab and atezolizumab)
times as likely to get bladder cancer Are Urological cancers
as people who don’t. Certain indus- treatable? What are the l CTLA-4 inhibitors (ipilimumab)
trial chemicals such as benzidine treatment options available? l VEGF inhibitors (axitinib, suni-
and beta-naphthylamine have been
linked with bladder cancer. The risk The treatment of urological malig- tinib, pazopanib, cabozantinib,
of bladder cancer increases with age. nancies has seen several significant lenvatinib, and bevacizumab)
Bladder cancer is common in men advancements in recent years. For l mTOR inhibitors (everolimus)
than in women. Chronic bladder irri- loco regional disease, treatment often
tation and Urinary infections, kidney consists of a multimodality approach, Urothelial carcinoma
and bladder stones. Schistosomiasis with the addition of systemic therapy Bladder cancer is the most common
(also known as bilharziasis), an infec- to radical local therapy in the form of malignancy arising from the urinary
tion with a parasitic worm that can get surgical resection or radiotherapy, in tract, with the most common histol-
into the bladder, is also a risk factor a bid to improve disease outcomes. ogy being urothelial carcinoma. Non
for bladder cancer. Optimizing treatment in the early- muscle invasive Bladder Cancer is
stage setting is especially crucial, best managed by endoscopic surgery
Prostate Cancer: Several inherited since the development of distant me- e.g. TURBT and Intravesical Mitomycin
mutations seem to raise prostate tastases is often the life-limiting fac- or/and BCG. In patients with high-risk
cancer risk, but they probably account tor in the natural history of urological tumors, full-dose intravesical BCG for
for only a small percentage of cases malignancies. All these treatment op- one to three years (induction plus
overall. For example, Inherited muta- tions are available in Bangladesh. 3-weekly instillations at 3, 6, 12, 18, 24,
tions of the BRCA1 or BRCA2 genes, 30 and 36 months), is indicated. The
which are linked to an increased risk Renal cell carcinoma (RCC) additional beneficial effect of the sec-
of breast and ovarian cancers in some Surgery is the best option for the ond and third years of maintenance
families, can also increase prostate treatment of organ confined RCC. should be weighed against its added
cancer risk in men (especially muta- Surgical resection of stage I to III re- costs, side effects and problems con-
tions in BRCA2). nal cell carcinoma (RCC) can be cura- nected with BCG shortage. Immediate
tive, but up to one-third of patients radical cystectomy (RC) may also be
While prostate cancer seems to eventually recur. Currently most of discussed with the patient.
run in some families, most prostate the RCC are amenable to be treated
cancers occur in men without a family with Partial Nephrectomy. This sur- On the basis of their individual risk
history of it. Prostate cancer is rare in gery may have done with Open clas- of progression, non-muscle invasive
men younger than 40, but the chance sical method or laparoscopic proce- bladder cancer patients are stratified
of having prostate cancer rises rap- dure or by Da Vinci Robotic assisted as having low, intermediate, high, or
idly after age 50. About 6 in 10 cases laparoscopic surgery which, unfortu- very high risk, which is pivotal to rec-
of prostate cancer are found in men nately is not available in our coun- ommending adjuvant treatment. For
older than 65. try yet. This partial nephrectomy patients with tumors presumed to
may preserve the renal function with be at low risk and for small papillary
Is painful urination a symptom of equal oncological outcome com- recurrences detected more than 1 yr
urological cancers? What are the pared to Radical Nephrectomy. For after a previous TURB, one immediate
other symptoms to look out for? larger tumors, Radical Nephrectomy chemotherapy instillation is recom-
may be a choice. mended. Patients with an interme-
Most of the time, symptoms don’t oc- diate-risk tumor should receive 1 yr
cur until the cancer has become more Currently Immunotherapy with of full-dose intravesical bacillus Cal-
advanced. Then, they depend on the monoclonal antibodies directed mette-Guérin (BCG) immunotherapy
type of cancer. Blood in the urine against programmed cell death 1 pro- or instillations of chemotherapy for
(without pain) is a symptom of blad- tein (PD-1) and cytotoxic T-lympho- a maximum of 1 yr. For patients with
der, kidney and prostate cancer—at cyte antigen 4 (CTLA-4) has become high-risk tumors, full-dose intravesi-
later stages, pelvic and back pain can an integral part of the management cal BCG for 1–3 year is indicated. For
also develop. In situation like the clot of RCC. patients at very high risk of tumor pro-
retention and Bladder tamponade gression, immediate or upfront radical
cystectomy should be considered.

46 THE PHARMA WORLD

Cystectomy is also recommended for Patients with high- to very high- Recently, lutetium-177-prostate-
BCG-unresponsive tumors. risk disease may be treated with radi- specific membrane antigen-617 with
cal local therapy, either radiotherapy standard of care treatment has shown
The radical cystectomy with Ortho- with concomitant androgen depriva- to improve overall survival in men
topic Bladder or Urinary Diversion for tion therapy (ADT), or radical prosta- with advanced-stage prostate-specific
muscle invasive Bladder Cancer. Fre- tectomy in selected cases. Concomi- membrane antigen–positive metastat-
quently a neoadjuvant Chemotherapy tant ADT administered with radical ic castration-resistant prostate cancer.
with platinum-containing regimen radiotherapy has shown benefits in
Radical Nephroureterectomy may be recurrence-free survival. Testicular cancer
indicated for Upper Tract Urothelial Although testicular cancer can affect
Cancer. Radical radiotherapy is a common- a man or boy at any age, it is most of-
ly used approach for the treatment ten found in men age 15 to 44 years.
Trimodal therapy with Maximum of localized prostate cancer. IMRT or It’s fairly rare and very treatable. With
TURBT Platinum based Chemotherapy IGRT Alone or combined with Brachy- early diagnosis and treatment, the
may be an option in select patients therapy and Cyber knife are recently risk of death from this cancer is small.
with Muscle Invasive Bladder cancer recommended in some centers, The
aiming to preserve the native Bladder POP-RT phase III study investigated Treatment for testicular cancer is
at cost of potential serious side ef- the benefit of prophylactic whole-pel- based mainly on the type and stage
fects in some cases. vic nodal radiotherapy over prostate- of the cancer. Testicular cancer begins
only radiotherapy in the treatment of as a scrotal mass, which is usually not
First-line therapy: A cisplatin-based early-stage prostate cancer. The POP- painful. Most testicular cancers origi-
combination chemotherapy regimen RT trial showed a benefit for prophy- nate in primordial germ cells. Germ
is the preferred initial therapy for pa- lactic whole-pelvic radiotherapy over cell tumors are categorized as semi-
tients with metastatic urothelial can- prostate-only in high risk patient. nomas (40%) or nonseminomas (tu-
cer of the bladder and urinary tract mors containing any nonseminomous
who are cisplatin eligible candidates. Management of metastatic pros- elements; 60%). Nonseminomas in-
Gemcitabine (1000 mg/m2 on days tate cancer has undergone a revolu- clude teratomas, embryonal carcino-
1, 8, 15) plus cisplatin (70 mg/m2 on tion over the past decade with the mas, endodermal sinus tumors (yolk
day 2), repeated every 28 days for a introduction of several novel agents sac tumors), and choriocarcinomas.
maximum of six cycles. An alternative and repurposing of others. Several Histologic combinations are com-
regimen consists of gemcitabine (1200 clinical trials reported improved out- mon; eg, teratocarcinoma contains
mg/m2 on days 1 and 8) and cisplatin comes with the intensification of an- teratoma plus embryonal carcinoma.
(75 mg/m2 on day 2), repeated every drogen deprivation therapy by the Functional interstitial cell carcino-
21 days for a median of six cycles. addition of docetaxel chemotherapy mas of the testis are rare (< 5%). Even
or novel hormonal agents (abirater- patients with apparently localized
Ineligible for platinum-based one, enzalutamide, or apalutamide) tumors may have occult nodal or vis-
chemotherapy – In the phase II KEY- in the metastatic castration-sensitive ceral metastases. For example, almost
NOTE-052 study, 370 patients with ad- state. The use of upfront docetaxel 30% of patients with nonseminomas
vanced urothelial carcinoma who were was shown to improve overall survival will relapse with nodal or visceral me-
not eligible for a cisplatin-based regi- (OS) in patients with mCSPC, especial- tastases if they undergo no treatment
men received initial systemic therapy ly for men with high-volume disease after orchiectomy. Risk of metastases
with pembrolizumab at 200 mg every (presence of visceral metastases and/ is highest for choriocarcinoma and
three weeks for up to two years or ≥ 4 bone metastases with ≥ 1 me- lowest for teratoma.
tastasis not involving the axial skel-
Prostate Cancer eton or pelvis). Ultrasonography for scrotal mass-
Treatment of early-stage prostate es, staging by abdominal, pelvic, and
cancer has traditionally been guided Relugolix has been recently ap- chest CT as well as tissue examina-
by a risk stratification model based proved as the first oral gonadotro- tion is recommended. Many patients
on the local extent of disease, serum pin-releasing hormone receptor discover the mass themselves during
prostate-specific antigen (PSA) levels antagonist agent with a superior car- self-examination. Monthly self-exam-
and the Gleason’s score. Patients with diovascular side-effect profile, and ination should be encouraged among
low- to very low-risk prostate cancer serum testosterone suppression com- young men.
are often put on active surveillance, pared with a gonadotropin-releasing
whereas patients with intermediate- hormone agonist, leuprolide. If a testicular mass is confirmed,
risk disease with a life expectancy of serum tumor markers () should be
>10 years are usually treated with rad- Poly-ADP ribose polymerase inhib- measured and a chest x-ray taken.
ical local therapy with either surgery itors (olaparib and rucaparib) have Serum markers i.e. AFP, beta-HCG,
or radiotherapy. demonstrated significant clinical ben- and lactate dehydrogenase [LDH] may
efit for patients harboring deleterious help differentiate benign from can-
Radical prostatectomy may the mutations in genes belonging to the cerous masses, but results are not
most popular option worldwide and homologous recombination repair definitive. Then, radical orchiectomy
can be offered with open laparoscopic pathway and have received Food and via an inguinal approach is indicated;
or Robotic assisted procedure. The last Drug Administration approval. the spermatic cord is exposed and
option is not available in this country.

THE PHARMA WORLD 47



clamped before the abnormal testis early stages, and because it seldom of medical (i.e., non-surgical) condi-
is manipulated. interferes with voiding or erectile tions, such as urinary tract infections
function, patients do not complain and benign prostatic hyperplasia,
The 5-year survival rate is > 95% until pain or a discharge from the with the management of surgical
for patients with a seminoma or non- cancer occurs. By this time, the cancer conditions such as bladder or pros-
seminoma localized to the testis or has usually progressed from being su- tate cancer, kidney stones, congenital
with a nonseminoma and low-volume perficial to invasive. Metastasis, which abnormalities, traumatic injury, and
metastases in the retroperitoneum. occurs with this type of carcinoma stress incontinence.
The 5-year survival rate for patients when the diagnosis or treatment is
with extensive retroperitoneal me- delayed, is usually lethal. Urology has traditionally been on
tastases or with pulmonary or other the cutting edge of surgical technol-
visceral metastases ranges from 48% Partial or total penectomy: A surgeon ogy in the field of medicine, includ-
(for some nonseminomas) to > 80%, either amputates the penis or removes ing minimally invasive robotic and
depending on site, volume, and his- part of it. If total removal is required to laparoscopic surgery, laser-assisted
tology of the metastases, but even treat the cancer, surgeons also create surgeries, and a host of other scope-
patients with advanced disease at a new opening for urine in the perine- guided procedures. Urologists are
presentation may be cured. um. For very advanced cancer, some- trained in open and minimally inva-
times the scrotum and testicles also sive techniques, employing real-time
Radical inguinal orchiectomy: Surgery must be removed, which requires that ultrasound guidance, fiber-optic en-
is the cornerstone of treatment and the patient take testosterone supple- doscopic equipment, and various
helps provide important diagnostic ments for the rest of their lives. lasers in the treatment of multiple
information; it also helps formulate benign and malignant conditions. In
the subsequent treatment plan. A Radiation Therapy: Radiation can be addition, urologists are pioneers in
cosmetic testicular prosthesis may used to treat early-stage penile can- the use of robotics in laparoscopic
be placed during orchiectomy. Lymph cer or in addition to surgery when surgery. Urology is closely related to
node dissection: For non-seminomas, cancer has reached the lymph nodes. (and urologists often collaborate with
many experts consider standard Sometimes a radiation source can the practitioners of) oncology, neph-
treatment to be retroperitoneal lymph be placed directly into or next to the rology, gynecology, andrology, pediat-
node dissection. For clinical stage 1 penile tumor (called brachytherapy), ric surgery, colorectal surgery, gastro-
tumors in patients who have no prog- which protects surrounding tissue enterology, and endocrinology.
nostic factors that predict relapse, an from radiation. Radio sensitizers may
alternative is active surveillance (fre- be used to make the penile tumor UTFB was established in 16th Au-
quent serum marker measurements, more sensitive to radiation therapy. gust, 2011 with a mission to create a
chest x-rays, CT). Nerve-sparing dis- world standard urology institution
section is often possible, particularly Chemotherapy: Topical chemotherapy for urological treatment, education,
for early-stage tumors, which usually (an anti-cancer ointment) can be used training and research. The Founda-
preserves ejaculation. for very early-stage penile cancers. tion will also have different educa-
Penile cancer is an aggressive disease tional program for awareness of dif-
Radiation therapy: An option for sem- and after systemic progression it is vir- ferent disease for example Prostate
inoma after unilateral orchiectomy tually incurable. While this squamous cancer, Bladder cancer, Urinary stone
is radiation therapy, usually 20 to 40 cell cancer responds to chemothera- disease. The Foundation will promote
grays (Gy; a higher dose is used for py, successful treatment of lymphatic deceased multi organ Transplantation
patients with a nodal mass) to the pa- metastases can only be achieved with which is yet to be introduced in this
ra-aortic regions up to the diaphragm. aggressive surgical treatment in com- country. The foundation will develop
bination with chemotherapy. All the an academy for urology education
Chemotherapy: Nodal masses > 5 cm, options of treatment are described is training and research. Currently this
lymph node metastases above the available in Bangladesh. Foundation is providing evaluation
diaphragm, or visceral metastases of all urological disease and treating
require initial platinum-based com- As a founder President and CEO most of them except the advancer
bination chemotherapy followed by would you please introduce Urology treatment for which we take the help
consolidative surgery for residual and Transplantation Foundation of the referral center. We are providing
masses. Pretreatment sperm banking of Bangladesh to our readers? limited service of screening of Urologic
should be considered. What are the services provided? Cancer particularly prostate cancer. We
also treat all Uro-oncoloical challeng-
Penile Cancer The urinary and reproductive tracts ing cases like Prostate cancer Bladder
Penile cancer is uncommon, but when are closely linked, and disorders of cancer Kidney cancer testicular cancer
it is diagnosed, it is psychologically one often affect the other. Thus, a and penile cancer as described above
devastating to the patient and often major spectrum of the conditions alone or with collaboration.
presents a challenge to the urologist. managed in urology exists under the
Benign, premalignant, and malignant domain of genitourinary disorders. This foundation also provides
conditions must be differentiated. Urology combines the management a highest level tumor Board facil-
ity to interested patients. We have
This is a slow-growing cancer in its

THE PHARMA WORLD 49