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Rapid Alert; Drug Product: Unregistered and Falsified Lipiodol Ultra Fluide 480mg/mL Injection

Asad Ullah Recall Alerts
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Rapid Alert

DRAP Alert NoNo  I/S/09-24-37
Action DateOctober 05, 2023
Target Audience1. Regulatory Field Force.
2. Healthcare Professionals – Physicians, Pharmacists, and Nurses.
3 Procurement officer at hospitals and institutions
4. General Public.
Problem StatementThe regulatory field force of DRAP and the Chief Drug Inspector Office, Karachi have identified a suspected falsified lot of Lipiodol Ultra Fluide 480mg/ml Injection which was intended to supply to tertiary care hospitals. The said product is not registered in Pakistan and is not imported using special permission pathways.
Threats to Public HealthThe use of falsified or counterfeit Lipiodol injection can pose serious health risks as it may contain unknown ingredients or no active ingredient at all. This can lead to ineffective treatment, worsening of the condition, or unexpected side effects. In some cases, falsified products have been found to contain toxic materials which expose patients to harmful substances. The safety, sterility, and quality of the falsified products referenced in this alert are also unknown.

The product identification details are as under: –

Therapeutic Goods Affected:-

Product NameCompositionBatch / LotManufacture Name (as stated on label)Remarks
Lipiodol Ultra Fluide 480mg/ml Solution for Injection (10ml)

Registration No. Nil		Ethiodized-oil
(radio-opaque contrast injection)		Batch No.: 15LU606A

Exp. Date:
07-2024		Guerbet, 15 rue des Vanesses, Zone Paris Nord II FranceThe outer packaging, solution colour and consistency were different from the comparison to the original product.
Comparison of falsified Product against the original product by G.
Action InitiatedThe Regulatory Field Force has been directed to increase surveillance throughout the supply chain system including healthcare facilities to confiscate/seize this product from the market without any delay. Since this product is not registered with DRAP, it is not permitted to be stocked or sold in pharmacies or other retail outlets. However, it is crucial for all healthcare professionals, including pharmacists and chemists, to check their stock immediately and stop the distribution or supply of this product if it is found. Information related to the supplier of this product should be provided to the Regulatory field force (DRAP, Provincial Health Departments, and States) to ensure the removal of this product.
Advice for Healthcare Professionals-DRAP requests increased vigilance at hospitals and within the supply chains of institutions/pharmacies/healthcare facilities likely to be affected by this product.

-Adverse reactions or quality problems experienced with the use of these products shall be reported to the National Pharmacovigilance Centre (NPC), DRAP using Adverse Event Reporting Form or online through this link.

-Please click here for further information on problem reporting to DRAP.
Advice for ConsumersConsumers should not use this product and should contact their physician or healthcare provider if they have experienced any problem related to taking or using this drug product, and should report the incident to the Drug Regulatory Authority of Pakistan / National Pharmacovigilance Centre.

All therapeutic goods must be obtained from licensed pharmacies and other authorized/licensed retail outlets. The authenticity and condition of products should be carefully checked. Seek advice from your pharmacists or other healthcare professionals in case of any doubt.

National Control Laboratories for Biologicals, DRAP issued Guidelines for Lot Release of Biological Products

Asad Ullah Drugs

The regulation of lot release is an integral regulatory control to ensure the quality and safety of biological products. Its purpose is to verify that each batch/lot of the product meets the stipulated standards of manufacturing and quality control. The National Control Laboratory for Biologicals (NCLB), Islamabad assumes the responsibility of overseeing lot release function through reviewing the manufacturer’s protocol, analytical methods and summary protocol, and also conduct analytical testing if necessary. This is aimed at assuring that every product batch/lot that enters the market adheres to the approved specifications at the time of registration, including any post-registration modifications or variations. The primary objective is to safeguard the public from substandard product batches/lot.

The National Control Laboratories for Biologicals, DRAP has published guideline on the procedural requirement for lot release of biological products. This guidance document was drafted and uploaded in May 2023 seeking comments from stakeholders. It provides an overview of the lot release process how the procedure is established and what products are covered under the lot release system.

Guideline for lot release of biological drugsDownload

Shanghai Cooperation Organization (SCO) Pharmaceutical Development Conference; CEO DRAP emphasis cooperation to ensure drug safety and advancing research in the pharmaceutical field

Asad Ullah Events
Shanghai Cooperation Organization (SCO) Pharmaceutical Development Conference; CEO DRAP emphasis cooperation to ensure drug safety and advancing research in the pharmaceutical field

2nd SCO Conference on Pharmaceutical Cooperation

September 25, 2023, Suzhou

The SCO conference on the development of medical and pharmaceutical cooperation was held in Suzhou, China on September 25, 2023. The conference was attended by representatives from the public and private healthcare sectors of the Islamic Republic of Iran, the Republic of Kazakhstan, the People’s Republic of China, the Kyrgyz Republic, the Islamic Republic of Pakistan, the Russian Federation, and the Republic of Uzbekistan.

Mr. Asim Rauf, appreciated the organization of this significant event, which plays a crucial role in promoting regional cooperation and development in the pharmaceutical sector. He added that the SCO region holds immense potential for enhancing pharmaceutical collaboration, and we are committed to contributing to this shared vision. The platform of SCO offers an excellent opportunity to share insights, learn from each other’s experiences, and work collectively towards a safer, more accessible, and sustainable pharmaceutical landscape.

The pharmaceutical industry in Pakistan is evolving from its modest beginnings to become a significant contributor to our national economy as well as meeting around 80 % of domestic needs. Pakistan is eager to collaborate with our fellow SCO member states to harness the full potential of the pharmaceutical sector.

DRAP finalized the 2nd Edition of Guidelines on Post-Registration Variation of Drug Products

Asad Ullah Drugs

DRAP has finalized the second edition of its guidelines on procedure and data requirement for post registration variation of drugs. Registration / Marketing Authorization holders are responsible for the safety, efficacy, and quality of drug products that are placed on the market throughout their approved life cycle.

This guidelines are intended to provide information for submission of post-registration variation application by the registrations / marketing authorization holders of drug products. It includes categories of variations and the required documentation & procedures for submission of an application for a particular variation.

These Guidelines will assist both Regulators and Industry on the regulation of variation / changes to the original registrations / Market Authorization of products in terms of procedures and criteria for the appropriate categorization, reporting of changes and subsequent approval as required. Data requirements are listed out to evaluate the impact of the proposed / intended change on the quality, safety and efficacy of the locally manufactured / imported finished pharmaceutical and biological drug products intended for human and veterinary use.

These guidelines are intended to provide supportive information for submission of post registration variation application by the registrations / marketing authorization holders of the finished drug products to implement a change. The draft guidelines were uploaded on the website in July 2023 seeking comments of stakeholders on the contents of document.

The Guidelines have been finalized keeping in view the comments and suggestions of the Stakeholders. Please navigate to the Publications on the DRAP website for latest guidelines by DRAP.

Post Registration Variation Guidelines (Edition 02)Download

Decisions of 60th Meeting of Medical Device Board (Deficiency letter for Medical Devices Applications)

Asad Ullah Medical Devices Board

The Medical Device Board (MDB) of the Drug Regulatory Authority of Pakistan in its 60th meeting has deferred the following applications of registration of medical devices due to various deficiencies/shortcomings in the applications dossiers. These applicants are requested to furnish the requisite information/documentation as directed by the Medical Device Board. The detail is provided in the below attachment.

Deferred-letters-MDB-60Download

116th Meeting of Enlistment Evaluation Committee (EEC); Notice for Submission of Deficient Information / Documents

Ijaz Mustafa Enlistment Evaluation Committee, General

The 116th meeting of Enlistment Evaluation Committee (EEC), Division of Health and OTC, DRAP was held on 23rd May, 2023. The detailed of applications which required further information and documentation is attached hereunder for information by all stakeholders.

Deferred_list_116_Meeting_rDownload

Rapid Alert: Drug Product Recall: Incidents of loss and damage of vision with the off-label use of Avastin 100mg/4ml injection

Yasir Mahmood Recall Alerts , ,

Information Update on 3rd Nov, 2023: The recall of Avastin 100mg/4ml has been terminated based on the report of Central Drugs Laboratory, Karachi which declared the samples as of standard quality.

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Rapid Alert

DRAP Alert NoNo  I/S/09-24-36
Action DateSeptember 24, 2023
Target Audience1. Ophthalmologists and Endocrinologists
2. Healthcare Professionals – Physicians, Pharmacists, and Nurses.
3. Regulatory Field Force.
4. General Public
Problem StatementIncidents of loss of vision in diabetic patients have been reported following treatment with Altered/Dispensed/Diluted Avastin injection. This product is approved by the Drug Regulatory Authority of Pakistan (DRAP) to treat Colorectal and other metastatic carcinomas. The use of this drug product in diabetic retinopathy or other ophthalmic conditions is one of the off-label uses and is not approved by DRAP.

The incident is linked with the alteration/dispensing/dilution and sale of Avastin 100mg/4mL Injection under unhygienic/non-sterile conditions illegally and without any Drug Sale/Dispensing License (DSL) from Provincial Health Authority by M/s Genius Advanced Pharmaceutical Services Lahore.
Threats to Public HealthAvastin is a registered drug of M/s. Roche Pharma in Pakistan and is available in strength of 100mg/4ml and 400mg/16ml preparations. This drug is indicated for the treatment of colorectal and other metastatic carcinomas as a VGRF (vascular endothelial growth factor) inhibitor.

However, the use in diabetic retinopathy is an off-label use to block the growth of abnormal blood vessels in the eye. Since this drug was being dispensed/diluted/repacked in 1.25mg/0.05ml dose under unhygienic conditions and in an unapproved manner, therefore, its safety cannot be ascertained which may lead to damage and loss of vision in the patients.

The product identification details are as under: –

Therapeutic Goods Affected:-

Following is the detail of the alleged product:

Product InvolvedManufacturer
Inj. Avastin 1.25 mg/0.05ml

Composition: Bevacizumab
Registration No. Nil		Genius Advanced
Pharmaceutical Services.
Un-registered Product

Following is the detail of DRAP approved product:

Product NameSuspected BatchManufacturer/Importer
Avastin 100mg/4ml Injection


Composition: Bevacizumab
Registration No. 043004		H0352B11
B7266B20
B7266B07		M/s Roche Diagnostics, Germany


Importer:
M/s Roche Pharma, Karachi.
Registered Product
Action InitiatedThe Regulatory field force raided the premises of M/s Genius Advanced Pharmaceutical Services, Lahore, involved in the repacking and dispensing of Avastin injection under unhygienic/non-sterile conditions. The premises have been sealed and legal proceedings have been initiated against the personnel involved.

The Importer of the registered product has been directed to recall the suspected batches of Avastin 100mg injection from the marked immediately. The sale/distribution of registered Avastin Injection has been put on halt till verification of its quality through sampling and laboratory testing to safeguard public health. Healthcare Professionals, Pharmacists and Chemists have been directed to stop the distribution, dispensing and administration of this product immediately, and check their stocks and stop supplying this product. The remaining stocks should be quarantined and returned to the supplier/company.
Advice for Healthcare Professionals-DRAP requests increased vigilance at hospitals and within the supply chains of institutions/pharmacies/healthcare facilities regarding the off-label use of this product.

-Adverse reactions or quality problems experienced with the use of these products shall be reported to the National Pharmacovigilance Centre (NPC), DRAP using Adverse Event Reporting Form or online through this link.

-Please click here for further information on problem reporting to DRAP.
Advice for ConsumersPatients should not use this product for any ophthalmic disease and should contact their physician or healthcare provider if they have experienced any problem related to taking or using this drug product, and should report the incident to the Drug Regulatory Authority of Pakistan / National Pharmacovigilance Centre.

All therapeutic goods must be obtained from licensed pharmacies and other authorized/licensed retail outlets. The authenticity and condition of products should be carefully checked. Seek advice from your pharmacists or other healthcare professionals in case of any doubt.