Nearly half of doctors have encountered difficulties with patients over the recent Ranitidine ban incident, a survey showed.

Intermd, an online site for knowledge sharing among physicians, said it polled 1,021 physicians regarding the response against the Ranitidine ban from Oct. 2.

The survey result came after the Ministry of Food and Drug Safety suspended the manufacturing and selling of 269 Ranitidine-using medicines for heartburn, after detecting a carcinogen, N-Nitrosodimethylamine (NDMA), on Sep. 26.

According to the company, doctors who mostly prescribe Ranitidine participated in the survey -- internal medicine (39 percent), family medicine (19 percent), otolaryngology (7 percent), orthopedics (6 percent), neurology (5 percent), dermatology (4 percent), and general practitioners (18 percent).

Forty-nine percent of doctors said they had complaints from patients who had been taking Ranitidine for a long time. Other complaints about the Ranitidine ban included the absence of re-prescription guidelines (14 percent), difficulties in re-prescription to patients who had previously taken a portion of Ranitidine prescribed (13 percent), and concerns about choosing alternative prescription drugs (13 percent).

Also, 9 percent of doctors said they encountered difficulties as patients either doubted or distrusted the results of the regulator’s investigation into Ranitidine.

Regarding the physician's thoughts on how the ministry managed the situation, 41 percent of the doctors responded that the regulator should have controlled raw materials more thoroughly after last year's Valsartan crisis, caused by cancer-causing elements in high blood-pressure drugs.

Thirty-six percent replied the ministry is still issuing administrations orders only after foreign regulatory institutions take action. Twenty-three percent of physicians said, however, that the ministry's response was rapid and evolved when compared with the previous valsartan.

As for the ban on all Ranitidine items, 65 percent of respondents said that the suspension of sales of all items is an overreaction and can cause some confusion in hospitals, while 35 percent thought that the quick action was a job well done as the incident was directly related to national health.

Regarding the issue of NDMA detection, 70 percent of physicians said it was only a problem for Ranitidine and similar structural components, while 28 percent of physicians answered that it would be a problem for the entire H2 antagonist (H2RA) drugs.

The most effective alternative regimen for gastrointestinal disorders prescribed by doctors were H2RA medication drugs unaffected by the NDMA crisis such as Stogar and Gaster, cited by 48 percent, followed by proton-pump inhibitor (28 percent), cytoprotectant drugs (19 percent) and potassium-competitive acid blockers (4 percent).

"Its embarrassing situation as doctors have been prescribing Ranitidine drugs for a long time," a physician said. "In such circumstances, the patient and the doctor are the ones that suffer."

Another doctor said that the ministry needs to come up with a fundamental measure to prevent this from happening again.

The ministry should also release a statement making it clear that those situations are not the fault of medical institutions or doctors in responding to such cases, the doctor added.

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