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Excipients with Known Action


Announcement: List of Excipients with Known effect available in the medicines authorized for use in Lebanon

Date March 5th, 2024

The Lebanese National Pharmacovigilance Program (LNPVP) at the Ministry of Public Health (MoPH) has undertaken a comprehensive review of the available medicines authorized for use in the Lebanese market, with the collaboration and support of drug distributors and Marketing Authorization Holders (MAH) who actively contributed to the project.

The Role of Excipients in Medicines

According to the European Medicines Agency (EMA), excipients, constituents in medicines excluding the active substance, play crucial roles in drug formulation. These roles range from aiding in manufacturing processes to enhancing stability, bioavailability, and patient acceptability.

Understanding Excipients with Known Effect in Drug Formulation

Excipients contribute to product identification, overall safety attributes, effectiveness, and the delivery of the drug in use. Additionally, they play a key role in maintaining the integrity of drug products during storage. Although excipients are generally considered 'inert’, it is important to note that some may have a recognized action or effect in specific circumstances. Excipients with known effects may pose challenges in sensitive patients (those with allergies or specific intolerance syndromes), necessitating particular precautions during use. Therefore, to ensure the highest level of safety, it is advisable to consider these excipients when prescribing, dispensing, or providing advice on any medication.

The objective of the project

The main objective of the project was to establish a thorough compilation of excipients with known effects present in medications authorized for use in the Lebanese market in 2024. This compilation specifically focused on drugs for which input was received from both drug distributors and Marketing Authorization Holders (MAHs). As such the list is not exhaustive, and Healthcare professionals should give special care to controlling the excipients when prescribing or dispensing any medication.The received list underwent rigorous cleaning, validation, and compilation processes to serve as a valuable reference for identifying excipients with known effects that might be subject to inquiry.

List of Excipients with Known effect available in the medicines authorized for use in Lebanon
 
Excipients with a Known Effect List to be filled by the drug distributors
 
On behalf of the Lebanese National Pharmacovigilance Program (LNPVP) at the Ministry of Public Health (MoPH), we kindly request to provide information regarding your products in the context of a project on “Excipients with a Known Effect or Action”. 

The information related to pharmaceutical excipients with known effects is important in pharmacy practice. In general, excipients are considered to be ‘inert’. Whilst it is desirable that excipients should have little or no pharmacological action of their own, some do indeed have a recognized action or effect in certain circumstances. Excipients with a known effect have the particularity of being poorly tolerated in sensitive patients (allergic or presenting a particular intolerance syndrome) and require certain precautions for use. Consequently, in order to guarantee the best level of safety, it is useful to take these excipients into account when prescribing, dispensing or even advising of any medication.

The project aims to provide a list of drugs marketed in Lebanon with their corresponding excipients that have a known action or effect in certain circumstances.
 
You are therefore kindly requested to identify, from the provided list (Excipients with a Known Effect List to be filled by the drug distributors), the excipients with a known effect that are present in your corresponding drug products.

To this end, you are kindly invited to apply the following instructions:

The below link for the excel sheet (Excipients with a Known Effect List to be filled by the drug distributors) is a list of the products marketed in Lebanon with their relevant information. It is extracted from the latest Drugs Public Price List from the MoPH’s official website. (extracted on 7th March, 2023) Excipient List to be filled by drug distributors in Lebanon
 
For each of your products:
  1. In the “Agent” column (Column C), apply the filter to choose your company name; this will display only your products in the “Brand name” column (Column D).
  2. In the “Excipients” column (Column K), choose for each of your products the identified excipients from the dropdown list provided. To access the dropdown list, select the cell (under the ‘Excipient” column) corresponding to each product; a downwards arrow will appear at the lower-right corner of the cell. Select it and choose from the provided list of excipients.
  3. If your product contains more than one excipient, include each in a separate column (Columns M and O). Add as much columns as needed. If your product doesn’t contain any of the listed excipients, select the “None” option from the excipients’ dropdown list.
  4. Fill the “Route of Administration” column (Column J) appropriately using the drop down list. (Capitalize only the first letter)
  5. Fill the “Comment” column (Column Q) with any information present on the label and /or package leaflet regarding the identified excipients. If nothing is mentioned keep the cell blank.
  6. Please refer to raw number 4 as an example.
  7. Send us the filled excel sheet at the following email addresses: excipients.moph@gmail.com or excipients@moph.gov.lb
  8. Ensure that your file is named as follow: (name of the distributor-excipientlist2023),Example: Mersaco-excipientlist2023
 
You are kindly expected to reply back within 2 months after receiving this email (by May 31st, 2023), the latest.
 
Thank you for your time and cooperation.

Reminder,

Reference to previous communication related to the submission of Excipients with a known Action list, we would like to kindly remind all drug distributers and local manufacturers to complete this list by May 31st, 2023.

As per the previously shared instruction, the list must be filled out with utmost accuracy. It is essential to carefully select the appropriate excipient(s) and indicate the salt with its corresponding dose in the excipient dose section. Additionally, it is important to include any relevant package leaflet information in the comment section. We stress the importance of adhering to these instructions to ensure the safety and efficacy of medication use.

In case there are there are no excipients with known action in your corresponding products, please verify this by an email to excipients.moph@gmail.com.

We appreciate your cooperation in this matter.

Quality Assurance of Pharmaceutical Products Department
Lebanese National Pharmacovigilance Program
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ATC Name B/G Ingredients Dosage Form Price
R05CA12 LIBLAB COUGH SYRUP G Dried Ivy leaf extract - 35mg/5ml 35mg/5ml Syrup 237,860 L.L
R05CA12 HEDECTON COUGH G Ivy leaf soft extract - 40mg/5ml Syrup 467,657 L.L
R05CB01 FLUIMUCIL B N-acetylcysteine - 600mg 600mg Tablet, effervescent 567,102 L.L
R05CB01 ACC LONG G N-acetylcysteine - 600mg, Vitamin C - 75mg 600mg Tablet, effervescent 286,238 L.L
R05CB01 EXOMUC B N-acetylcysteine - 200mg 200mg Granules for solution 588,603 L.L
R05CB01 TREBON N G Acetylcysteine - 600mg 600mg Granules for suspension 596,666 L.L
R05CB01 FLUIMUCIL MUCOLYTIC B N-acetylcysteine - 2% 2% Syrup 595,322 L.L
R05CB02 BROMHEXINE G Bromhexine - 4mg/5ml 4mg/5ml Elixir 176,619 L.L
R05CB03 MUCOTAL PEDIATRIQUE G Carbocysteine - 100mg/5ml 100mg/5ml Syrup 298,205 L.L
R05CB03 MUCOTAL ADULTE G Carbocysteine - 250mg/5ml 250mg/5ml Syrup 308,444 L.L
R05CB06 API-MUCOL G Ambroxol HCl - 15mg/5ml 15mg/5ml Syrup 326,554 L.L
R05CB06 FLUIBRON G Ambroxol - 15mg/5ml 15mg/5ml Syrup 459,594 L.L
R05CB06 MUCUM G Ambroxol HCl - 15mg/5ml 15mg/5ml Syrup, sugar free, alcohol free 98,101 L.L
R05CB06 MUCOSOLVAN B Ambroxol HCl - 30mg/5ml 30mg/5ml Syrup 380,307 L.L
R05CB06 MUCOVIC FORTE G Ambroxol HCl - 30mg/5ml 30mg/5ml Solution, sugar free 293,086 L.L
R05CB06 MUCOVIC FORTE G Ambroxol HCl - 30mg/5ml 30mg/5ml Solution, sugar free 440,268 L.L
R05CB06 MUKORAL G Ambroxol - 30mg 30mg Tablet 201,576 L.L
R05CB06 MUCOSOLVAN LA B Ambroxol HCl - 75mg 75mg Capsule 345,368 L.L
R05CB06 SOLVAMUC SR G Ambroxol - 75mg 75mg Capsule 276,448 L.L
R05CB10 DILAMUC G Dried Ivy leaf extract - 170mg/100ml, Glycyrrhizic acid (Glycyrrhiza Glabra, Liquorice root) - 164mg/100ml, Thyme - 760mg/100ml Syrup 456,906 L.L
R05CB13 PULMOZYME BioTech Dornase alfa (desoxyribonuclease) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 54,658,804 L.L
R05CB13 PULMOZYME BioTech Dornase alfa (desoxyribonuclease) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution L.L
R05D 123 COLD AND FLU B Phenylephrine HCl - 5mg, Carbinoxamine HCl - 3mg, Caffeine anhydrous - 30mg, Codeine phosphate - 8mg, Acetaminophen - 325mg Tablet 409,552 L.L
R05D DULSANA WITH CODEINE B Menthol - 0.25mg/5ml, Ammonium chloride - 100mg/5ml, Codeine phosphate - 10mg/5ml, Ephedrine HCl - 4mg/5ml, Carbinoxamine maleate - 2mg/5ml Syrup 273,888 L.L
R05DA09 DIACOL G Dextromethorphan HBr - 27mg/15ml 27mg/15ml Syrup 442,124 L.L
R05DA20 ALGOMIEL COUGH SYRUP G Dextromethorphan HBr - 5mg, Carbinoxamine maleate - 2mg Syrup 639,925 L.L
R05DB13 SINECOD B Butamirate dihydrogenocitrate - 15mg/10ml 15mg/10ml Syrup, sugar free 521,411 L.L
R05DB13 RAPICOD G Butamirate citrate - 0.15% 0.15% Syrup 296,989 L.L
R05DB13 TUSSIN G Butamirate citrate - 7.5mg/5ml 7.5mg/5ml Syrup, sugar free 296,925 L.L
R05DB13 TUSSIN G Butamirate citrate - 7.5mg/5ml 7.5mg/5ml Syrup, sugar free 154,862 L.L
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    169
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