National List Of Essential Medicines (NLEM) 2022: Popular Antacid And 25 Medicines Removed, Full List

Dr Mansukh Mandaviya, Union Minister for Health and Family Welfare, has released the National List of Essential Medicines (NLEM) 2022. It includes 384 medicines, eight more than the last list issued in 2015. The last list in 2015 included 376 medicines. Nevertheless, 34 new medicines have been added to the current list, while 24 medicines have been removed.

"Several antibiotics, vaccines, anti-cancer drugs and many other important drugs will become more affordable and reduce patients' out-of-pocket expenses," said Mandaviya following the release of the list.

National List Of Essential Medicines (NLEM) 2022: Updates

• The Union health ministry eliminated 26 drugs from the newly revised list released by the National List of Essential Medicines (NLEM), including ranitidine and other stomach-related medications.
• Ranitidine is commonly sold under the trade names Aciloc, Zinetac, and Rantac, among others, and is commonly prescribed to treat acidity and stomachaches [1].
• Over 350 experts were consulted, and 140 consultations were held by an independent committee.
• According to the Food and Drug Administration (FDA), all ranitidine products, both injectable and oral, were recalled earlier in 2020 following the discovery of low N-nitrosodimethylamine (NDMA) levels. According to research, N-nitrosamines have been associated with stomach, oesophagus, nasal cavities, and bladder cancers [2][3].
• A total of 384 drugs are now covered by the NLEM, including anti-infectives such as ivermectin, mupirocin, and nicotine replacement therapy drugs [4].
• Union Health Minister Mansukh Mandaviya has announced a price cap in order to reduce patients' medicinal expenses. He added that some antibiotics, vaccines and anti-cancer drugs would now be more affordable and more accessible.
• It is expected that the prices of the number of high-demand medicines in India will decrease with the release of the new essential list, including insulin glargine for diabetics, delamanid for tuberculosis, and ivermectin for parasites.

List Of Essential Medicines Removed

The Health Ministry released the new National List of Essential Medicines (NLEM), which contains 384 drugs. Meanwhile, 26 drugs that were removed from the list will cease to be available in the country.

The 26 excluded medicines include:

1. Alteplase
2. Atenolol
3. Bleaching Powder
4. Capreomycin
5. Cetrimide
6. Chlorpheniramine
7. Diloxanide furoate
8. Dimercaprol
9. Erythromycin
10. Ethinylestradiol
11. Ethinylestradiol(A) Norethisterone (B)
12. Ganciclovir
13. Kanamycin
14. Lamivudine (A) + Nevirapine (B) + Stavudine (C)
15. Leflunomide
16. Methyldopa
17. Nicotinamide
18. Pegylated interferon alfa 2a, Pegylated interferon alfa 2b
19. Pentamidine
20. Prilocaine (A) + Lignocaine (B)
21. Procarbazine
22. Ranitidine
23. Rifabutin
24. Stavudine (A) + Lamivudine (B) 25. Sucralfate
26. White Petrolatum

On A Final Note...

The Health Ministry has discussed the matter with the Drug Controller General of India and All India Institute of Medical Sciences (AIIMS) regarding removing ranitidine from the essential stock of medicines due to concerns related to cancer throughout the world.

Rantac has been under investigation since 2019, when the US-based Food and Drug Administration found probable cancer-causing impurities in the drug. As part of a drug safety review, drug regulators discovered that ranitidine samples contained "unacceptable levels" of the cancer-causing impurity N-nitrosodimethylamine (NDMA).