Take Two Candies, Call in Morning

by

Paulo Rebêlo
Wired News
June, 2002

Few people enjoy taking medicine, but how about if it came packaged in candy or ice cream?

That’s what the Brazilian National Association of Magistral Pharmaceutics (Anfarmag) is bringing to Brazil this year.

In an official note earlier this month, Anfarmag said that med-candies are the best solution for kids who face problems swallowing pills or just can’t stand the taste of some medicine. “Children don’t refuse medicine when they taste and are shaped like a lollipop, for example,” says Marco Perino, Anfarmag’s vice president.

The idea of dispensing medicine in candy form has been a controversial subject for more than 50 years, with the primary concern centering on the fear of overdose.

“The dangers may outweigh the benefits,” said Dr. Humayun J. Chaudhry, chairman of the Department of Medicine at the New York College of Osteopathic Medicine. “Adults are able to tell the difference between candies and medication, but it would certainly not be realistic to expect the same thing from children.”

Even for adults, he added, there’s the constant risk of overdose or wrong dosage. It’s far more likely for someone to swallow an entire pill than eat an entire lollipop.

In April, the U.S. Food and Drug Administration (FDA) told three American pharmacies to stop selling nicotine lollipops and nicotine lip balm over the Internet — products considered illegal since they didn’t have the FDA approval. The FDA said that candy-like products present a risk of accidental use by children.

Nevertheless, such directives aren’t expected to happen in Brazil. Anfarmag represents the so-called “manipulation pharmacies,” which neither requires a previous authorization or an official registry in the Brazilian Health’s Ministry. However, manipulated drugs can be sold only at manipulation pharmacies, so customers will be properly warned.

“Some of these pharmacies are already implementing the candy-like technology in Brazil for testing purposes, but we expect the real boom only after October when we’ll promote an international seminar of magistral pharmaceutics,” Perino said.

According to Perino, everybody is aware of the overdose risk especially among children. “The intoxication rate is high and candy-like drugs requires more accurate treatment. But we expect a double caution from the Brazilian families.”

Dr. Mario Geller, Fellow of the American College of Allergy, Asthma & Immunology, believes that the controversy isn’t that complex at all. He summed up candy-medicines as both good and bad: good, because kids will take them; bad, because they increase the likelihood of overdose. “The risk/benefit ratio should be balanced when regulations are set for each community,” said Geller, who’s currently in Rio de Janeiro.

Despite taste and shape, the drug packages also seem to be another concern.

In the United States, there’s the example of Sweet Tarts, a sour-tasting candy popular among children, which looks almost identical to Tums, a sweet-tasting antacid available over the counter that contains calcium carbonate as its active ingredient. According to Chaudhry, in excess dosage Tums may be harmful to the gastrointestinal and metabolic state of a child, if not fatal.

If a tasty medicine can achieve enough consistency and assure complete use, many argue that it is worth having available. Although the corporate desire to sell more and more medicine is a fairly known aspect among specialists.

“If this initiative really gets going, education of the public will be essential, child-resistant caps should be mandatory, such medication should be kept away from children and be thrown away when it expires. The danger to children of these candy-like drugs is too high to risk even introducing these products to the general population,” Chaudhry said.