Ciprofloxacin counterfeited with zinc phosphide in India #fakedrug

Recent death of about 15 women in Indian state of Chhattisgargh has been linked to counterfeited antibiotics called ciprofloxacin. The women who visited sterilization camp were given this drug as antibiotic drug after the operation. Media reports citing government officials have said that laboratory tests of the drug, which was mass distributed in that area, was found to contain a poisonous chemical known as zinc phosphide. 

What is Ciprofloxacin?

Ciprofloxacin is 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic acid with a faintly yellowish in color. It is a commonly used drug to kill both gram-negative and gram-positive pathogens (antibiotic) from a group of fluoroquinolone. This drug is used to treat problems including infections of bones and joints, endocarditis, gastroenteritis, malignant otitis, respiratory tract infection, cellulitis, urinary tract infection, prostatitis, etc. It was 35st most prescribed drug and 5th most commonly prescribed antibacterial in the USA in 2010. Thats why many counterfeiters have targeted this drug to make money illegally. 

Chemical structure of Ciprofloxacin

What is counterfeit drug?

The contaminated suspect drug reported recently in India was produced by a local pharmaceutical company. India is known for producing fake or sub-standard or counterfeited drugs. There were several concerns about the drugs produced in India. According to WHO, fake medicines are a global problem and they mostly come from developing countries including India and mostly end up in Africa. The United States Food and Drug Administration (FDA) has banned at least 35 manufacturing plants from India. One WHO report tells that one in every five drugs sold by Indian manufacturers was spurious. In a recent survey, about 12% drugs sold in Delhi were found to be sub-standard.

According to FDA counterfeit drugs are fake drugs containing contamination or wrong or no active ingredient. They may contain wrong dose and illegal and harmful to health.

Zinc phosphide is a gray crystalline inorganic compound commonly used to kill rodents. It is is added ~1% in rat food to kill the rat. Acid hydrolysis of phosphide releases a toxic gas known as phosphine. There is no clear logic why the Indian counterfeiter added this poison to the antibiotic pills.