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According to the Ho Chi Minh City Department of Health, in addition to the addition of 1,000 gamma-globulin vials, 21,000 injectable phenobarbital tubes have recently arrived in Vietnam after a long interruption, promptly supplementing an important source of medicine for the treatment of severe hand, foot and mouth disease at 3 specialized pediatric hospitals and the Tropical Diseases Hospital in the city, which is at its peak.
Phenobarbital is an important treatment drug included in the treatment regimen for hand, foot and mouth disease issued by the Ministry of Health in Decision No. 1003/QD-BYT dated March 30, 2012. According to this regimen, phenobarbital can be taken orally or by injection, with injection being preferred in severe cases.
Phenobarbital is used for children with many advantages and few side effects and has been used by doctors for pediatric patients for a long time.
In recent weeks, the number of hand, foot and mouth disease cases has increased rapidly with the reappearance of Enterovirus 71 genotype B5,...
In hand, foot and mouth disease, phenobarbital has the role of stopping prolonged seizures and preventing seizure recurrence. In addition, phenobarbital also has a sedative effect, reducing neurological manifestations and startles in children. In addition, when there is cerebral edema (in severe cases), the drug contributes to reducing cerebral edema and reducing the brain's need for oxygen consumption.
Injectable phenobarbital has a rapid onset of action in a short period of time (5 minutes after injection), reaches peak effect quickly (15-30 minutes) and has a relatively short duration of action (6 hours). Compared to the oral form, it has a late onset of action (> 60 minutes), a long duration of action (10-12 hours) and depends on the absorption of each child. Injectable phenobarbital is indicated for children with hand, foot and mouth disease in the risk group and severe group (group 2b, group 3).
Oral phenobarbital may be used for children with group 2a hand, foot and mouth disease (mild, can be monitored). In hand, foot and mouth disease (or other diseases) where the child has seizures, the first-line drug is a benzodiazepine such as diazepam or midazolam, not phenobarbital.
However, difficulties in treatment have occurred when the domestic supply of phenobarbital has been limited and interrupted for a long time since the end of 2020. In this situation, the professional council of the Ho Chi Minh City Department of Health met and agreed to choose other temporary sedatives to replace those currently on the market such as Diazepam, Midazolam... while waiting for Vietnamese pharmaceutical enterprises to find supplies from other countries as soon as possible.
At the same time, the Department of Health also sent an official dispatch requesting the Drug Administration of Vietnam - Ministry of Health to support in finding drug supply sources and importing companies to meet the treatment needs of Phenobarbital in hospitals.
According to the announcement from the Drug Administration of Vietnam in Official Dispatch No. 8498/QLD-KD dated June 22, 2020 regarding the supply of Phenobarbital 100mg/ml, the manufacturer Daihan Pharm Co., Ltd will no longer produce Danotan. The Department has sent a document requesting drug importing companies to contact foreign partners to find alternative drug sources.
After a long search, on February 1, 2023, Central Pharmaceutical Joint Stock Company CPC1 found a supplier of alternative phenobarbital and was granted a license to import 21,000 vials of Barbit injection 200mg/ml (phenobarbital injection) from the manufacturer Incepta Pharmaceutical Ltd (Bangladesh) to Vietnam by the Drug Administration of Vietnam.
It took a long time to complete the procedures because Phenobarbital is a psychotropic drug in the group of drugs that must be specially controlled, so it requires an export license from the competent authority of the exporting country. By July 31, 2023, 21,000 tubes of injectable phenobarbital had arrived in Vietnam and were immediately supplied by Central Pharmaceutical Joint Stock Company CPC1 to specialized pediatric hospitals and the Hospital for Tropical Diseases in Ho Chi Minh City to serve the treatment of hand, foot and mouth disease, which is at the peak of the epidemic.
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