Hadeer Akram Abdul Razzaq

University Sains Malaysia (USM), Malaysia

Title: The hazards of multiple pharmaceutical excipients…the unnoted polypharmacy


Hadeer Akram AbdulRazzaq has completed his PhD at 2013 in School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM). He conducted many researches in fields of clinical pharmacy and pharmacy practice. He is Assistant Professor in University Sains Malaysia (USM). He published more than 70 papers and abstracts in reputed journals and has been served as Editorial Board Member and active reviewer in several journals. He is member in American College of Clinical Pharmacy (ACCP), American Heart Association (AHA), International Society of Pharmacovigilance (ISOP), and Asian Pacific Society of Respirology (APSR).


In spite of the availability of polypharmacy guidelines for the cardiac pharmacotherapy, there has yet to be a guideline for the polypharmacy of pharmaceutical excipients. This study aims to determine whether there is an impact on the multiple uses of pharmaceutical excipients and to detect the polypharmacy of pharmaceutical excipients according to the severity of the adverse drug reactions (ADRs). There were 504 cardiac patients involved and attended at the cardiac clinic of Penang General Hospital, Malaysia. A validated self-reporting questionnaire used to collect 56 symptoms, while serious ADRs were collected from their progress file. All information about the pharmaceutical excipients was collected either from medications’ leaflets or directly from the manufacturers. The result of the study showed that polypharmacy and severity of excipients' ADRs depended on the number of the same type of excipient. The number of ADRs reported by patients was 22, 54, 42, 38, and 42 for those who received 5, 10, 15, 20, and 22 excipients respectively. Moderate and severe complaints of ADRs were significantly increased if the number of active and excipients was higher than 11 and 15 respectively. Current study predicted the polypharmacy of excipient to be 10 (alone) and 15 (with active ingredients). Pharmacists’ awareness needs to be improved by implementing education interventional programs. Beside this, the prescriptions are needed to be checked especially the pharmaceutical excipients to avoid the polypharmacy of pharmaceutical excipients in those use chronic multiple therapies to minimize the incidence of ADRs.