Contaminated medicines (Cold Syrup) in Iraq

The World Health Organization (WHO) have issued a medical alert about a batch of substandard (contaminated) medication identified in Iraq. Substandard medical products are products that fail to meet either their quality standards or specifications.

The affected medication is COLD OUT Syrup, with active ingredients listed as paracetamol and chlorpheniramine maleate. The combination of these ingredients are used to relieve symptoms associated with the common cold and allergies.

Samples of this syrup were found to contain unacceptable amounts of diethylene glycol and ethylene glycol contaminants which can be toxic to humans when consumed and can prove fatal.

Further information about this adverse event, including the affected batch numbers of medication are detailed in the WHO medical product alert.

Advice for Travellers

Substandard and falsified (counterfeit) medical products are a growing problem that occurs throughout the world. A wide range of substandard and counterfeit medicines are available, including pain medications, antimalarials, antibiotics, blood pressure medicine and vaccines.

If during travel a traveller requires medication for a new illness or condition they should be advised:

• to only purchase medicines from a reputable pharmacy or medical facility and obtain a receipt
• to inspect packaging closely for signs of poor-quality printing, spelling or labelling, which may suggest counterfeiting
• not to obtain medicines from people or suppliers which are not linked to a reputable pharmacy or medical facility

Travellers who take regular or intermittent medication should be encouraged to obtain these in the UK prior to travel, especially if there is any cause for concern about the legitimacy or quality of medications or medical products at their destination.

• Whenever possible, travellers should take sufficient supplies of chronic and preventative medicines, including over the counter medications to treat simple conditions with them to cover the duration of the trip, including extra to cover potential delays, lost, stolen or damaged supplies.
• Those travelling with children may wish to bring medicines from the UK with them to alleviate common symptoms such as mild pain, cold symptoms and/or fever.

In the event that further medicines need to be obtained abroad (for example, if a trip is extended, medicines are lost or stolen or the planned itinerary is changed) then travellers, in addition to the measures above, should also be advised to:

• carry a copy of their prescription which should include both the generic and brand names of any medicines they are taking
• ask the pharmacist about the active ingredient in the medicine and check that it is the same as their own medicine

See the TRAVAX Counterfeit Medicines and Travelling with Medicines pages for further information.