Bitter Pills:Medicines & The Third World Poor | Page 110

that "their use as body-builders or tonics is quite unjustified", not least because
anabolic steroids have very nasty side-effects. <63) They can cause irreversible
virilisation (hirsutism, enlargement of the clitoris and deepening of the voice).
Most patients on anabolic steroids suffer some adverse effects to the liver, which
can include jaundice and liver tumours. Another possible side effect is sodium
retention causing oedema and heart failure. But experts stress that they can be
particularly harmful to children:' 'The use of anabolic steroids to promote growth
in underdeveloped children may lead to premature fusion of the ephiphyses and
stunting of growth in adolescence." <64>
ORABOLIN DROPS
However, in Bangladesh the Dutch manufacturers Organon have been promoting
a number of anabolic steroids specifically "for paediatric use in conditions like
marasmus, malnutrition, poor weight gain, retarded growth, kwashiorkoretc,"
listing one advantage after another without a word of warning about the hazards.
Doctors are told, for example, that either one of Organon's two products
Durabolin and Deca-Durabolin "stimulates appetite and ensures adequate food
intake ... checks protein depletion... increases resistance against infectious diseases
[ and ] improves the general constitution and restores sense of well being''. (6S|
Dr. Schweiger, a British doctor working in a remote rural area of Bangladesh,
drew our attention to the problem in 1980. A visiting Organon sales representative
had specifically pointed out their anabolic steroid, Orabolin drops, because he
knew the doctor was "working with malnourished children". <66) The insert on
Orabolin from the Therapeutic Index of Organon (Bangladesh) is reproduced
overleaf together with Organon's data sheet on Organon tablets for British
doctors. (Orabolin Drops are not sold in Britain.)
Doctors in Bangladesh have been told that Orabolin is "a powerful anabolic agent"
which is "exceptionally well tolerated, causes no fluid retention and is free from
harmful effects on liver... The raspberry flavoured liquid administered in drops
is especially meant for younger children and infants." No warnings are given.(67)
Doctors in Britain are advised that Orabolin is "not recommended for children".
Warnings include the fact that "anabolic steroids may cause fluid retention
.. .tumours of the liver have been reported occasionally'', and that the development
of tumours "cannot at present be excluded, and this should be considered when
the use of this product is proposed, especially in young people who are not suffering
from life-threatening disorders". (68)
In December 1981 Organon informed us that "It is our policy that promotion
both verbal and written should be confined to indications as approved by the
respective health authorities. It is therefore obligatory for local companies to have
all material used for doctors' information approved by headquarters.
Unfortunately sometimes the system does not work and something slips through.
The printed material you saw, when in Bangladesh [ i.e. September 1980 ] had
not yet arrived (and consequently not approved) with Organon International. We
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