The Union Health Ministry implemented a ban on 156 "irrational" FDC medicines, effective immediately. These medicines, including widely used antibiotics, painkillers, and multivitamins, were commonly used to treat fever, cough, and infections. The ban was imposed due to the associated health risks and lack of therapeutic justification for the ingredients in these FDCs.

What are FDC medicines?

FDCs or fixed-dosed combinations, also known as "cocktail drugs," are medications that combine multiple drugs in a single pill. They are designed to treat multiple symptoms or conditions simultaneously. While they offer convenience, they can pose significant risks. These risks include the possibility of overdose, adverse interactions between the drugs, and the development of antibiotic resistance. Additionally, many FDC medicines lack sufficient scientific evidence to support their safety and efficacy.

Expert opinions on FDC medicines

Experts have raised concerns about the use of FDC medicines. They believe that many of these combinations lack sufficient scientific evidence to support their safety and effectiveness. Additionally, the combination of multiple drugs in a single pill can increase the risk of adverse side effects and interactions with other medications.

Experts have also found that FDC medicines may not be as effective as individual drugs in treating certain conditions. It is important to note that safer and more effective alternatives are available for most of the medical conditions that FDC medicines were used to treat. One particular concern is the inclusion of antibiotics in some FDCs. Overuse of antibiotics can contribute to the development of antibiotic resistance, a major public health threat.

The risks of FDC medicines

The use of FDC medicines can lead to adverse effects, including serious ones. Additionally, safer alternatives, tested in clinical trials, are available to treat the same medical conditions. Experts recommend prescribing drugs individually based on a patient's clinical symptoms rather than combining them in FDCs.

The ban on irrational FDC medicines by the Union Health Ministry can be seen as a positive step towards promoting rational drug use and protecting public health. The goal is to eliminate unnecessary and potentially harmful drug combinations. This is a step forward in reducing the risks associated with medication and ensure safer and more effective treatment options for patients.

The highly pathogenic avian influenza (H5N1) virus has been detected in New Zealand for the first time, raising concerns for the country's native birds.

NZ health authorities confirmed the virus in a wild seabird while stressing that there is currently no evidence of wider transmission within the country.

The infected bird, a brown skua, was found on Petone Beach in Wellington on July 10 and tested positive for H5N1. The detection comes just weeks after the virus was confirmed in Australia, a development that had prompted New Zealand authorities to prepare for its possible arrival. the country now confirming 14 infections.now confirming 14 infections.

New Zealand Biosecurity Minister Andrew Hoggard said the case appears to be isolated.

"There is no evidence of any mass mortality in wildlife or transmission between wild birds in New Zealand," Hoggard said, while urging the public to remain vigilant and report sick or dead birds.

Health and wildlife officials have launched enhanced surveillance to determine whether additional infections emerge in wild bird populations.

Global Human Cases Remain Rare but Serious

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The latest H5N1 detection comes as the US Centers for Disease Control and Prevention (CDC), in June, reported identifying 12 human H5N1 infections outside the US between August 4, 2025, and June 10, 2026.

According to the CDC, the cases were reported in:

• Bangladesh
• Cambodia
• India

Importantly, the CDC said no person-to-person transmission was identified in any of these cases. Most infections occurred after direct or close contact with infected poultry or other sick animals.

The agency said the international cases do not change its assessment that the risk of H5N1 to the general public remains low, but they reinforce the need for continued monitoring.

Cambodia's Ministry of Health on July 9 confirmed the fifth H5N1 human infection of 2026, in a 9-month-old girl from Phnom Penh. It is the 39th case in the country in the last three years.

Why Surveillance Matters

The CDC noted that sporadic human infections are expected as H5N1 continues circulating widely among wild birds and poultry across multiple regions.

"While rare, these H5N1 bird flu cases in humans underscore the need for strong systems to monitor and prepare for influenza," the agency said, calling for robust surveillance and testing.

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Bird Flu Viruses That Can Infect Humans

Scientists have identified five avian influenza virus subtypes capable of infecting humans:

• A(H5)
• A(H6)
• A(H7)
• A(H9)
• A(H10)

Although the overall risk to the public remains low, health experts called for continued surveillance in birds, animals, and humans, which will be essential as H5N1 continues to spread geographically.

How To Protect Yourself

Health authorities recommend the following precautions:

• Avoid direct contact with sick or dead wild birds and other animals whenever possible.
• Observe wildlife from a safe distance.
• Wear appropriate personal protective equipment (PPE) if handling sick or dead birds or animals is unavoidable.
• Avoid touching surfaces contaminated with bird droppings, saliva, mucus, litter, or bedding from infected or suspected animals.
• Do not consume raw milk or raw milk products, particularly from animals suspected or confirmed to be infected with avian influenza.
• Report sick or dead birds to local authorities if encountered.

Amid reports of rare botulism cases in the UK, the country's Medicines and Healthcare products Regulatory Agency (MHRA) has issued a safety warning for all botulinum toxin type A products, including Botox and other cosmetic injectables.

The regulator said cases of iatrogenic botulism—botulism caused by medical treatment—have been reported following both therapeutic and cosmetic use of botulinum toxin products when the toxin spreads beyond the intended injection site.

"Patients should seek immediate medical advice if they experience signs and symptoms," the MHRA said.

Why Are Botulinum toxin At Risk?

Botulinum toxin medicines are widely used for cosmetic procedures, such as reducing facial wrinkles, as well as for treating conditions including muscle spasms, excessive sweating (hyperhidrosis), and an overactive bladder.

While these medicines are considered safe when used correctly, the MHRA warned that, in very rare cases, the toxin can spread beyond the injection site and cause botulism—a serious and potentially life-threatening condition.

To improve awareness, the regulator has worked with manufacturers to update product information and patient leaflets to more clearly highlight the risk of iatrogenic botulism.

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Symptoms Can Appear Up to Four Weeks Later

The MHRA warned that symptoms may not appear immediately after treatment. They can develop within days or even up to four weeks after receiving a botulinum toxin injection.

Patients are advised to seek immediate medical attention if they experience:

• Difficulty swallowing
• Slurred speech or difficulty talking
• Difficulty breathing or shortness of breath
• Muscle weakness

Who Is at Higher Risk?

According to the MHRA, the risk of serious side effects may be higher in:

• People with underlying neurological disorders
• Those with a history of difficulty swallowing (dysphagia)
• Those with a history of aspiration (inhaling food or fluids into the lungs)
• Patients receiving high doses of botulinum toxin
• Procedures performed outside licensed indications or at unapproved injection sites
• Use of counterfeit or unlicensed botulinum toxin products

Health officials say early recognition of symptoms is critical, as prompt treatment can help prevent serious complications.

"While botulism is a rare infection, it can be serious. There are effective treatments available, and we recommend seeking immediate medical advice if you have had a recent treatment and are experiencing symptoms such as difficulty swallowing," said Dr. Martin Bewley, Consultant in Health Protection at the UK Health Security Agency (UKHSA).

Dr. Alison Cave, Chief Safety Officer at the MHRA, recommended that healthcare professionals and patients be aware of the symptoms of botulism and act quickly if they arise. Importantly, the expert "strongly urged the public to avoid unlicensed products and seek treatment only from appropriately qualified practitioners."

What Is Botulism?

Botulism is a rare but serious illness caused by a toxin produced by the bacterium Clostridium botulinum. The toxin attacks the nervous system and can lead to paralysis, breathing difficulties, and, in severe cases, death if not treated promptly.

Because it can rapidly affect the muscles involved in breathing, botulism is considered a medical emergency.

The US Food and Drug Administration (FDA) has approved a once-daily pill that can lower low-density lipoprotein (LDL), commonly known as "bad" cholesterol, a major risk factor for heart disease.

Developed by Merck, enlicitide, which will be marketed as Lipfendra, is the first FDA-approved oral PCSK9 inhibitor for reducing LDL cholesterol.

Lipfendra has been approved as an adjunct to diet and exercise to reduce LDL cholesterol in adults with primary hypercholesterolemia, including those with heterozygous familial hypercholesterolemia (HeFH).

The approval is based on two Phase 3 clinical trials showing that Lipfendra can reduce LDL cholesterol to 50–60 mg/dL or even lower in many patients.

"Results from these Phase 3 trials showed treatment with Lipfendra resulted in reductions across other atherogenic lipoproteins associated with atherosclerotic cardiovascular disease (ASCVD) risk, including non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (ApoB)," Merck said.

High LDL cholesterol is a major risk factor for atherosclerotic cardiovascular disease (ASCVD), the leading cause of death globally.

"In two Phase 3 trials, LIPFENDRA led to impressive reductions in LDL-C. Now, for the first time, patients have an oral PCSK9 inhibitor for LDL lowering," said Dr. Ann Marie Navar, lead author of the clinical trial and associate professor at the University of Texas Southwestern Medical Center.

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How Does Lipfendra Work?

Lipfendra is a 20 mg once-daily tablet that works by blocking PCSK9, a protein that regulates LDL receptors in the liver.

Normally, PCSK9 reduces the number of LDL receptors available to remove cholesterol from the bloodstream. By inhibiting this protein, Lipfendra allows more LDL receptors to remain active, enabling the liver to clear more LDL cholesterol from the blood.

Unlike statins, which lower cholesterol by blocking an enzyme the liver uses to produce cholesterol, Lipfendra targets the PCSK9 pathway. It is also the first oral medicine in this class, whereas existing PCSK9 inhibitors are administered as injections.

What Did the Clinical Trials Show?

The FDA approval was supported by two Phase 3 studies, including a 24-week trial involving 2,912 participants, which demonstrated significant reductions in LDL cholesterol.

The studies found that:

• Lipfendra lowered LDL cholesterol by up to 60%.
• Many participants achieved LDL levels of 50–60 mg/dL or lower.
• The drug also reduced non-HDL cholesterol and ApoB, two additional markers associated with cardiovascular risk.
• Side effects were similar to those seen with placebo.

The cholesterol-lowering effect was comparable to that seen with injectable PCSK9 inhibitors.

Merck is now conducting a cardiovascular outcomes trial to determine whether Lipfendra also lowers the risk of heart attacks, strokes and cardiovascular death, as injectable PCSK9 inhibitors have previously been shown to do.

Lipfendra: How Much Does It Cost?

Merck said Lipfendra will be available in the United States within the next few weeks. The company has set a list price of $315 for a 30-day supply, according to Merck spokeswoman Julie Cunningham.

Who Could Benefit From Lipfendra?

Lipfendra is intended for adults with hypercholesterolemia, a condition characterized by elevated LDL cholesterol that can lead to plaque buildup in the arteries.

The drug may particularly benefit:

• Adults with primary hypercholesterolemia.
• People with heterozygous familial hypercholesterolemia (HeFH).
• Patients who need additional LDL lowering despite diet, exercise or statin therapy.
• Individuals looking for an oral alternative to injectable PCSK9 inhibitors.