Pharmaceuticals: Restrictions in Use and Availability
(2001; 40 pages) View the PDF document
Table of Contents
Open this folder and view contentsIntroduction
Close this folderMonocomponent products
View the documentAlatrofloxacin mesilate
View the documentAldesleukin
View the documentAmineptine
View the documentAmfepramone hydrochloride
View the documentAristolochia
View the documentAstemizole
View the documentBromfenac
View the documentBuprenorphine
View the documentBuspirone hydrochloride
View the documentCamphor
View the documentChlormezanone
View the documentCisapride
View the documentDantron
View the documentDequalinium
View the documentDexfenfluramine hydrochloride
View the documentDiphenoxylate
View the documentDoxycycline hydrochloride (capsules)
View the documentDronabinol
View the documentEbrotidine
View the documentEpoetin alfa and epoetin beta
View the documentErythrityl tetranitrate
View the documentFenfluramine
View the documentFlunitrazepam
View the documentFurazolidone
View the documentGentamicin (topical preparations)
View the documentGrepafloxacin hydrochloride
View the documentGinkgo biloba
View the documentKetamine hydrochloride
View the documentKetorolac
View the documentLamivudine
View the documentLevamisole hydrochloride
View the documentLexipafant
View the documentLoxoprofen sodium
View the documentMedifoxamine
View the documentMepacrine
View the documentMetamizole sodium
View the documentMethylrosanilinium chloride
View the documentMetoclopramide (paediatric)
View the documentMibefradil
View the documentMisoprostol
View the documentNandrolone
View the documentOxeladin citrate
View the documentPexiganan
View the documentPhenolphthalein
View the documentPhentermine
View the documentPhentolamine mesilate
View the documentPhenylbutazone
View the documentPiperazine
View the documentPromethazine
View the documentProxibarbal
View the documentPyrithione zinc
View the documentPumactant
View the documentRituximab
View the documentSertindole
View the documentSibutramine
View the documentSulfaguanidine
View the documentTerfenadine
View the documentTilbroquinol
View the documentTolcapone
View the documentTramadol
View the documentTroglitazone
View the documentTrovafloxacin mesilate
View the documentZopiclone
Open this folder and view contentsCombination Products
Open this folder and view contentsGroup Products


Product name:


CAS number:



1[(4-fluorophenyl)methyl]-N-[1-[2-(4-methoxyphenyl)ethyl]- 4-piperidinyl]-1H- benzimidazol-2-amine


Effective Date

Description of action taken
Grounds for decision


July 2000

Astemizole has been voluntarily withdrawn on the basis of prolongation of the QT-interval and ventricular arrhythmias. (Reference: Communication to WHO, 9 August 2000)

Brunei Darussalam

July 1999

The manufacturer withdrew astemizole worldwide because of serious adverse cardiovascular reactions. (Reference: Official letter to Regulatory Agencies, Jansses-Cilag, 1 July 1999.)


June 1999

Astemizole was withdrawn from the market following reports of adverse drug reactions published by the FDA and the decision of Janssen Pharmaceutica to remove the drug in the USA. (Reference: Letter to WHO from the Ministry of Health and Quality of Life, Port Louis, Mauritius, 27 December 2000.)



The Department of Health Bureau of Food and Drugs have noted the voluntary withdrawal by the sponsoring company of the antihistamine, astemizole due to its association with severe cardiac adverse events when used inappropriately with contraindicated drugs. (Reference: Communication from the Department of Health and Bureau of Food and Drugs to WHO, 15 August 2000.)



The National Pharmaceutical Administration in the Ministry of Health has banned astemizole since it has been associated with adverse drug reactions including irregular heart rhythms and severe allergic reactions if taken at higher than recommended doses or in conjunction with some other drugs including antihypertensives and anti-asthmatics. (Reference: Communication to WHO, 2 August 2000.)

South Africa


The South African Medicines Control Council has withdrawn products containing astemizole because of the potential for serious drug interactions. (Reference: Information from the Pharmaceutical Services in the Ministry of Health in South Africa.)


2 July 1999

The Pharmacy Board of the Ministry of Health, in the United Republic of Tanzania has withdrawn astemizole from the market. (Reference: Communication to WHO from the Ministry of Health, Tanzania, 20 November 2000.)

United Kingdom


Astemizole has been reclassified to Prescription only Medicine as a result of new data on interactions from postmarketing surveillance studies. These data highlight an increased risk of QT prolongation with concomitant administration of oral or parenteral formulations of azole antifungals, macrolide antibiotics except azithromycin, selective serotonin reuptake inhibitors, HIV protease inhibitors and mibefradil (now withdrawn worldwide). In addition, astemizole is contraindicated for use in patients with hepatic dysfunction. (Reference: The Pharmaceutical Journal 261, p.9, 4 July 1998.)

United Arab Emirates

June 1999

The Ministry of Health has banned the sale of astemizole with effect from 23 June 1999 on account of increased risk of QT prolongation with concomitant administration of oral or parenteral formulations of azole antifungals, macrolide antibiotics except azithromycin, selective serotonin reuptake inhibitors and HIV protease inhibitors. (Reference: Communication with WHO, 10 July 2000



Janssen, the manufacturer of the histamine H1-receptor antagonist, astemizole, (HismanalR) has announced that it is voluntarily withdrawing the 10-mg formulation from the market. Since the drug's approval in 1988, new adverse reaction data has necessitated a series of labelling changes and warnings. In the light of the choices of other prescription antihistamines now available and the overall risk benefit profile of this drug, the Food and Drug Administration supports the decision of the company to withdraw the product. (Reference: FDA Talk Paper T99-29, 21 June 1999.)

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