Saturday, April 10, 2010

.: I am a Muslim doctor :.

born not to be an ordinary doctor. born to be a Muslim doctor.

muslim doctor is different from other doctor. he not only treat patient physically but also spiritually. muslim doctor always remind his patients about purpose of living in this world. i also would like to be one.

arixtra vs heparin vs clexane

one of patient that i attended has DVT. she is a pregnant woman in 17 weeks of pregnancy. she presented with unilateral right leg swelling upto thigh at 9 weeks of pregnancy and was diagnosed to have DVT. she was treated with clexane.

i flash backed meeting with another patient about 3 months ago. he also got clexane for his heart problem. that was the first time i heard about that medication. he told me that he was informed by the nurse about ingredients of clexane. there is pig enzyme in clexane. he cannot refuse clexane as he was told that clexane is the best drug for him. i paused, not knowing what to say and not knowing about alternative drug.

now, the similar case comes back to me. it urged me to find the answer. what drug can substitute clexane (which is 'halal')? is clexane better than heparin? why not give heparin?

now i know that:
heparin is derived from porcine or bovine.
clexane is low molecular weight heparin, is derived from intestinal mucosa of pigs.

"Muzakarah berpandangan bahawa Islam menegah penggunaan ubat dari sumber yang haram bagi mengubati sesuatu penyakit, kecuali dalam keadaan di mana tiada ubat dari sumber yang halal ditemui dan bagi menghindari kemudharatan mengikut kadar yang diperlukan sahaja sehingga ubat dari sumber yang halal ditemui.

Oleh itu, berhubung dengan penggunaan ubat Clexane dan Fraxiparine yang dianggap darurat kepada para pesakit bagi mencegah formulasi pembekuan darah secara serta-merta ketika pesakit berada pada tahap kronik, Muzakarah bersetuju memutuskan bahawa penggunaan kedua-dua jenis ubat ini adalah ditegah kerana ia dihasilkan dari sumber yang diharamkan oleh Islam, memandangkan pada masa ini telah terdapat alternatif ubat iaitu Arixtra yang dihasilkan daripada sumber halal dan mempunyai fungsi serta keberkesanan yang sama dengan Clexane dan Fraxiparine."

also, i've found an article written in NST (new straits times) about arixtra. so, we should have no doubt not to use clexane as first choice. we should first choose arixtra. go!go!arixtra!

however, the problem is 'is arixtra widely used in Malaysia?', 'is every hospital in malaysia has arixtra?'

this is not a joke. this is not something that we can play2. if not us, muslim doctors, who else would stand, backing up our muslim patients?

patients are innocent. they don't know options they have. they put their trust on doctors.
so we, muslim doctors should not disappoint them. give the best for patients' benefits. to gain not only medical knowledge but also 'medical fiqh' is essential for us, muslim doctors.


Jacknaim said...

salam. sebenrnya ada satu lg pendapat yg membenarkan penggunaan clexane.. ade mse nanti sy post. ada perbahasan dia.

tp of course, the best ialah utk cr yg non-orcine base. utk pregnant lady, bleh je cuba heparin and change to warfarin masa third trimester

tautanhati said...

terima ksh for the sharing.jgn lupa n jgn lama2 ye.nk tau psl perbahasan tu.

~cAhaYap3tUnjUk~ said...

saya pon dah lame tercari2 tentang perbahasan penggunaan clexane tu... rase bersalah je bile tgk patient muslime diberi clexane even kadang2 that particular drug tak brape indicated pon for that patient... they all very innocent... hope can share the discussion about clexane...

蔥爆牛肉Frank said...


taufiq said...

are you a houseman? it is so surprised that you only heard about clexane 3 months ago.. you should have learned about it in your medical school.. as a muslim doctor, i think the best is to update ourselves regularly and don't be lazy.. otherwise, cuma tergolong dalam golongan yang tau cakap tapi tak tau buat, and tertinggal jauh di belakang jika berbanding dengan doktor2 bangsa lain.. tak hairan la terdapat ramai pesakit melayu sendiri yang tak sudi dirawat oleh doktor melayu sendiri..

liyanatasneem said...

thanks for your info. I've just learn about this drug...

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