Indonesian Journal of Pharmacy

Bioactivity of Fucoxanthin From Brown Seaweed as Antioxidant and Anti-melanogenesis: A Narrative Review

Wirasti Wirasti, Retno Murwanti, Nanang Fakhrudin, Erna Prawita Setyowati — Tue, 17 Dec 2024 00:00:00 +0700

Whitening cosmetics with anti melanogenesis activity are very popular in the world. Many studies are trying to identity new ingredients that exhibit antimelanogenesis effect for the developing of new products. There has been a rapid increase in the use of natural anti hyperpigmentation agents from marine sources for pharmaceutical and cosmetic applications. The aims of this review is to provide an overview of the antioxidant and anti melanogenesis effect of brown seaweed which contains a large amount of fucoxanthin as a skin whitening agent. Fucoxanthin from brown algae sources has also developed for use in cosmetics. Most of the articles we reviewed lack detailed investigations of molecular target, which are essential for meeting the criteria of cosmetic and pharmaceutical use. Recently, several carotenoids have been discovered from brown seaweed by examining their anti-melanogenesis and mechanisms. Despite the rarity of in vivo and clinical investigations of marine molecular mechanism algae derivates whitening agents. The novelty of this review is to discuss fucoxanthin as a major carotenoid in brown algae as an antioxidant and anti-melanogenesis. An anti-melanogenesis test is generally preceded by an antioxidants activity test. Almost all brown algae have a good antioxidant effect (compared to control). This suggests that brown seaweed has antioxidant properties. In addition, the melanogenesis effecf of brown algae was better compared to the control

The Effect of Covid-19 Pandemic on Treatment Management, and Clinical Outcome of Patients with Acute Coronary Syndromes (ACS): A Systematic Review and Meta-Analysis

Tue, 17 Dec 2024 00:00:00 +0700

This systematic review and meta-analysis aimed to summarize the available evidence on the impacts of the COVID-19 pandemic on treatment management, and clinical outcomes among patients with acute coronary syndrome (ACS). PubMed and ScienceDirect were searched from January 2020 to September 2021 to identify relevant studies. For dichotomous variables, meta-analysis was performed using the random-effects model. For continuous variables, descriptive synthesis was conducted. Sixty-three articles were included in the review. The time from symptom onset to First Medical Contact (FMC) was significantly longer during the COVID-19 pandemic in 50% of the studies (17/34). One-third of the studies (9/26) observed significantly longer door-to-balloon (DTB) times during the pandemic. Approximately 73 % of studies (11/15) indicated a significantly longer total ischemic time during the pandemic era. The pooled results did not show a significant difference in in-hospital mortality during the COVID-19 pandemic among patients with ST-elevation myocardial infarction (STEMI) (RD = -0.01, 95% CI -0.02, 0.00) and non-ST-elevation myocardial infarction (NSTEMI) (RD = -0.01, 95% CI -0.01, 0.00). No significant difference in the proportion of patients who underwent Percutaneous Coronary Intervention (PCI) was found across the pandemic period. The COVID-19 pandemic seemed to prolong the time to receive treatment in most settings. Education campaigns and well-planned ACS pathways to ensure timely treatment for patients with ACS during the pandemic/crisis are warranted.

Fourier Transform Infrared Spectroscopy Combined with Chemometrics for Analysis of Gelatin on Foreign Produced Soft Candy

Nina Salamah, Any Guntarti, Hari Susanti, Atika Sakinah Putri Lauleuwulu — Tue, 17 Dec 2024 00:00:00 +0700

Data from the Central Bureau of Statistics shows that processed food and beverage imports have increased and are the most imported products in Indonesia. Soft candy is a processed product that contains gelatin and can be sourced from pork or beef. The analytical technique used to analyze food ingredients, one of which is FTIR. This study will determine whether FTIR can investigate bovine and porcine gelatin in soft candy products combined with chemometrics. This type of research is non-experimental. The method used is FTIR analysis combined with PLS and PCA. Candies were isolated using the protein precipitation method. The isolation results were analyzed for their functional groups using FTIR. PLS is used to optimize the selected range of wavenumbers as a chemometric model, a quantitative analysis to find calibration values and internal and external validation. PCA functions to classify market candy according to its source. The results showed that FTIR detected the functional groups -OH, aliphatic CH, C=O, -NH, -CN. The optimized wave number using PLS is 1600 – 1621.92 cm^-1. The calibration parameter using RMSEC produces a value of 0.188 and an R² value of 0.999. Internal validation obtained an RMSECV value of 2.891 and an R² value of 0.990.

In contrast, external validation produces an RMSEP value of 1.652 and an R² value of 0.998. The PCA grouping shows that codes Hrb and Y are close to bovine gelatin source points, while code C is not close to beef or porcine. So FTIR cannot distinguish the source of bovine or porcine gelatin from candy, but PLS and PCA help is needed.

An Integrated in Silico-In Vitro-In Vivo Approach for Pharmacokinetic Studies of Andrographolide Using Aqueous Extract of Andrographis Paniculata (Burm.F.) Wall. Ex Nees

Fri, 16 Aug 2024 00:00:00 +0700

Andrographis paniculata is a herbal plant that has been used traditionally for decades to treat a wide range of diseases. To this date, no research on the integration of in silico, in vitro, and in vivo pharmacokinetics (PK) has been documented on andrographolide (AG), the primary bioactive compound in A. paniculata. In this study, we employed an in silico approach to predict the physicochemical properties, metabolism, and toxicity of AG. PK properties were validated using in vitro assays and further tested in Wistar rats. Based on in silico prediction, AG demonstrated to be a soluble, permeant, and lipophilic drug. AG was regarded as a non-mutagenic and non-carcinogenic drug with a low risk of oral absorption. In vitro assays showed that AG was stable at all pH levels tested, had a high equilibrium solubility and moderately stable in the mouse plasma. AG was also permeant across the Caco-2 monolayer with P_app values of 9.627 × 10⁻⁶ cm/s (apical) and 18.1 × 10⁻⁶ cm/s (basolateral). It had a stable metabolism in the liver microsomes and did not have any inhibitory effects on the enzymes CYP2C8, CYP2C19, CYP2D6, or CYP3A4 (MDZ). Based on in vivo results, the volume of distribution and clearance were both high, with a short elimination half-life (0.17 ± 0.0 h) contributing to the low oral bioavailability (~2%). Rapid oral absorption was shown with T_max of 0.25 h. Our data revealed promising drug-like properties of AG, and its pharmacokinetics profiles support its potential in developing andrographolide-based products from natural resources.

Antiinflammatory and Antimelanogenic Effects of Xylocarpus granatum J. Koenig Leaf Extract Cream on UVB Radiation-Induced Sunburn in Guinea Pigs

Wed, 18 Sep 2024 00:00:00 +0700

Xylocarpus granatum J. Koenig is a medical mangrove plant predominantly found in tropical and subtropical coastal regions, including Indonesia. The plant contains bioactive compounds such as flavonoids, tannins, saponins and steroids, which exhibit antioxidant, antiinflammatory and antimelanogenic effects. This study was aims to determine the antiinflammatory and antimelanogenesis effect of Xylocarpus granatum leaf ethanol extract cream. The compounds of Xylocarpus granatum leaf ethanol extract was identified by using gas chromatography-mass spectrometry. The potential of the extract as a sunscreen was evaluated through the analysis of sun protection factor (SPF) value. The antioxidant activity of the extract was assessed using the DPPH method. The antiinflammatory and antimelanogenic effects of cream were evaluated through histopathological analysis of epidermal thickness and melanin levels in ultraviolet B (UVB)-exposed ginea pig skin. The Xylocarpus granatum leaf extract was found to contain 16 compounds, of which 11 compounds were identified as antioxidant, antiinflammatory, and/or antimelanogenic. The Xylocarpus granatum leaf extract exhibited a high level of sun protection with an SPF value of 35.56. Additionally, the extract displayed strong antioxidant activity, as indicated by an IC50 value of 64,57 ppm. Treatment with 10% Xylocarpus granatum leaf extract cream significantly reduced epidermal thickness (p-value = 0.165), while 15% Xylocarpus granatum leaf extract cream showed a significant decrease in melanin levels (p-value = 0.828) compared to the hydroquinone treatment. This study concluded that Xylocarpus granatum leaf extract exhibit as a potential source for the development of health-related products, particularly those involving antioxidant, antiinflammatory and antimelanogenic properties.

Thymoquinone Increased Warfarin 7-hydroxylation in Human Liver Microsomes and Induced the Expression of CYP2C9 in HepG2 Cells

Tue, 17 Dec 2024 00:00:00 +0700

The herbal-drug interaction is an interesting phenomenon that can induce therapeutic complications in patients. Warfarin is widely used as an anticoagulant, which has a narrow therapeutic index. The combination of herbal and warfarin has consequences in the outcome therapy on the attenuation of drug efficacy or increased toxicity. This study aims to investigate the effect of thymoquinone on warfarin 7-hydroxylation activity in human liver microsome (HLM) and the expression of CYP2C9 in HepG2 cells. To investigate the co-administration of thymoquinone on warfarin 7-hydroxylation was conducted using HLM and HepG2 cells. The study was divided into three groups: control, warfarin, and combination of warfarin-thymoquinone. The metabolite of 7-hydroxywarfarin (7-OH warfarin) in HLM was determined using HPLC-MS/MS. Furthermore, the induction effect of thymoquinone on the expression of CYP2C9 in HepG2 cells was determined by RT-PCR. The results of the validated method used were selective for HLM 7-hydroxywarfarin, with an LLOQ of 0.62 μM, and it meets the criteria for accuracy and precision for metabolite analysis. The results showed that the co-incubation of thymoquinone at 0.37mM significantly increased warfarin 7-hydroxylation activity (P < 0.05). In addition, the incubation for 72 hours of thymoquinone also significantly induced the expression of CYP2C9 in HepG2 cells (P < 0.05). These findings provide valuable insights that the combination of thymoquinone with warfarin significantly increased the warfarin 7-hydroxylation activity in human liver microsomes and expression of the CYP2C9 in HepG2 cells, which may have an impact on the clinical outcomes of warfarin in patients.

In Vitro Drug Release Study of Bisacodyl Enteric-Coated Tablet in Various Artificial Dissolution Media

Raditya Iswandana, Alvian Nathanael, Erny Sagita — Tue, 17 Dec 2024 00:00:00 +0700

This study aims to investigate the effect of dissolution media on the release of bisacodyl from an enteric-coated tablet. Genuine phosphate buffer pH 7.4 (phosphate buffer), rat cecal-containing phosphate buffer pH 7.4 (rat cecal), lactase-containing phosphate buffer pH 7.4 (lactase), probiotics-containing phosphate buffer pH 7.4 (probiotics), and probiotics & lactase-containing phosphate buffer pH 7.4 (probiotics-lactase) were used as the colon simulation media. The study was carried out in a modified type I dissolution test apparatus for 12 hours: 2 hours in HCl pH 0.1 M, 3 hours in phosphate buffer pH 6.8, and 7 hours on colon simulation media, sequentially. The sample aliquots were analyzed using a UV-Vis spectrophotometer. At the end of the dissolution period, the bisacodyl released from tablets in phosphate buffer, rat cecal, lactase, probiotics, and probiotics-lactase were, respectively, 42.095%; 85.835%; 70.594%; 92.832%; and 110.63%. The dissolution media, which contains probiotics and lactase, facilitated the highest bisacodyl release, followed by probiotics, rat cecal, lactase, and phosphate buffer. The drug-release profile among various dissolution media showed significant differences, with p-values < 0.05. It can be concluded that pH, microbial activity, and enzyme content significantly influence the release profile of bisacodyl from enteric-coated tablets.

Pentagamavunone-1 suppresses MYCN-positive HuH-7 Cancer Cell Growth via Mitotic Arrest in vitro

Tue, 17 Dec 2024 00:00:00 +0700

High expression of MYCN is usually found in progressive liver cancer. The present study investigated the potential effects of Pentagamavunone-1 (PGV-1) against the MYCN-positive human hepatocellular carcinoma (HCC) cell line in vitro based on the cellular physiology. The MYCN-positive cell line, HuH-7, was employed as a cell model in this study. The cytotoxic effect of PGV-1 was observed using the trypan blue exclusion method while its alterations to the cell cycle and level of intracellular reactive oxygen species (ROS) were determined through flow cytometry. Further, the cellular morphology of the cells was presented with Hoechst and X-gal staining whilst the expression of MYCN was detected by Western blot. The results demonstrated that PGV-1 was cytotoxic to HuH-7 cells with GI₅₀of 0.36 μM, much lower than sorafenib and peretinoin which had GI₅₀of 2.07 and 45.6 μM, respectively. PGV-1 inhibited the growth of HuH-7 cells in a dose-dependent manner, even after removal of the drug. Flow cytometry analysis confirmed that the cycle of HuH-7 cells appeared to arrest in the G2/M phase and intracellular ROS levels were increased. Moreover, the Hoechst staining showed chromosomal condensation in the mitotic phase, particularly in prometaphase. The X-gal staining confirmed that the PGV-1-treated cells undergo senescence. PGV-1 also decreased MYCN expression in HuH-7 cells. All these findings imply that PGV-1 is a potential agent to inhibit MYCN-positive liver cancer cells via mitotic arrest.

An Antioxidant Activity of Extract of Zingiber cassumunar Rhizome, Guazuma ulmifolia Leaves and Their Combination in High-Fat Diet-Fed Rats

Tue, 17 Dec 2024 00:00:00 +0700

Oxidative stress is related to several metabolic diseases, including hyperlipidemia. Previous studies have shown the antioxidant properties of Zingiber cassumunar rhizomes and Guazuma ulmifolia leaves. The objective of this study was to see the antioxidant activity of Z. cassumunar rhizomes, G. ulmifolia leaves extracts, and their combinations in high-fat diet fed (HFD) rat. The water extract of Z. cassumunar rhizomes and G. ulmifolia leaves was evaporated in a freeze dryer to produce dry extracts. The Wistar rats were assigned into six groups at random: normal, positive, negative, Z. cassumunar rhizome extract at 400 mg/kg BW (ZC); G. ulmifolia leaf extract at 50 mg/kg BW (GU), and the combination of Z. cassumunar rhizome extract and G. ulmifolia leaf extract at (350+50) mg/kg BW (ZC+GU). The rats were fed HFD for 28 days, and the treatment groups also received the extracts for the last 14 days. The combination ZC+GU increased the endogenous antioxidant activity namely superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px). The metabolite oxidation, malondialdehyde (MDA) was also found to decrease. The conclusion of the study showed that ZC, GU, and ZC+GU had quite high antioxidant activity to inhibiting oxidative stress.

Effect of Deodorization Methods on Physico-Chemical and Fatty Acids Properties of Reﬁned Milkfish (Channos Channos) By-Product Oil

Masrukan, Rini Yanti, Widiastuti Setyaningsih, Sri Raharjo — Tue, 17 Dec 2024 00:00:00 +0700

Milkfish oil possesses beneficial properties for human health due to its composition of omega-3 fatty acids, which are essential fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are long-chain unsaturated fatty acids susceptible to oxidation and produce compounds that cause odors from oil degradation. Ultrasound-assisted extraction was performed for 68 min at 84 °C with a solvent-to-sample ratio of 3:1 mL/g using d-limonene as a bio-solvent to extract milkfish by-product oil. One of the crucial stages in the oil refining process is deodorization. In this study, several deodorization techniques were used, including liquid-liquid extraction (LLE), steam distillation (SD), and solid-phase adsorption using activated carbon (AC), zeolite (ZT), bentonite (BT), and diatomite (DT). Refined milkfish by-product oil during refining with the deodorization method showed significant differences in physical-chemical characteristics, nutrition, and saturation levels compared with crude oil. The LLE method can significantly reduce the acid and peroxide values and maintain the composition of omega-3 fatty acids. The low temperature used in LLE can prevent the oxidation and degradation of oil. The LLE and solid-phase adsorption method is beneficial because it is low-cost, efficient, and easy to use in milkfish oil deodorization.

Identification of Antioxidant Compounds from Gynura procumbens Using LC-MS/MS-Based Metabolomics

Aurelia Cyntia Putri, Auliya Ilmiawati, Mohamad Rafi — Tue, 17 Dec 2024 00:00:00 +0700

Gynura procumbens or commonly known as sambung nyawa is one of Indonesian medicinal plants. This plant has antioxidant activity, but no reported studies have been performed to identify antioxidant compounds from G. procumbens leaves using a metabolomics approach. In this study, we aimed to identify antioxidant compounds from G. procumbens by LC-MS/MS-based metabolomics. G. procumbens was extracted by maceration using ethanol p.a, 70%-, 50%-, 30% ethanol, and water as the extracting solvent. Metabolite profiling using LC-MS/MS could putatively identify about 54 metabolites from all extracts. We found that flavonols are the most abundant group in all ethanol extracts. Antioxidant activity was determined using the DPPH method. The antioxidant activity of all extracts yielded IC₅₀ values ranging 90.39 to 140.75 mg/L, indicating strong to medium activity. Antioxidant compound prediction was done by correlating metabolites profile and antioxidant activity using orthogonal partial least square-discriminant analysis (OPLS-DA). From the OPLS-DA, five compounds are predicted as antioxidant compounds, namely kaempferol 3-O-rutinoside, 4-hydroxybenzaldehyde, 4,5-dicaffeoylquinic acid, 3-dicaffeoylquinic acid, and 1 unknown compound. The five metabolites had a p-value (<0.05), fold change (>1.5), and variable importance in the projection (VIP) (>1.46), which indicated that these metabolites had a significant contribution to the antioxidant activity from G. procumbens leaves.

Efficacy of Single Love Garlic Extract on Self Nanoemulsifying Drug Delivery System (SCGE-SNEDDS) on Cytokine Expression In Vitro

Tue, 17 Dec 2024 00:00:00 +0700

Single clove Garlic Extract (SCGE) is a potential agent for anti-inflammation, several bioactive are lipophilic, volatile. A novel drug delivery system is required to preserve the bioactive and enhance the solubility. Self Nanoemulsfying Drug Delivery System (SNEDDS) can load extract that formed from carrier oil (VCO), surfactant (Tween-80), and co-surfactant (Glycerol), SCGE-SNEDDS prepared by mixing the surfactant and co-surfactant and adding the carrier oil with SCGE (20 mg/ml). The characteristics response emulsification time in 73.82 ± 0.91 second, % transmittance value of 78.86 ± 0.23%, and pH of 6.83 ± 0.72. The average particle size was 0.46 ± 0.01, Z-Average 23.10 ± 0.69, and zeta potential -33.07 ± 0.45 mV. The toxicity assay was determined in the 3T3-L1 cell line using MTT. The dose SCGE-SNEDDS in rank 62.5, 125, 250, 500, 1000, 2000 and 4000 µg/mL. SCGE-SNEDDS have a good response, characteristics, proved to be non-cytotoxic, and high cell viability (83.3 %). SCGE-SNEDDS had potential effect on the expression of TNF-α, not potential decreases IL-1β and increases IL-10 cytokines in 3T3-L1 cells.

Prevalence, Attitude and Practice of Herbal Medicine in Bahrain

Huda J. Habib, Abdelrahman N. Ibrahim, Sherry N. Nasralla, Adnan A. Bekhit — Tue, 17 Dec 2024 00:00:00 +0700

In the last few years, there has been a growing interest in using herbs worldwide for treating various diseases, however, there is not much knowledge about the prevalence of herbal medicine (HM) use in Bahrain. The objective of this study is to assess the prevalence, attitude, perception, and practice of using HMs by the Bahraini population. A cross-sectional study was conducted on 694 individuals aged 18–65 years from the Kingdom of Bahrain. A snowball non-random sampling design with an electronically distributed structured questionnaire was used to collect data. The questionnaire had 19 questions divided into four themes. Information was obtained on sociodemographic characteristics, perceptions, attitudes, and the practice of using HMs among participants. Most of the respondents (73.5%) were females. 73.6% of the participants were interested in HMs, and approximately 90.5% were interested in receiving more information about HMs. It was found that 92.4% of participants declared to have used HMs; with 86.7% of them applying HMs for therapeutic purposes; 61.6% of them reporting partially successful efficacy. 85.6% of the sample believed that the reason for using herbs was the lower rate of side effects compared to conventional medicines. More than half of the participants thought that herbs were safer than conventional medicines (61.8%). Additionally, most of the participants used the internet and social media as their main sources of information (80.5%), while 78.9% got information about herbs from friends. It was also found that there were several sociodemographic characteristics that affected individuals’ perceptions, practices, and attitudes; age and gender being the most common. HM usage is increasing in Bahrain for therapeutic purposes, and thus, it is vital to create trusted channels enhancing knowledge and awareness of the Bahraini population about the proper use of herbs and their potential side effects.

Network Pharmacology and Molecular Mechanism of Traditional Indonesian Medicine in Hypertension Treatment

Lusi Agus Setiani, Fadlina Chany Saputri, Arry Yanuar, Abdul Mun’im — Tue, 17 Dec 2024 00:00:00 +0700

Scientific herbal formulations are used clinically to treat hypertension, but their functional molecular mechanisms remain to be elucidated. This study was identified the molecular pathways by which scientific herbal remedies for treating hypertension work. The identified compounds were then excluded by measuring oral bioavailability and drug similarity. The network was created using Cytoscape version 3.8, and the predicted target information was obtained from a number of databases, including SwissTarget Prediction, STRING, Online Mendelian Inheritance in Man (OMIM), and Kyoto Encyclopedia of Genes and Genomes (KEGG). The decoction’s method for lowering hypertension was then clarified using an enrichment analysis. It was discovered that bioavailability and drug similarity metrics existed for a total of 44 identified substances. The results of pathway analysis using KEGG revealed that the potential targets were correlated antihypertensive mechanism of herbal medicine such as the HIF-1 signaling pathway, Relaxin signaling pathway, PI3K signaling pathway, and MAPK signaling pathway. Scientific herbal formulas' pressure-lowering mechanisms include those related to vascular endothelium and atherosclerosis, which involve several signaling pathways such as the HIF-1 signaling pathway, the Relaxin signaling pathway, the PI3K signaling pathway, and the MAPK signaling pathway.

Validating the Instrument of Parents' Knowledge and Attitudes towards Giving Antibiotic for Children in two Hospitals at South Sulawesi

Nur Afra Yusni Saidi, Herlina Rante, Sylmina Dalily Alkaff, Bustanul Arifin — Tue, 17 Dec 2024 00:00:00 +0700

To translate, adapt and validate the instrument of Parents' Knowledge and Attitudes towards giving Antibiotics for Children. Participants were recruited from two hospitals in South Sulawesi, one private and one government hospital. The study started with the translation of the instrument from English to Indonesian (forward and backward translation). Next, the translation result was tested on 40 participants. The final stage was validation involving 300 participants. The analysis used known group validity, construct validity, product-moment correlation, and factor analysis. Internal consistency between items used Cronbach Alpha. A total of 300 participants (200 in private hospitals and 100 in government hospitals). From the participants, 113 participants were outpatients and 187 were inpatients. In the adaptation stage, some vocabulary changes were made to sentences that were not understood by participants in instrument items using words easily understood by the participants. For example, in the knowledge domain, the word "pathogen" was changed to ‘disease-causing bacteria’. In the validation stage, the significance value was 5%, and the r-table value was 0.113. Based on the validity test on 14 items in the knowledge domain, the r-count value was 0.256-0.589, while on 12 items in the attitude domain, the r-count value was 0.375-0.662. The Kaiser-Meyer-Olkin (KMO) value was 0.793. From 14 question items in the knowledge domain, 3 factors were formed. Cronbach alpha value of each domain was >0.6, knowledge (0.759) and attitude (0.744). Instrument reliability for outpatient and inpatient care was 0.768 and 0.752 for knowledge, 0.740 and 0.744 for attitude, respectively. The results of this study indicate that the instrument of Parents' Knowledge and Attitudes towards giving Antibiotics to Children is reliable and valid. This instrument can be used for both outpatients and inpatients.

A Survey on Medicine Shortage in Community Pharmacies in Yogyakarta Province, Indonesia

Tue, 17 Dec 2024 00:00:00 +0700

Access to quality healthcare has been considered an apolitical objective on a global scale. Despite this, there are occasionally shortages of medicines because they are not always readily available. A drug supply problem that necessitates a change that affects patient care and requires the use of an alternative agent is known as a medicine shortage. A shortage can occur at any point during a medicine's lifecycle and in any part of the pharmaceutical distribution chain (pharmacy, pharmaceutical company, or wholesaler). This research aims to evaluate the availability of medications in pharmacies in Special Region of Yogyakarta. A cross-sectional survey was conducted in 120 pharmacies in Yogyakarta province, during March to May 2022. WHO essential medicine indicators were used to observe the list of medicine shortage, and its characteristics, including the reasons for medicine shortages in pharmacies, classification of unavailable drugs, and the consequences of medicine shortages. Data were presented descriptively. There were 650 drug items (a total of 1560 items) in one month that were unavailable at 91 pharmacies (75.83%) at least once every six months. The active ingredients that are in short supply are atorvastatin (44.17%), diazepam (21%), azythromycin (13.33%), and haloperidol (13.21%). The medications that were in high demand were also the ones that were in short supply. The reasons for the medicine shortages were rarely communicated to the pharmacies. Customers were able to fill their prescriptions since there were usually enough alternatives. But every third time, there were problems at the pharmacy because there weren't enough medicines. Due to the potential for unhappy customers and increased workload for the pharmacy staff, these shortages may be significant for both the customer and the pharmacy.