Medical community defends Tiktoker over multivitamins ‘advice’ debate

A screengrab of Arshie Larga in this video uploaded on his Twitter on Dec. 24, 2022 (Screengrab by Interaksyon by Twitter/Arshiethromycin)

The local medical community supported pharmacist and TikTok content creator Arshie Larga after his tweets earned questions when he opened a discourse about a multivitamin tablet.

Arshie on Thursday posed a question to Filipino Twitter users taking Berocca, clarifying that it was not a sponsored post.

“Sa mga gumagamit ng Berocca, may question po ako,” he tweeted with a smiling face emoji.

“Kapag umiinom kayo ng Berocca, umiinom pa ba kayo ng iba pang vitamins? Like sinasabayan [niyo] pa ba ito ng ascorbic acid or other multivitamins? (P.S. not a sponsored tweet),” Arshie added.

More than an hour after, he tweeted that he was “happy” with the replies of most social media users.

“Hindi na po kailangan sabayan pa ng ascorbic acid at iba pang brand ng multivitamins ang Berocca. MVT [multivitamins] + Minerals na po kasi ang laman ng Berocca. Kung iinom man po kayo ng ibang vit/minerals, piliin [niyo] ‘yung wala pa sa contents ng Berocca — like iron,” the pharmacist wrote.

Arshie also shared a picture showing a breakdown of what a Berocca tablet contains.

“Applicable din po ito sa ibang brands ng multivitamins. Basta always read the label para hindi pare-pareho ang contents ng MVT na iniinom [niyo]. Sayang lang. Sasama lang sa ihi mo ‘yung sobrang vit [vitamin]. ‘Di rin maganda sa katawan ang sobrang vit c kasi pwede ka magka-kidney stones,” Arshie added.

“Napa-tweet lang ako ng ganito kasi ‘yung customer ko kanina ang daming iniinom na multivitamins together with Berocca. Even before, I’ve encountered similar cases like this so na-curious lang ako HAHAHA. Again, not a sponsored tweet,” the pharmacist continued.

Not everyone was welcoming of the post, however.

One Twitter user commented, “Aren’t you giving medical advice already? That should be done only by doctors, not pharmacists.”

Screengrab by Interaksyon from Twitter

Whe Arshie saw @wawam’s comment, he responded that the multivitamins he was talking about were not prescription medicine.

“Hindi naman po prescription medicine ang Berocca. Pharmacist[s] are allowed naman po to give medical advice, lalo [na] for vitamins and otc [over-the-counter] meds. Actually, ginagawa po namin ‘yun araw-araw sa botika,” the pharmacist said.

User @wawam quoted some of Arshie’s words and told him to “be careful” of saying such things.

Screengrab by Interaksyon from Twitter

The pharmacist then shared an excerpt of Republic Act 5921 or the Pharmacy Law to emphasize his point about their roles.

“‘Pharmacists are allowed to give drug information services’. ‘Yun lang naman po ang intention ng tweet ko. Sana po maliwanag na sa inyo. Salamat po,” Arshie responded to @wawam.

In defense of pharmacists

Physicians who saw the exchange came to Arshie’s defense, with one commending what the pharmacist did on Twitter.

“As a doctor, okay lang naman ang magbigay ng advice, mas lalo na sa over-the-counter meds. Pinag-aralan nila ‘yan as a Pharmacist,” cardiologist-electrocardiologist Dot Tioleco wrote.

“‘Di naman siya nag-diagnose and nagbigay ng medical treatment. So sa akin, approve ako sa ginagawa ni @Arshiethromycin,” he added.

Tioleco further said the medical community is not restricted to physicians despite @wawam’s perception that only doctors can dispense medical advice.

“The medical community includes the Pharmacists, Nurses, Therapists etc. Hindi puro doktor. Cooperation po ang paggagamot,” the cardiologist tweeted.

“Hindi lahat ng medical advice ay kailangan ng gamot. Healthy lifestyle and proper diet are medical advice na hindi naman kailangan ng gamot,” Tioleco added.

A pharmaceutical chemistry teacher also chimed in the discussion.

“‘Medical’ is not restricted to medicine, as in the program that makes you an MD (physician) after graduation. Those terms are not completely synonymous kaya baka may hindi pagkakaintindihan. Physicians consult in clinic, pharmacists counsel in pharmacies. Similar but not same,” user @sertraline_ wrote.

“Talking about [or] giving advice on dose strengths, dosage regimens and drug interactions are part of pharmacy practice and dispensing. What MDs [medical doctors] primarily do that RPhs [registered pharmacists] shouldn’t are diagnosis and prescription of (Rx only) drugs; that said, most multivitamins are not even Rx meds,” the user added.

Nephrologist Carlo Trinidad said Arshie was “well within his area of expertise” when the latter shared the advice.

“Strictly speaking, he is still well within his area of expertise when he gave the [advice]. In the hospital, we work with pharmacists and they countercheck drug interactions of meds we order in the chart. It is inevitable that there will be [an] overlap between health professions,” he tweeted.

Physician Gene Nisperos, faculty member at UP Manila’s College of Medicine, regarded pharmacists as “the last gatekeepers of patient safety.”

“They advise patients regarding the meds they take, including side effects, and check on possible drug-drug interactions. Yes, they have oversight functions,” he tweeted in response to the discourse.

Another physician defended Arshie in a separate post.

“In defense of the pharmacists. Pharmacists, like doctors, can give advice on what meds to take for something, but they can’t prescribe or diagnose. The public shouldn’t expect them to replace doctors, and it’s not the pharmacists’ fault patients do that. Blame crappy healthcare,” physician Jonathan E. Sy wrote.

“As a doctor, I highly value and respect pharmacists like @Arshiethromycin who work to make healthcare more accessible to the masses. Do y’all know how hard it is to learn how drugs work for the very first time? Ask any doctor or med student. And to pack it all in ’60s,” he added.

Pharmacists are popularly known for providing medications to customers according to physician prescriptions.

However, they actually have a crucial role in the effective delivery of health services, according to former Philippine Pharmacists Association president Leonila Ocampo.

She said clinical pharmacy is a specialty practice and that pharmacists are also called medical experts.

“They are the ones who study the details and components of a drug or medicine,” Ocampo said in a 2011 interview.

She added that pharmacists are supposed to be the medication managers and counselors who help patients achieve the optimum benefits of medication.

“It is the pharmacists’ duty to check the prescription for any potential adverse drug effects and interaction, inappropriate dosing,” Ocampo said before.

“She should also monitor the effects of the medicine [good and bad] on individual patients, provide medical counseling to patients for various diseases and lastly, provide drug information to guide the public and other health professionals,” she continued.

In order to become a pharmacist, an individual has to graduate with a bachelor’s degree in pharmacy, chemistry, health sciences, or a related field.

They must then pursue an internship at a hospital or drugstore and then pass the licensure examination for pharmacists conducted by the Professional Regulation Commission.

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