Iran is facing a fresh shortage of the brand-name anti-rejection drug Myfortic with pharmacies halting distribution in several cities and clinicians warning that forced switches to substitutes could endanger a minority of kidney-transplant patients.
Patients in Mashhad said rations shrank from two months to one week before stocks of the drug (mycophenolic acid 360 mg) “fell to zero,” with pharmacists advising a move to domestically made equivalents, the ILNA news agency reported.
Fatemeh Pour-Rezagholi, secretary of Iran’s Kidney Transplant Scientific Association, said originator-brand supplies have not been distributed recently, citing foreign-exchange constraints, sanctions-related frictions and customs delays.
She added that Iranian versions are available and effective for most patients, but unplanned brand changes can be stressful or risky for those early post-transplant or with prior rejection. Importers have indicated the original brand may return later in winter, according to ILNA.
Doctors and pharmacists told ILNA that 70-80% of recipients tolerate domestic formulations, but roughly 10-20% may require a specific brand or closer therapeutic-drug monitoring.
Patient groups and clinicians are urging clearer import timetables, steadier FX allocation for critical transplant drugs and contingency guidance to minimize unplanned switches.
Clinicians say the fiscal and human costs are far higher if grafts fail and patients return to dialysis, and have asked regulators to protect a baseline of imports for high-risk cases while stabilizing domestic supply for the majority.
US sanctions policy formally exempts most medicines and many medical devices, with humanitarian channels – such as Switzerland’s state-backed payment mechanism – designed to process vetted transactions.
In practice, suppliers and aid groups say persistent “over-compliance” by global banks, shippers and insurers fearful of sanctions risk, which can delay or block payments, shipments and insurance even for lawful medical goods.
Economists also point to the rial’s volatility and domestic pricing and procurement rules as recurring hurdles that raise import costs and complicate supply planning.
According to Mehr News on Monday, Iran has raised medicine prices several times in recent months under a “realistic pricing” policy meant to support the domestic pharmaceutical industry, but insurance coverage has not kept pace – leaving patients to shoulder a growing share of drug costs as reimbursements lag behind the hikes.
Iran International learned that actors Parsa Pirouzfar and Ali Shadman, and actresses Setareh Pesyani and Sahar Dowlatshahi were among more than 20 guests detained.
Shadman and Pesyani remain in custody, with cases opened in Tehran’s Ershad (morality) prosecutor’s office against Shadman and six others on charges including “violating public decency, promoting vice, drinking alcohol, and possession of alcoholic beverages,” according to people familiar with the matter.
Sources said Pirouzfar was taken to hospital after the raid.
Several detainees were released later on undertakings or bail, while separate files were opened for other guests, many from the theater community.
There was no immediate comment from Tehran police or the judiciary on the reported detentions.
Alcohol is banned in Iran and violations carry fines, lashings or prison, with stiffer penalties for production and distribution. The prohibition dates to 1979, but homemade brewing and smuggling have created a steady underground supply. Rights groups and health officials report periodic mass poisonings from counterfeit liquor.
Despite the ban, discreet drinking has edged into some public venues. Iranian and state‐affiliated outlets have acknowledged “secret menus” at a handful of restaurants and cafés, where beer or spirits are served under code names or in disguised containers.
Prosecutors and police regularly announce raids and closures for serving alcohol, mixed-gender dancing or hijab violations, part of wider morality crackdowns.
Authorities have stepped up enforcement over the past two years, sealing cafés in Tehran and other cities and publicizing arrests.
Officials say tougher action is needed to deter bootlegging and to uphold Islamic codes. Critics counter that decades of prohibition have pushed consumption into riskier, unregulated channels.
“The continued drying and the cut in permanent flows have brought land subsidence and the death of Gavkhouni to a point of no return and even put drinking water on the threshold of threat,” said Dariush Golalizadeh, the provincial environment department chief.
“The Zayandeh-Roud played a key role in recharging aquifers and preventing subsidence. With multi-year drought and sharply reduced inflows, alongside heavier pumping from wells and wastewater use, subsidence has intensified alarmingly.”
Golalizadeh said the internationally listed Gavkhouni wetland downstream of Isfahan is turning into a dust hotspot. “When the wetland falls apart, it means there are serious problems in water and land management above it.”
He linked the ecological stress to livelihoods, saying orchards, urban green spaces and farmers have been hit across the basin. Authorities are now working on support programs for Isfahan’s eastern districts to soften the blow to agriculture, he said.
The official urged emergency measures to keep minimum flows to the river and wetland.
“At present, because of the sharp drop in river yield, drinking water is under threat,” he said. “We are looking to other sources, but rising temperatures and drought have cut inflows to a minimum.”
