FDA warns of risk from mixed-up prescriptions

Doctors and pharmacists have been warned that mix-ups in prescriptions of three drugs with similar names but vastly different effects have led to serious health problems.

The drugs are:

• Toprol-XL, also known by the generic name metoprolol succinate, which is for treating hypertension, chest pain and some kinds of heart failure. It is manufactured by AstraZeneca.
• Topamax, also known as topiramate, which is used to treat epilepsy and to prevent migraines. It is made by Ortho-McNeil Neurologics Inc.
• Tegretol, also known as carbamazepine, which is used to treat some kinds of seizures and trigeminal neuralgia, a nerve disorder that causes stabbing head pain. It is manufactured by Novartis.

In letters to doctors and pharmacists, AstraZeneca asked them to take extra care in prescribing these drugs. The letters were released Tuesday by the Food and Drug Administration.

According to letters from AstraZeneca’s chief medical officer, Glenn J. Gormley, patients who received the wrong drugs reported recurrences of seizures, hallucinations and hypertension.

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At least one suicide attempt was possibly linked to failing to receive the right drug, Gormley wrote, and at least one patient who erroneously received Toprol-XL experienced a dangerous drop in heart rate.

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Gormley asked doctors to write legible prescriptions that include both the brand and generic names of the drugs, and asked pharmacists to double-check drug names against prescriptions.

The FDA has oversight over drug names during its approval process.