Monday, April 22, 2013

Interesting advice on prescribing from Rev Prescrire February 2013; 33 (352): 138-142. Some things i picked out.


– Injectable promethazine, an antihista- mine used in severe urticaria, can cause cutaneous necrosis and gangrene (Prescrire Int n° 109). Better to use injectable dexchlorpheniramine.

– Iron dextran carries a higher risk of hypersensitivity reactions than other injectable iron preparations (Prescrire Int n° 126).


– Tibolone, a synthetic steroid hormone used for post-menopausal hormone replacement therapy, has androgenic adverse effects, in addition to those of its oestrogen and progestin components (car- diovascular disease, breast and ovarian cancer, etc.) (Prescrire Int n° 111). When a woman opts for hormone therapy despite the risks, it is best to use the low- est-dose oestrogen + progestin combina- tion for the shortest possible time. 


 – Moxifloxacin is no more effective than other fluoroquinolones but carries a risk of Lyell’s syndrome, fulminant hepatitis, and more frequent cardiac disorders (Rev Prescrire n° 327);

 – Duloxetine can cause liver damage (Prescrire Int n° 111);



– Ketoprofen gel carries a higher risk of cutaneous disorders than other topical NSAIDs (Prescrire Int n° 109, 112);

 – Strontium ranelate can cause neuropsy- chiatric disorders and hypersensitivity reactions, including Lyell’s syndrome and Dress syndrome (drug reaction with eosinophilia and systemic symptoms.), and also venous thromboembolism (Prescrire Int n° 125);