The drugs approved as safe for marketing and prescription to consumers in the U.S. are constantly monitored by the Food and Drug Administration (FDA). The monitoring system is seriously flawed, being little more than the next stage of drug testing "in the wild". This effectively reduces consumers to the level of "lab rat" as their experiences, or some of them anyway, are recognized and reported to the FDA.

If consumers grin-and-bear-it through some unwanted reaction and hence it is not reported or if for any other reason it is not conveyed to the FDA, it will not contribute to knowledge of the drug’s performance. Equally, if the reaction is already well documented it will frequently go unreported.

Nevertheless, every month the FDA releases one more month’s worth of changes to the Contraindications, Boxed Warnings, Warnings, Precautions and Adverse Reactions information associated with the drugs and medical equipment it has previously approved. This data is released in a quite timely fashion actually, but monthly summaries are provided in arrears. For example, the November 2005 summary has just been released.

In this November data some 55 products are included. Eight Contraindcation updates were made, three Boxed Warning updates, 14 Warnings updates, 41 Precautions updates and 17 Adverse Reactions updates. That’s a lot of updates and they represent a lot of problems associated with these approved products. I think this is actually just the tip of the iceberg.

While much of the material is best suited to medical or health professional consumption, there is some value for anyone in perusing the data. In any event, take a look at the scope and the types of problems that the FDA is comfortable continuing to expose consumers to. Their Summary is presented below.

Summary View: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER) — November 2005

The summary view includes drug products with safety labeling changes to the CONTRAINDICATIONS, BOXED WARNING, WARNINGS, PRECAUTIONS, or ADVERSE REACTIONS sections. The “quick view” table below provides the drug name and sections modified. Click on the drug name to go to the detailed view. The detailed view includes sections and subsections modified, a description of new or modified safety information in the Contraindications or Warnings sections and a link to the revised prescribing information.

Key: C=CONTRAINDICATIONS, BW=BOXED WARNING, W=WARNINGS, P=PRECAUTIONS, AR=ADVERSE REACTIONS

 

DRUG NAME

SECTIONS MODIFIED

C

BW

W

P

AR

Cipro I.V. (ciprofloxacin) for Intravenous Infusion X   X  X  

Cipro (ciprofloxacin hydrochloride) Tablets

Cipro (ciprofloxacin) Oral Suspension

X    X  X  
Cipro XR (ciprofloxacin extended-release tablets) X   X X  
DDAVP Injection (desmopressin acetate)  X     X  

DDAVP Nasal Spray (desmopressin acetate)

X     X  

DDAVP Rhinal Tube (desmopressin acetate)

X     X  
DDAVP Tablets (desmopressin acetate) X     X  
Norvir (ritonavir capsules) Soft Gelatin & (ritonavir oral solution) X   X X  
C 
BW
W
P
AR
Strattera (atomoxetine hydrochloride) Capsules   X X X  
Tracleer (bosentan) Film-coated Tablets   

X

X X X
Xyrem (sodium oxybate) Oral Solution   X X X  
C 
BW
W
P
AR
Agenerase (amprenavir) Oral Solution      X X  
Aranesp (darbepoetin alfa) for Injection     X   X
Effexor XR (venlafaxine hydrochloride) Extended-Release Capsules      X X X
Mevacor (lovastatin) Tablets     X X  
NovoSeven Coagulation Factor VIIa (Recombinant)     X   X
Ortho Evra (norelgestromin /ethinyl estradiol transdermal system)      X    
Tarceva (erlotinib) Tablets      X    
C 
BW
W
P
AR
Amaryl (glimepiride tablets)        X X
Aredia (pamidronate disodium for injection) for Intravenous Infusion        X  

Avelox (moxifloxacin hydrochloride) Tablets

Avelox I.V. (moxifloxacin hydrochloride in sodium chloride injection)  

      X  X
Bicillin C-R (penicillin G benzathine and penicillin G procaine injectable suspension) Disposable Syringe 4 mL for deep IM injection only        X  
Bicillin C-R (penicillin G benzathine and penicillin G procaine injectable suspension) Tubex 1 mL and 2 mL for deep IM injection only        X  
Bicillin C-R 900/300 (penicillin G benzathine and penicillin G procaine injectable suspension) Tubex 2 mL for deep IM Injection only        X  
Bicillin L-A (penicillin G benzathine injectable suspension) Disposable Syringe for deep IM injection only        X  
Bicillin L-A (penicillin G benzathine injectable suspension) Tubex 1 mL and 2 mL for deep IM injection only        X  
Derma-Smoothe/FS (fluocinolone acetonide) Topical Oil, 0.01%        X  X
Effexor XR (venlafaxine hydrochloride) Extended-Release Capsules        X  
Fosamax (alendronate sodium) Tablets and Oral Solution        X
Fosamax Plus D (alendronate sodium/cholecalciferol) Tablets        X X
Hiprex (methenamine hippurate tablets, USP)       X  
Ketek (telithromycin) Tablets        X X
Kytril (granisetron hydrochloride) Injection        X  
Kytril (granisetron hydrochloride) Tablets and Oral Solution        X  
Lamisil (terbinafine hydrochloride tablets)       X X
Lexiva (fosamprenavir calcium) Tablets        X  
Neutrexin (trimetrexate glucuronate for injection)       X  

Pamidronate Disodium Injection 

Pamidronate Disodium for Injection  

      X  
Parlodel SnapTabs (bromocriptine mesylate) Tablets and Capsules       X X
PEG-Intron (peginterferon alfa-2b) Powder for Injection       X  
Pletal (cilostazol) Tablets       X  
Revatio (sildenafil citrate) Tablets       X X
Singulair (montelukast sodium) Tablets, Chewable Tablets, and Oral Granules       X X
Valtrex (valacyclovir hydrochloride) Caplets       X  

Zyvox (linezolid) Tablets and Injection

Zyvox (linezolid) for Oral Suspension 

      X  
C 
BW
W
P
AR
Angiomax (bivalirudin)         X
Avalide (irbesartan-hydrochlorothiazide) Tablets         X
Avapro (irbesartan) Tablets         X

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