Alert over sound-alike drugs CMAJ 1997;157:15 The Motherisk Program in Toronto, a counselling service for pregnant women and their health care professionals on exposure to drugs and other substances or diseases in pregnancy, has become aware of 9 cases in which pinaverium (Dicetel) was dispensed by pharmacists instead of doxylamine­pyridoxine (Dicletin). The cases were in BC, Manitoba, Ontario, Nova Scotia and Newfoundland. The sole manufacturer of pinaverium (Solvay Kingswood, Scarborough, Ont.) is also aware of another unconfirmed report. Doxylamine­pyridoxine is a combination of an antihistamine with anti-emetic properties and a vitamin B6 supplement; it is available in Canada only by prescription. It has been shown to be safe during pregnancy, and Health Canada has labelled it for use in pregnancy, specifically to treat "morning sickness."1 Pinaverium is a calcium antagonist specific to the gastrointestinal tract, which is used in the treatment of irritable bowel syndrome. There are no data on its safety during pregnancy. In each case, it appears that the prescription was written correctly and was not the cause of the dispensing error. However, considering that there are many well-known examples of confusion among drugs with similar names,2 the similarity between Dicetel and Dicletin may lead to more of these errors. To decrease the risk of prescribing or dispensing errors, physicians should consider writing the diagnosis and both the generic and trade name of the drug on each prescription when either doxylamine­pyridoxine or pinaverium is given to patients.3 If CMAJ readers are aware of any such errors, we would appreciate their informing us at the telephone number below. Benoit Bailey, MD, MSc Adrienne Einarson, RN Gideon Koren, MD, ABMT The Motherisk Program Division of Clinical Pharmacology Hospital for Sick Children Toronto, Ont. Tel 416 813-6780 References Ornstein M, Einarson A, Loren G. Bendectin/Dicletin for morning sickness: a Canadian follow-up of an American tragedy. Rep Toxicol 1995;9:1-6. Janda SM. Look-alike or sound-alike medications pairs. Vet Hum Toxicol 1994;36:256. Vitillo JA, Lesar TS. Preventing medication prescribing errors. Ann Pharmacother 1991;25:1388-94. Send a letter to the editor responding to this letter Envoyez une lettre ŕ la rédaction au sujet de cette lettre | CMAJ July 1, 1997 (vol 157, no 1) / JAMC le 1er juillet 1997 (vol 157, no 1) |