adr.org.uk West Midlands Centre for Adverse Drug Reactions

West Midlands Centre for Adverse Drug Reactions

The West Midlands Centre for Adverse Drug Reactions (CADRE) is an educational and academic unit concerned with the study of adverse drug reactions and other issues related to the adverse effect of medicines. It has been based at City Hospital in Birmingham since 1993, and has strong links to the Department of Clinical Pharmacology at Birmingham Unversity. The centre's staff undertake research and education within the region, and present research both regionally, nationally, and internationally - as well as publishing in the scientific press. The centre's staff also edit the Adverse Drug Reaction Bulletin, which has been published since 1966.

The centre maintains a rolling news service related to drug safety on this page.

Drug Safety Update: Volume 3, Issue 8, March 2010

admin March 11th, 2010

The MHRA have published the March issue of Drug Safety Update, including:

  • Natalizumab (Tysabri): risk of progressive multifocal leukoencephalopathy increases after two years of therapy.
  • Fluoxetine: possible small risk of congenital cardiac defects, similar to that with paroxetine.
  • Sirolimus: different immunoassays for therapeutic drug monitoring—risk of incorrect dose adjustment.
  • Drug Safety Update gains NHS Evidence accreditation.
  • MHRA conference for doctors in training.
  • Patient Information Leaflet of the month: Human Varicella-Zoster Immunoglobulin vaccine.

MMR vaccine and autism

admin February 15th, 2010

A member of our staff has written an editorial on the story of MMR vaccine and autism for The Pharmaceutical Journal.

Drug Safety Update Feb 2010

admin February 15th, 2010

Drug Safety Update has been issued, including the following safety advice

  • Tacrolimus: new oral liquid (Modigraf); formulations not interchangeable without careful therapeutic monitoring.
  • Yellow Card Scheme update
  • Problem with postal delivery of Yellow Cards.
  • Swine flu portal update
  • Suspected adverse reactions to flu antivirals and vaccines confirm recognised safety profile.
  • Orlistat safety update.
  • Nicotine replacement therapy and harm reduction.
  • Sibutramine: suspension of EU licenses recommended as evidence indicates risks outweigh benefits.
  • Off-label intraocular use of recombinant tissue plasminogen activator: risk of intraocular lens opacification.
  • Please report suspected adverse reactions associated with intra-articular use of local anaesthetics.

Sibutramine withdrawn (Reductil)

admin January 22nd, 2010

Sibutramine has been withdrawn.

The European-wide review of the anti-obesity drug sibutramine (Reductil) has concluded and an opinion reached recommending the suspension of the licence for the medicine across Europe.

Evidence suggests that there is an increased risk of non-fatal heart attacks and strokes with this medicine that outweighs the benefits of weight loss, which is modest and may not be sustained in the long term after stopping treatment.

Prescribers are advised not to issue any new prescriptions for Reductil and to review the treatment of patients taking the drug.

Pharmacists are asked to cease dispensing the medicine. People who are currently taking Reductil are advised to make a routine appointment with their doctor to discuss alternative measures to lose weight. There are no health implications if people wish to stop treatment before seeing their doctor.

The EMEA document [PDF] and Questions and Answers [PDF]

Drug Safety Update January 2010

admin January 13th, 2010

The MHRA have published a new Drug Safety Update (January 2010 [PDF]), which includes information on phenytoin:

HLA-B*1502 may be associated with an increased risk of developing SJS in individuals of Thai or Han Chinese ethnic origin when treated with phenytoin. If these patients are known to be HLA-B*1502-positive, phenytoin should be avoided when alternative therapy can be given. Use of phenytoin should only be considered if the benefits are thought to outweigh the risks

• In the Caucasian and Japanese population, the frequency of HLA-B*1502 is extremely low, and thus it is not possible at present to conclude on risk association. Adequate information about risk association in other patients of other ethnic origin is currently not available

as well as, gadolinium-containing contrast agents, and methylphenidate in children.

re:Action 38

admin November 30th, 2009

The Yellow Card Centre West Midlands has issued re:Action number 38:

HPV vaccination
Varenicline and self-harm
Uncomfortable ulcers: Nicorandil-induced genital ulcers.

[PDF]

Yellow Card Scheme

admin November 7th, 2009

Report here: http://www.yellowcard.gov.uk

Drug Safety Update: Volume 3 Issue 3, October 2009

admin October 12th, 2009

The MHRA have issued the October 2009 Drug Safety Update.

  • Ceftriaxone: incompatibility with calcium-containing solutions—updated advice
  • High-dose cyproterone acetate: potential risk of (multiple) meningiomas
  • Yellow Card Scheme update
  • Human papillomavirus (HPV) immunisation programme—first year safety review
  • Smoking and smoking cessation: clinically significant interactions with commonly used medicines
  • Aspirin: not licensed for primary prevention of thrombotic vascular disease
  • Varenicline and suicidal behaviour: cohort study provides some reassurance

Varenicline and neuropsychiatric reactions

admin October 6th, 2009

In recent years concerns about neuropsychiatric adverse drug reactions associated with varenicline have been raised both in the UK and the US. In Europe warnings were issued by EMEA. A recent BMJ study using the GPRD database has cast some doubt on the strength of such an association. We recently performed an analysis of the utility of using spontaneous patient reports of suspected adverse reactions to varenicline left on a number of blogs. Here is a poster we are presenting at the International Society of Pharmacovigilance conference this week.

Varenicline: evaluation of the utility of spontaneous consumer reports of suspected adverse effects filed on internet sites [PDF]

Angioedema and angiotensin-II receptor blockers

admin October 6th, 2009

Angioedema is a rare serious adverse drug reaction (ADR) to angiotensin-converting enzyme inhibitors (ACE-I), with an incidence of 0.1% to 1.0%. If untreated it can be life-threatening. Debate exists over the safety of switching to an angiotensin-II receptor blocker (ARB), due to case reports of angioedema, and the mechanism of ARB-associated angioedema. The DoTS system of ADR classification provides a structured template for examining the Dose and Time relationship, and potential Susceptabilities to an ADR.

Here is a poster we are presenting at the International Society of Pharmacovigilance conference this week.

Angioedema associated with angiotensin-II receptor blockers: a DoTS classification
and analysis
[PDF].

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