Warnings have now been given that parents who must use the flu treatment medication Tamiflu should use caution in dosing their children. The medication was shipped with improperly labeled boxes that give instructions for dosing based on a system not marked on the syringe used for administering the drug.
The news came from scientists at three universities, Weill Cornell School of Medicine in New York City , Northwestern University Feinberg School of Medicine in Chicago and Emory University in Atlanta and was eventually published in the New England Journal of Medicine.
Advising doctors and pharmacist to watch for the error and to give parents the proper dosage information the scientists cite a case where the young 6 year old daughter of two doctors was faced with this problem and the parents had to work out the best dosage on their own.
The dosing error leaves the box labeled for teaspoon measurements while the syringe is labeled for metric measurement. The labeling error poses a problem for parents who might give the wrong dose to their children or infants without realizing it. Overdosing with the drug could have a toxic effect while underdosing could leave the child with little to no effect in treating the H1N1 virus it’s being used against.
CORRECTION SUBMITTED BY ROCHE
Regarding this post Roche corporation representative contacted us and provided the below information.
We would like to share you the available information on the subject so please read below links and information provided by Roche:
From FDA Web site
Tamiflu (oseltamivir) for Oral Suspension
Audience: Pharmacists, pediatrics healthcare professionals
[Posted 09/24/2009] FDA issued a Public Health Alert to notify prescribers and pharmacists about potential dosing errors with Tamiflu (oseltamivir) for Oral Suspension. U.S. health care providers usually write prescriptions for liquid medicines in milliliters (mL) or teaspoons, while Tamiflu is dosed in milligrams (mg). The dosing dispenser packaged with Tamiflu has markings only in 30, 45 and 60 mg. The Agency has received reports of errors where dosing instructions for the patient do not match the dosing dispenser. Health care providers should write doses in mg if the dosing dispenser with the drug is in mg. Pharmacists should ensure that the units of measure on the prescription instructions match the dosing device provided with the drug.
From CDC Web site
Note on Tamiflu Oral Suspension Syringe
Pharmacists with access to Tamiflu® oral suspension should be aware that an oral dosing dispenser with 30 mg, 45 mg, and 60 mg graduations is provided in the packaging for the manufacturer’s product rather than graduations in milliliters (mL) or teaspoons (tsp). There have been cases where the units of measure on the prescription dosing instructions (mL, tsp) do not match the units on the dosing device (mg), which can lead to patient or caregiver confusion and dosing errors. When dispensing commercially manufactured Tamiflu® oral suspension, pharmacists should ensure the units of measure on the dosing instructions match the dosing device provided. If dosing instructions specify administration using mL or tsp the device included in the Tamiflu® product package should be removed and replaced with an appropriate measuring device. When dispensing Tamiflu® oral suspension for children younger than 1 year of age, the oral dosing dispenser that is included in the product package should always be removed and replaced with an appropriate measuring device.
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