February 3, 2005 - 1:31pm
In this week's New England Journal, there's an add from Janssen Pharmaceutica warning that some people who were prescribed reminyl (galantamine HBr) for Alzheimer's symptoms have been receiving amaryl from the pharmacist instead. Because amaryl treats diabetes, people with the wrong pills can have serious consequences from low blood sugar.
What's the difference between the pills? I'm surprised (and appalled) that such a mistake happened multiple times.
Lj, medication dispensing errors happen quite often for various reasons. Confusion can arise when brand names and/or generic names are similar, tablets or capsules look almost identical or the doctor's handwriting is illegible. And, of course, people make mistakes - even pharmacists and doctors.
In the case of REMINYL vs AMARYL, Janssen states the dispensing errors probably happened because of the similarity between the brand names. Possibly the pharmacist misinterpreted the doctor's RX or the doctor was confused.
From the FDA Safety Information and Adverse Event Reporting Program - MedWatch - August 2004 -
The following information is from Janssen Pharmaceutica Products. Contact the company for a copy of any referenced enclosures.
IMPORTANT SAFETY ALERT REGARDING MEDICATION ERRORS
Dear Healthcare Professional:
Janssen Pharmaceutica Products, L. P. and Johnson & Johnson Pharmaceutical Research & Development, L. L. C. have recently been made aware of several reports of medication errors involving confusion between REMINYL® 1 (galantamine hydrobromide), a drug approved for the treatment of mild to moderate dementia of the Alzheimer’s type, and AMARYL® 2 (glimepiride), a product of Aventis Pharmaceuticals Inc., indicated for the treatment of non-insulin-dependent (Type 2) diabetes mellitus. These reports include instances in which REMINYL was prescribed but AMARYL was incorrectly dispensed and administered instead, leading to various adverse events including severe hypoglycemia and one death.
According to the spontaneous reports submitted to the FDA and the United States Pharmacopoeia, prescriptions have been incorrectly written, interpreted, labeled, and/ or filled due to the similarity in names between REMINYL and AMARYL®. These two products have an overlapping strength (4 mg) and an overlapping dosage form (tablets). In addition, both products have generic names (galantamine vs glimepiride) that might lead to their storage in close proximity.
It is important to note that REMINYL has a starting dosage of 4 mg TWICE a day, whereas AMARYL® is initially dosed at 1-2 mg ONCE a day, with a maximum starting dosage of 2 mg.
REMINYL is supplied for oral administration as 4 mg (round, off-white), 8 mg (round, pink), and 12 mg (round, orange-brown) tablets. REMINYL tablets are imprinted “JANSSEN