In less than 24 hours, Phenergan will no longer be available in one of the largest teaching hospitals in our area. Because of the decision of 6 appointed justices in our US Supreme Court, the hospital is removing all of the Phenergan in the hospital’s stock.
Thus continues the assault on many of the antiemetic stalwarts that we have been using for decades.
Bendectin was the first antiemetic to go the way of the dodo bird after famous plaintiff attorney Melvin Belli sued Merrell Dow Pharmaceuticals. No credible evidence was ever found that Bendectin caused birth defects as the plaintiff attorneys alleged.
Droperidol was another great nausea medicine that got the FDA’s dreaded “black box.”
Then the FDA went after Tigan suppositories.
Compazine was next to get the dreaded “black box” kiss of death.
Just last week, Reglan joined the “black box” club due to a risk of tardive dyskinesia.
Now Phenergan is going to take a hit. After the publicity, many doctors and hospitals will be afraid to use it.
It’s just amazing that the medical profession has been poisoning patients with all of these medications for decades and just now we’re finding out about it.
Luckily, we still have Zofran and other 5-HT3 receptor antagonists – if patients can afford it.
I wrote a prescription for 12 Zofran ODT tablets for a patient who was vomiting last week. The pharmacist called me and said that the prescription would cost $260 and it wasn’t covered on the patient’s insurance. Could I change it to something else?
I wasn’t willing to take the chance if the patient had a bad outcome.
Defensive medicine strikes again. Avoid the bad outcome.
I wrote about the Wyeth case here and here. I’m by no means a staunch drug manufacturer supporter, but pretend that you’re running a manufacturing company. What are you supposed to do with your drug labels now? Overlawyered.com has a summary of opinions about the Supreme Court’s decision as well as a link to the published opinion.
The product labeling for Phenergan had the following language in it:
I skimmed the 80 page US Supreme Court opinion and it appears that the majority believed that “Wyeth could have unilaterally added a stronger warning about IV-push administration.” Good thinking. Now you’ve just opened the legal floodgates to every Tom, Dick and Harry who has ever had a bad outcome from taking a medication. All they have to claim is that the warnings on the medication bottle “weren’t strong enough” and they’ve got the opinions of six Supreme Court justices to guide them on their quest for independent wealth at the expense of a drug manufacturer.
Extending the Supreme Court’s logic puts every pharmaceutical manufacturer on notice that they must discover each and every way someone could possibly misuse their product and specifically warn the public not to use the product in that manner.
Don’t pour Phenergan in electric sockets – it could start a fire and burn down your house
Don’t feed Phenergan to your goldfish – it could burn their scales off and give you emotional distress
Don’t gargle with Phenergan – it could cause caustic burns to your throat and you could get disfiguring burns and you could suffocate to death
Don’t mix Phenergan with Frosted Flakes – it could cause an exothermic reaction with the Frosted Flakes, resulting in nasal irritation if you breathe the fumes
Actually, I created a Supreme Court-approved label that all pharmaceutical companies could use when they decide to manufacture medications. I’ll bet that some companies will find it very helpful:
If this label makes you feel nauseous, be careful.
There aren’t that many antiemetics left that doctors will be willing to prescribe to you.
UPDATE MARCH 7, 2009
The ink wasn’t even dry on the opinion and firms are out looking for “mass tort” clients.