Potential Signals of Serious Risks/New Safety Information Identified from the Adverse Event Reporting
The table below lists the names of products and potential signals of serious risks/new safety information that were identified for these products during the period October - December 2008 in the AERS database. The appearance of a drug on this list does not mean that FDA has concluded that the drug has the listed risk. It means that FDA has identified a potential safety issue, but does not mean that FDA has identified a causal relationship between the drug and the listed risk. If after further evaluation the FDA determines that the drug is associated with the risk, it may take a variety of actions including requiring changes to the labeling of the drug, requiring development of a Risk Evaluation and Mitigation Strategy (REMS), or gathering additional data to better characterize the risk.
FDA wants to emphasize that the listing of a drug and a potential safety issue on this Web site does not mean that FDA is suggesting prescribers should not prescribe the drug or that patients taking the drug should stop taking the medication. Patients who have questions about their use of the identified drug should contact their health care provider. FDA will complete its evaluation of each potential signal/new safety information and issue additional public communications as appropriate.
Potential Signals of Serious Risks/New Safety Information Identified from the Adverse Event Reporting System (AERS) between October - December 2008
|
Product Name: Active
Ingredient (Trade) or Product Class |
Potential Signal of Serious Risk/New Safety Information |
Additional
Information (as of July 15, 2010) |
|---|---|---|
| Apomorphine (Apokyn) | Psychiatric events | FDA is continuing to evaluate this issue to determine the need for any regulatory action. |
| Choriogonadotropin alfa (Ovidrel) | Anaphylactic reactions | FDA is continuing to evaluate this issue to determine the need for any regulatory action. |
| Clomiphene citrate (Clomid) | Visual disorders | FDA is evaluating this issue to determine if the labeling, which includes visual disorders in the Warnings and Adverse Reactions sections, is adequate. |
| Clozapine orally disintegrating tablet (FazaClo) | Deaths | This issue relates to a finding, based on AERS reports, that the proportion of death events versus all events is higher for FazaClo than for other clozapine products. The reported events in the death cases are similar for FazaClo and other clozapine products. FDA is continuing to evaluate this issue. |
| Darifenacin (Enablex) and Solifenacin (Vesicare) | Angioedema and other allergic reactions | FDA is continuing to evaluate these issues to determine the need for any regulatory action. |
| Drospirenone/ethinyl estradiol (Yasmin) | Pancreatitis | FDA is evaluating this issue to determine if the labeling, which includes pancreatitis, is adequate. |
| Efavirenz (Sustiva) | Birth defects involving the eye and face |
This issue stemmed from a
case of anophthalmia in AERS that was originally
reported to the Antiretroviral Pregnancy
Registry (APR). The labeling was updated in
March 2009 to include a description of this
case.
In March 2010, FDA issued
Safety Labeling changes about Reproductive Risk
Potential to the Warnings and Precautions
section of the Labeling for Sustiva. |
| Fibrin
sealant products, human (Evicel, Tisseel, Artiss) |
Air embolism |
 FDA issued a Safety Alert on July 9, 2010. The Warnings and Precautions section of the labeling for fibrin sealant products, including Evicel, was revised to emphasize recommended spraying pressure and proximity to tissue in November 2009.
Dear Healthcare
Professional letters for fibrin sealant
products were issued in
September 2009
and
October 2009.
Fibrin sealant (Tisseel) Labeling (PDF - 146KB) |
| Hydrochlorothiazide in combination products | Skin reactions |
The Adverse Reactions
section of the labeling for Ziac was updated
November 2009 to address this issue.
The Adverse Reactions
section of the labeling for Lotensin HCT was
updated November 2009 to address this issue.
The Adverse Reactions
section of the labeling for Hydrochlorothiazide/Triamterene
(Dyazide) was updated February 2010 to address
this issue.
The Adverse Reactions
section of the labeling for Propanolol/Hydrochlorothiazide
(Inderide) was updated March 2010 to address
this issue. FDA is continuing to evaluate this issue to determine if labeling is adequate for the various hydrochlorothiazide-containing combination products. |
| Imiquimod cream (Aldara) | Dysuria due to severe local reactions during use in the genital area |
This issue was identified during a review of imiquimod adverse events as required by the Best Pharmaceuticals for Children Act and was presented at the November 18, 2008 Pediatric Advisory Committee meeting: One Year Post-Exclusivity Adverse Event Review: Imiquimod Pediatric Advisory Committee Meeting November 18, 2008 (PDF - 83 KB) (refer to Slide 24). The labeling will be updated to include this event. |
| Modafinil (Provigil) and Armodafinil (Nuvigil) | Serious skin reactions |
This issue was originally identified from AERS reports and added to labeling in 2007. An FDA Drug Safety Newsletter article featured this issue in Fall 2007: Modafinil (marketed as Provigil): Serious Skin Reactions. FDA is continuing to evaluate this issue to determine the need for any further regulatory action. |
| Orlistat (Xenical, Alli) | Hepatotoxicity |
FDA issued an Early
Communication about an Ongoing Safety Review on
this issue in August 2009.
FDA issued a
Completed Safety
Review Communication
for Alli/Xenical in May 2010.
This issue was added
to the Precautions and Adverse Reactions
sections of the labeling for Xenical in May
2010.
FDA is continuing to evaluate this issue to determine the need for any further regulatory action. |
| Polyethylene glycol oral laxative (various trade names) | Neuropsychiatric events |
FDA has determined that no regulatory action is needed at this time. |
| Raltegravir (Isentress) | Psychiatric events |
The Adverse Reactions
section of labeling (postmarketing experience)
was updated to include psychiatric events. Raltegravir (Isentress) labeling approved November 4, 2009 (PDF - 362KB) |
| Selegiline (Emsam) | Hypertension | FDA is continuing to evaluate this issue to determine the need for any regulatory action. |
| Sumatriptan/naproxen (Treximet) | Myocardial infarction | FDA evaluated case reports in AERS and determined that the current labeling, which includes a Boxed Warning addressing myocardial infarction, is adequate. |
| Testosterone gel (Androgel, Testim) | Adverse
events from accidental exposure
|
May 2009 FDA News Release, Testosterone Gel Safety Concerns Prompt FDA to Require Label Changes, Medication Guide, describes the addition of a Boxed Warning to the labeling addressing adverse events in children and women due to accidental exposure to testosterone gel. Testosterone gel (AndroGel) Labeling approved September 18, 2009 (PDF - 385KB) Testosterone gel (Testim) Labeling approved September 18, 2009 (PDF - 259KB) |
| Tolterodine tartrate (Detrol) | Stevens-Johnson syndrome | FDA has determined that the current Tolterodine tartrate labeling is adequate and that no further regulatory action is needed at this time. |
| Varenicline (Chantix) | Angioedema, serious skin reactions, visual impairment, accidental injury |
In July 2009, FDA approved
revised labeling (changes to Precautions and
Adverse Reactions sections and changes to the
Medication Guide) to include angioedema, serious
skin reactions, and accidental injury. Varenicline (Chantix) Labeling approved July 1, 2009 (PDF - 285KB) |