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3-16-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Biogen notified healthcare professionals of revisions to the WARNINGS, PRECAUTIONS/Drug Interactions and ADVERSE REACTIONS/Post-Marketing Experience sections and Medication Guide. Severe hepatic injury, including cases of hepatic failure, has been reported in patients taking Avonex. Asymptomatic elevation of hepatic transaminases has also been reported, and in some patients has recurred upon rechallenge. In some cases, these events have occurred in the presence of other drugs that have been associated with hepatic injury. The potential risk of Avonex used in combination with known hepatotoxic drugs or other products (e.g. alcohol) should be considered prior to Avonex administration, or when adding new agents to the regimen of patients already on Avonex.

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3-17-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Eli Lilly and FDA notified healthcare professionals about revisions to the
WARNINGS section of labeling for Xigris [drotrecogin alfa (activated)], a
biological therapeutic product indicated for the treatment of adult patients
with severe sepsis who are at high risk of death. This warning is based upon
analyses of two clinical trial databases. Among patients with single organ
dysfunction and recent surgery, all-cause mortality was numerically higher
in the Xigris group compared to the placebo group. Patients with single
organ dysfunction and recent surgery may not be at high risk of death and
therefore may not be among the indicated population. Xigris should be used
in these patients only after careful consideration of the risks and
benefits.

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3-21-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and PharMEDium Services of Houston notified healthcare professionals of
the withdrawal of one lot of PharMEDium Services Magnesium Sulfate 1 gram in
50mL D5W (piggyback) IV solution, which may be contaminated with Serratia
marcescens bacteria that can cause serious, life-threatening illness in
patients with compromised immune systems. This product is frequently
administered intravenously to patients undergoing cardiac surgery and was
apparently distributed to several hospitals around the country. To date it
has been associated with at least 5 recent cases of Serratia marcescens
infection in a hospital in New Jersey. FDA, the U.S. Centers for Disease
Control and Prevention, and other public health authorities are
investigating this problem to determine if other lots of this product may be
affected.

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3-21-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and HeartSine Technologies, Inc. notified healthcare professionals of a
worldwide recall of HeartSine samaritan AED models SAM-001, SAM-002, and
SAM-003 with certain serial numbers within the range of 1270 - 2324. These
devices may in some cases shut down before delivering a shock, which could
result in a delay in treatment or death. This recall was initiated after
receipt of several user complaints of shut-down during an attempted charge.
HeartSine Technologies, Inc. believes that some of the affected devices
could exhibit longer than usual charging rates, causing an alarm and
shutdown of the device. Distributors and customers should contact the
manufacturer to determine if their product(s) are affected, and arrange to
obtain a field upgrade kit as soon as possible.

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3-23-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and the Department of Justice initiated seizures of all finished Vail
500, 1000, and 2000 Enclosed Bed Systems made by Vail Products, Inc., in a
response to ongoing concerns about manufacturing quality and labeling. Use
of these systems poses a public health risk because patients can become
entrapped and suffocate, resulting in severe neurological damage or death.
FDA is aware of approximately 30 entrapments resulting from use of the Vail
Enclosed Bed Systems, of which at least 7 resulted in death.

FDA advises consumers to stop using Vail 500, 1000 and 2000 Enclosed Bed
Systems until they receive additional instructions from Vail Products.

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3-24-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Wyeth Pharmaceuticals announced that Trecator-SC (ethionamide tablets, USP)
Sugar-Coated Tablets have been reformulated to film-coated tablets and
renamed Trecator. The new film-coated tablet is more rapidly absorbed,
resulting in higher peak concentrations (Cmax) of ethionamide, which may
potentially lead to patient intolerance when introduced at the same initial
dose as the old sugar-coated tablet. As a result, patients should be
monitored and have their dosages re-titrated when switching from the
sugar-coated tablet to the film-coated tablet.

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3-25-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis and FDA notified healthcare professionals of revisions to the
DOSAGE AND ADMINISTRATION and WARNINGS sections of the prescribing
information to reflect new safety information on management of patients with
advanced cancer and renal impairment, whose baseline creatinine clearance is
60 ml/min or lower. The recommended Zometa doses for patients with reduced
renal function (mild and moderate renal impairment) are provided in a table.
It is recommended that, during treatment, serum creatinine be measured
before each dose and treatment should be withheld for renal deterioration.

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3-28-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Harmony Brands, Oak Park, Michigan, a national distributor of health,
cosmetic and other consumer products, is voluntarily recalling its B-Sure
brand One-Step Home Pregnancy Test because its safety and efficacy can no
longer be assured. Consumers who have the product in their possession should
not use it and should return the product to the point of purchase for a
refund. Women who have used the test may wish to contact their health care
provider to verify the test results. There have been no reports of failures
of the product, and there have been no reports of injury or illness
associated with their use. The test was sold throughout the United States in
a variety of retail outlets, including Dollar Stores and convenience stores.

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4-1-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Ortho-McNeil Neurologics modified the PRECAUTIONS section of the Prescribing
Information for Reminyl, approved only for the treatment of mild to moderate
Alzheimer's Disease. The changes provide new safety information regarding
the results of two randomized, placebo-controlled trials of 2 years duration
in subjects with mild cognitive impairment(MCI). A total of 13 subjects on
REMINYL (n=1026) and 1 subject on placebo (n=1022) died. The deaths were due
to various causes which could be expected in an elderly population. About
half of the REMINYL deaths appeared to result from various vascular causes
(myocardial infarction, stroke), and sudden death.

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4-7-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

After concluding that the overall risk versus benefit profile is
unfavorable, FDA has requested Pfizer, Inc. to voluntarily withdraw Bextra
(valdecoxib) from the market. This request is based on:

* The lack of adequate data on the cardiovascular safety of long-term use of
Bextra, along with the increased risk of adverse cardiovascular (CV) events
in short-term coronary artery bypass surgery (CABG) trials that FDA believes
may be relevant to chronic use.

* Reports of serious and potentially life-threatening skin reactions,
including deaths, in patients using Bextra. The risk of these reactions in
individual patients is unpredictable, occurring in patients with and without
a prior history of sulfa allergy, and after both short- and long-term use.

* Lack of any demonstrated advantages for Bextra compared with other NSAIDs.


Patients currently taking Bextra should contact their physicians to consider
alternative treatments. FDA is also asking manufacturers of all marketed
prescription NSAIDs, including Celebrex (celecoxib), a COX-2 selective
NSAID, to revise the labeling (package insert) for their products to include
a boxed warning and a Medication Guide. The boxed warning will highlight the
potential for increased risk of CV events with these drugs and the
well-described, serious, and potentially life-threatening gastrointestinal
(GI) bleeding associated with their use. The Medication Guide will accompany
every prescription NSAID at the time it is dispensed to better inform
patients about the CV and GI risks. Finally, FDA is asking manufacturers of
non-prescription (OTC) NSAIDs to revise their labeling to include more
specific information about the potential GI and CV risks, and information to
assist consumers in the safe use of the drug. This announcement does not
apply to aspirin as it has clearly been shown to reduce the risk of serious
adverse CV events in certain patient populations.

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4-12-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The Food and Drug Administration has issued a public health advisory to
alert health care providers, patients, and patient caregivers to new safety
information concerning an unapproved, "off-label" use of certain
antipsychotic drugs approved for the treatment of schizophrenia and mania.
FDA has determined that the treatment of behavioral disorders in elderly
patients with dementia with atypical (second generation) antipsychotic
medications is associated with increased mortality. Clinical studies of
these drugs in this population have shown a higher death rate associated
with their use compared to patients receiving a placebo.

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4-19-95 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis Pharmaceuticals and FDA notified healthcare professionals about
revisions to the WARNINGS and PRECAUTIONS sections of the prescribing
information for TRILEPTAL (oxcarbazepine) tablets and oral suspension,
indicated for use as monotherapy or adjunctive therapy in the treatment of
partial seizures in adults and children ages 4-16 years with epilepsy. The
updated WARNINGS section describes serious dermatological reactions,
including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis
(TEN) that have been reported in both children and adults in association
with Trileptal use. The PRECAUTIONS section has been updated to include
language regarding multi-organ hypersensitivity reactions that have been
reported in association with Trileptal use.

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4-20-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Dade Behring and FDA notified healthcare professionals of a class 1 recall
of MicroScan Rapid Pos Inoculum Broth, Lot numbers 050905A-1, 051005A-1,
051605A-1, 051705A-1, 052305B-1, and 052805B-1 used to inoculate
MicroScan(r) Rapid Fluorogenic Gram Positive MIC/BP panels, which are
intended for the determination of antimicrobial susceptibility of
gram-positive organisms. The recall was initiated to prevent health risk to
patients due to potential false antibiotic susceptibility results. The
possibility of inaccurate susceptibility results for a pathogen could lead a
physician to prescribe incorrect or suboptimal therapy.

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4-22-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Berlex, Inc. reminded healthcare professionals of the prescribing
information for Betaseron (interferon beta-1b) as it pertains to hepatic
toxicity. Betaseron is approved for the treatment of relapsing forms of
multiple sclerosis to reduce the frequency of clinical exacerbations. There
have been reports during post-marketing safety surveillance of serious
hepatic injury including autoimmune hepatitis and severe liver damage
leading to hepatic failure and transplant. Liver function testing is
recommended at regular intervals (one, three, and six months) following
introduction to Betaseron therapy, and then periodically thereafter in the
absence of clinical symptoms.

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4-25-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Pfizer Inc. and FDA notified healthcare professionals of the voluntary
recall of one lot (40,000 bottles) of 100 mg capsules of its epilepsy
medication, Neurontin, after a manufacturing mechanical failure resulted in
some bottles containing empty or partially filled capsules. Patients taking
Neurontin to control epilepsy could experience seizures from a missed dose
of the product. 100 mg strength capsules from lot #15224V -- distributed in
October and November, 2004 -- are included in the recall. The production lot
was distributed only in the United States. No other Neurontin lots were
affected.

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4-28-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Eli Lilly and FDA notified healthcare professionals of the stopping of enrollment in a randomized, double-blind, placebo-controlled trial of Xigris in pediatric patients with severe sepsis. Xigris is not indicated for use in pediatric severe sepsis. A planned interim analysis showed that Xigris was highly unlikely to show an improvement over placebo in the primary endpoint of "Composite Time to Complete Organ Failure Resolution" over 14 days.

A numerical increase in the rate of central nervous system (CNS) bleeding in the Xigris versus the placebo group was also noted. Over the infusion period the number of patients experiencing an intracranial hemorrhage event was 4 versus 1 for the overall population (Xigris vs. placebo), with 3 of the 4 events in the Xigris group occurring in patients aged 60 days or less.

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4-28-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Kingswood Laboratories, Inc and FDA notified healthcare professionals of a
nationwide recall of Moi-Stir Oral swabsticks due to the finding that
certain lots contain molds including Aspergillus and Penicillium which could
result in respiratory infections. The swabsticks contain a saliva supplement
intended to relieve dry mouth, physically clean the oral cavity, thin
phlegm, and lower dental caries rates.  The product was distributed to
hospitals, hospital wholesalers, pharmacies, nursing homes, physician and
dentist offices, consumers, some government medical facilities, and as free
samples to a small number of individuals.  Doctors and dentists should
consider screening patients who are at risk for infections, especially those
with weakened immune systems (low white blood cell counts) who have used the
Moi-Stir Swabstick.

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4-29-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Bedford Laboratories and FDA notified healthcare professionals of the
voluntary recall of one lot of Famotidine Injection, 20 mg/2 mL (NDC
55390-029-10), Lot# 609336, exp. 04/06, due to a lack of sterility
assurance. This prescription product was distributed in August 2004
throughout the United States to wholesalers and distributors, who further
distributed the product to hospitals.

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5-2-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Laerdal Medical Corporation and FDA notified healthcare professionals of a
voluntary recall of all lots of CM 100-Heartstart Adapter Cable, Cat. No.
920650 (Adapter Cable). Wires within the defibrillator adapter cables are
susceptible to breakage that prevented delivery of defibrillation shocks.
The test method described in the defibrillator instructions for use will not
detect internal breaks in the adapter cables. Use of these Adapter Cables
should be discontinued.

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5-10-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals that serious injury or death can occur
when patients with implanted neurological stimulators undergo MRI
procedures. The FDA received several reports of serious injury, including
coma and permanent neurological impairment. The mechanism for these adverse
events is likely to involve heating of the electrodes at the end of the
leadwires, resulting in injury to the surrounding tissue. The public health
notification also offered recommendations for preventive actions.

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5-11-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA warned the public about the sale of counterfeit versions of Lipitor,
Viagra, and an unapproved product promoted as "generic Evista" to U.S.
consumers at pharmacies in Mexican border towns. The "generic Evista" was
analyzed by FDA in coordination with the National Association of Boards of
Pharmacy and was found to contain no active ingredient. The counterfeit
Lipitor and counterfeit Viagra were analyzed by Pfizer, Inc. and were also
found to contain no active ingredient. Consumers who have any of these
counterfeit products should not use them and should contact their healthcare
provider immediately.

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5-11-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

LifeScan, Inc, initiated a worldwide notification to all users of its
OneTouch Ultra, InDuo and OneTouch FastTake Meters. LifeScan found that it
was possible for consumers, in the course of setting their meter's date and
time, to accidentally change the unit of measure and thereby misinterpret
their blood glucose results. The notification program includes letters to
registered users and health care professionals, and also special
instructions inserted in each package of test strips. The products are
distributed worldwide primarily through retail pharmacy and mail order
channels.

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5-12-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

MRL Inc. and FDA notified healthcare professionals of a voluntary worldwide
recall of 597 AED20 Automatic External Defibrillators manufactured between
February and July of 2004. The AED20 may display a "Defib Comm" error
message during use resulting in a failure of the device to analyze the
patient's ECG and deliver the appropriate therapy which prevents the
defibrillator from resuscitating a patient. The company has received 12
related complaints with this specific group of AED20's, including one
instance which may have prevented patient resuscitation.

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5-18-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

BioMerieux and FDA notified healthcare professionals of a class 1 recall of
MDA Simplastin HTF (human thromboplastin factor) tissue reagent, a tissue
thromboplastin reagent used in determination of the prothrombin time (PT) in
human plasma. The prothrombin time (PT) laboratory test is used to control
the use of oral anticoagulant therapy, (i.e. Coumadin) in patients with
bleeding disorders. Mislabeling problems with certain lots of this product
could result in inaccurate test results, which in turn could lead to
improper patient treatment - in some cases resulting in serious or
life-threatening injury. Although BioMerieux initiated a recall of these
products in March 2005, its notifications to purchasers incorrectly
indicated that the problem was of no clinical significance. The company is
now clearly informing its customers about the importance of this problem and
the need to respond to it. Laboratories that have this reagent should not
use it, but instead contact the company. Laboratories that have used this
reagent should also contact any physicians or medical institutions whose
patients may be affected by this problem.

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5-18-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis and FDA notified dental healthcare professionals of revisions to
the prescribing information to describe the occurence of osteonecrosis of
the jaw (ONJ) observed in cancer patients receiving treatment with
intravenous bisphosphonates, Aredia (pamidronate disodium) and Zometa
(zoledronic acid). The prescribing information recommends that cancer
patients receive a dental examination prior to initiating therapy with
intravenous bisphosphonates (Aredia and Zometa), and avoid invasive dental
procedures while receiving bisphosphonate treatment. For patients who
develop ONJ while on bisphosphonate therapy, dental surgery may exacerbate
the condition.

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5-20-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The Master's Miracle (TMM) company of Minneapolis, Minn., and FDA alerted
the public against applying the company's TMM brand Fortified Mineral
Neutralizer and Ultra Fortified Mineral Neutralizer to the eyes because
these products may be contaminated with Pseudomonas aeruginosa, Pseudomonas
flourescens/putida and Enterobacter cloacae -- bacteria that, if applied to
the eyes, might lead to serious injury, including possible blindness. The
products are labeled as a Dietary Supplement and distributed nationwide in 8
oz., 20 oz. and one-gallon size containers.

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5-24-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Serono and FDA notified healthcare professionals of revisions to the BOXED WARNING, WARNINGS, and DOSAGE AND ADMINISTRATION sections of the prescribing information for Novantrone [mitoxantrone], indicated for treatment of multiple sclerosis (MS). The Dear Healthcare Professional letter provides additional information concerning the risks of cardiotoxicity associated with Novantrone and also provides supplemental information regarding secondary acute myelogenous leukemia (AML) reported in MS patients treated with Novantrone.

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6-01-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The Food and Drug Administration notified consumers and healthcare
professionals of a nationwide recall of all manufactured drugs (mostly
generic prescription drugs, including drugs containing acetaminophen) from
Able Laboratories of Cranbury, NJ, because of serious concerns that they
were not produced according to quality assurance standards. Able
Laboratories has ceased all current production.

FDA recommends that people who have been taking drugs produced by this firm
speak with their health care provider or pharmacist to obtain a replacement
drug product. Consumers should continue taking the medication until they
have spoken with their health care provider. FDA has provided a list with
the names of the recalled drugs and their imprint codes, marks (usually
letters and numbers) found on the surfaces of drugs.

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6-03-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

McNeil Specialty Pharmaceuticals and FDA notified consumers and healthcare
professionals about a nationwide recall of all lots and all flavors of
Children's TYLENOL Meltaways 80 mg, Children's TYLENOL SoftChews 80mg, and
Junior TYLENOL Meltaways 160mg. The recall addresses issues regarding the
design of the blister package, information on the package, and bottle
cartons for the products that may be confusing and lead to improper dosing,
including overdosing.

Read the complete MedWatch 2005 Safety summary, including a link to the firm
press release, at:

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6-10-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Bristol-Myers Squibb and FDA notified healthcare professionals of revisions
to the WARNINGS, PRECAUTIONS/Pregnancy and Information for Patients, and
PATIENT INFORMATION sections of the prescribing information for Sustiva
(efavirenz), indicated in the treatment of HIV-1 infection. The revisions
are a result of four retrospective reports of neural tube defects in infants
born to women with first trimester exposure to Sustiva, including three
cases of meningomyelocele and one Dandy Walker Syndrome. As Sustiva may
cause fetal harm when administered during the first trimester to a pregnant
woman, pregnancy should be avoided in women receiving Sustiva. An
antiretroviral pregnancy registry has been established to monitor fetal
outcomes of pregnant women exposed to Sustiva.

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6-15-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA has requested that sponsors of all non-steroidal anti-inflammatory drugs
(NSAID) make labeling changes to their products. FDA recommended proposed
labeling for both the prescription and over-the-counter (OTC) NSAIDs and a
medication guide for the entire class of prescription products. All sponsors
of marketed prescription NSAIDs, including Celebrex (celecoxib), a COX-2
selective NSAID, have been asked to revise the labeling (package insert) for
their products to include a boxed warning, highlighting the potential for
increased risk of cardiovascular (CV) events and the well described,
serious, potential life-threatening gastrointestinal (GI) bleeding
associated with their use. FDA regulation 21CFR 208 requires a Medication
Guide to be provided with each prescription that is dispensed for products
that FDA determines pose a serious and significant public health concern.

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6-16-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Qualitest Pharmaceuticals and FDA notified healthcare professionals and
consumers of a voluntary nationwide recall of AccuSure Insulin Syringes 1cc,
28 Gauge 1/2 Inch, distributed between October 2004 and June 2005. There may
be 1cc syringes which are mislabeled as 1/2 cc syringes on the plastic inner
wrap holding 10 individual syringes, which could potentially result in
confusion by the patient or caregiver, resulting in an incorrect dose or
amount being administered.

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6-16-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Quality Care Products, LLC, a federally licensed drug re-packager, and FDA
notified healthcare professionals of a nationwide recall of any and all
numbers repackaged from drugs that were manufactured by Able Laboratories
Inc. This recall is due to Able Laboratories voluntary recall of all of
their drug products because of the FDA's serious concerns that they were not
produced according to quality assurance standards.

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6-17-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

AstraZeneca and FDA notified healthcare professionals of new approved labeling for Iressa that states the medicine should be used only in cancer patients who have already taken the medicine and whose doctor believes it is helping them. New patients should not be given Iressa because in a large study Iressa did not make people live longer. There are other medicines for non-small cell lung cancer (NSCLC) that have shown an ability to make people live longer.

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6-21-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Guidant Corporation notified health care providers and patients of
the recall of certain implantable defibrillators and cardiac
resynchronization therapy defibrillators. These devices, surgically
implanted in persons who have a type of heart disease that creates the risk
of a life-threatening heart arrhythmia (abnormal rhythm), can develop an
internal short circuit without warning, resulting in the devices' inability
to deliver an electrical shock during episodes of arrhythmia -- which could
lead to a serious, life-threatening event. There have been two deaths
reported to FDA suspected to be associated with this malfunction. The
devices affected by this notification are:
PRIZM 2 DR, Model 1861, manufactured on or before April 16, 2002
CONTAK RENEWAL, Model H135, manufactured on or before August 26, 2004
CONTAK RENEWAL 2, Model H155, manufactured on or before August 26, 2004

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6-24-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Vail Products is permanently ceasing the manufacture, sale and distribution
of all Vail enclosed bed systems, and will no longer be available to provide
accessories, replacement parts, or retrofit kits. On June 23 and 24, 2005,
revised instruction manuals and warning labels were mailed to customers with
Vail 500, Vail 1000 or Vail 2000 enclosed bed systems. The revised manuals
include new warnings, precautions, and instructions for use. FDA is advising
hospitals, nursing homes and consumers who have a Vail enclosed bed system
to stop using it and move the patient to an alternate bed. Consumers who are
using Vail beds at home can consult with their physicians about other
options.

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6-28-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Boston Scientific and FDA notified healthcare professionals of a recall of
all Hemashield VANTAGE vascular grafts manufactured in the last two years
due to the potential for the device, used in peripheral procedures, to fray
or tear during suturing and lead to post-operative complications. Boston
Scientific is aware of three reported post-operative failures which occurred
between three and seven days post-procedure. In all of these cases, the
patients were successfully treated by re-suturing the graft or replacing it.

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7-01-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

In response to recent scientific publications that report the possibility of
increased risk of suicidal behavior in adults treated with antidepressants,
the FDA has issued a Public Health Advisory to update patients and
healthcare providers with the latest information on this subject. Even
before the publication of these recent reports, FDA had already begun the
process of reviewing available data to determine whether there is an
increased risk of suicidal behavior in adults taking antidepressants. The
Agency has asked manufacturers to provide information from their trials
using an approach similar to that used in the evaluation of the risk of
suicidal behavior in the pediatric population taking antidepressants. This
effort will involve hundreds of clinical trials and may take more than a
year to complete.

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7-05-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified consumers and healthcare professionals about the risks of
taking Liqiang 4 Dietary Supplement Capsules because they contain glyburide
- a drug that could have serious, life-threatening consequences in some
people. The product is manufactured by Liqiang Research Institute, China,
and marketed throughout the United States in herbal stores and through mail
order by Bugle International of Northridge CA. Glyburide is a drug used to
lower blood sugar, and is safe and effective when used as labeled in
FDA-approved medications. People who have low blood sugar or those with
diabetes can receive dangerously high amounts of glyburide by consuming
Liqiang 4. Consumers should immediately stop using these products and seek
medical attention, especially if they are currently being treated with
diabetes drugs or if they have symptoms of fatigue, excessive hunger,
profuse sweating, or numbness of the extremities.

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7-08-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals of updated labeling for Cialis,
Levitra and Viagra to reflect a small number of post-marketing reports of
sudden vision loss, attributed to NAION (non arteritic ischemic optic
neuropathy), a condition where blood flow is blocked to the optic nerve. FDA
advises patients to stop taking these medicines, and call a doctor or
healthcare provider right away if they experience sudden or decreased vision
loss in one or both eyes. Patients taking or considering taking these
products should inform their health care professionals if they have ever had
severe loss of vision, which might reflect a prior episode of NAION. Such
patients are at an increased risk of developing NAION again. At this time,
it is not possible to determine whether these oral medicines for erectile
dysfunction were the cause of the loss of eyesight or whether the problem is
related to other factors such as high blood pressure or diabetes, or to a
combination of these problems.

Read the complete MedWatch 2005 Safety summary, including links to the new
labeling information and additional information for healthcare providers and
consumers at:

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7-08-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Janssen and FDA notified healthcare professionals of changes to the BOXED
WARNING/WARNINGS,CONTRAINDICATIONS,PRECAUTIONS, and DOSAGE AND
ADMINISTRATION sections of the prescribing information for Duragesic. These
changes include important safety information in the following areas of the
labeling: Use Only in Opioid-Tolerant Patients, Misuse, Abuse and Diversion,
Hypoventilation (Respiratory Depression), Interactions with CYP3A4
Inhibitors, Damaged or Cut Patches, Accidental Exposure to Fentanyl, Chronic
Pulmonary Disease, Head Injuries and Intracranial Pressure, Interactions
with Other CNS Depressants, and Interactions with Alcohol and Drugs of
Abuse.

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7-14-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a public health advisory to notify health care professionals and
consumers that the sponsor of Palladone, Purdue Pharma, has agreed to
suspend sales and marketing of Palladone (hydromorphone hydrochloride,
extended release capsules), a potent narcotic painkiller, because of the
potential for severe side effects if Palladone is taken with alcohol.
Drinking alcohol while taking Palladone may cause rapid release of
hydromorphone, leading to high drug levels in the body, with potentially
fatal effects. High drug levels of hydromorphone may depress or stop
breathing, cause coma, and even cause death.

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7-15-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a public health advisory to alert health care professionals,
patients and their caregivers of reports of death and other serious side
effects from overdoses of fentanyl in patients using fentanyl transdermal
(skin) patches for pain control. Deaths and overdoses have occurred in
patients using both the brand name product Duragesic and the generic
product. Some patients and health care providers may not be fully aware of
the dangers of this very strong narcotic painkiller. The directions for
using the fentanyl skin patch must be followed exactly to prevent death or
other serious side effects from overdosing with fentanyl.

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7-18-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a Preliminary Public Health Notification and Advice for Patients
for Guidant VENTAK PRIZM 2 DR and CONTAK RENEWAL Implantable Cardioverter
Defibrillators to provide clinicians with current information and guidance
concerning malfunctions occurring with these devices, which were the
subjects of a Class I recall announced by FDA on July 1, 2005. The
malfunction that is the subject of the recall causes damage to the device's
circuitry, potentially resulting in the inability to deliver the required
shock during episodes of arrhythmia. This malfunction could lead to a
serious, life-threatening event. Importantly, the device does not give any
sign of impending failure, and there is no test that predicts whether any
particular device will fail. The affected devices are:

VENTAK PRIZM 2 DR, Model 1861, manufactured on or before April 16, 2002
CONTAK RENEWAL, Model H135, manufactured on or before August 26, 2004
CONTAK RENEWAL 2, Model H155, manufactured on or before August 26, 2004

--------------------

7-19-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Guidant notified physicians and patients of new safety information for
certain models of cardiac pacemakers manufactured between November 25, 1997
and October 26, 2000. A hermetic sealing component used in these devices may
experience a gradual degradation, resulting in a higher than normal moisture
content within the pacemaker case late in the device's service life. The
clinical behaviors associated with this failure mode can result in serious
health complications. Guidant has confirmed twenty reports of loss of pacing
output associated with this failure mode, including five patients
experiencing syncope. Loss of pacing output has also been associated with
reports of presyncope requiring hospitalization. Guidant has received two
reports of sustained Maximum Sensor Rate ("MSR") pacing in which heart
failure may have developed in association with sustained high rate pacing.
Physicians should consider the unique needs of individual patients and the
specific technical recommendations set forth in the July 18, 2005 physician
communication. Guidant recommends that physicians consider replacing devices
for pacemaker-dependent patients and advises patients to seek medical
attention immediately if they notice shortness of breath, dizziness,
lightheadedness or a prolonged fast heart rate.

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7-20-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Danco Laboratories and FDA have revised the BOXED WARNING and WARNINGS
sections of the Prescribing Information, the Medication Guide and Patient
Agreement to inform healthcare professionals of four cases of septic deaths
in the United States, all reported from California, from September 2003 to
June 2005 in women following medical abortion with mifepristone (Mifeprex)
and misoprostol. The bacteria causing sepsis has been identified in two of
the cases as Clostridium sordellii. The two confirmed cases of Clostridium
sordellii did not have the usual signs and symptoms of an infection. All
providers of medical abortion and their patients need to be aware of the
risks of sepsis.

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7-20-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Genentech and FDA revised the WARNINGS, ADVERSE REACTIONS sections and
Patient Information Sheet for RAPTIVA (efalizumab), indicated for the
treatment of adult patients (18 years or older) with chronic moderate to
severe plaque psoriasis who are candidates for systemic therapy or
phototherapy. Healthcare professionals and patients were informed about
reports of immune-mediated hemolytic anemia and warnings regarding
postmarketing reports of thrombocytopenia and serious infections including
necrotizing fasciitis, tuberculous pneumonia, bacterial sepsis with seeding
of distant sites, severe pneumonia with neutropenia, and worsening of
infection (e.g. cellulitis, pneumonia) despite antimicrobial treatment.

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7-21-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Baxter Healthcare Corporation and FDA notified healthcare professionals of a
Class I recall of all models of its Colleague Volumetric Infusion Pumps
because they can shut down while delivering critical medication and fluids
to patients. Baxter has received six reports of serious injury and three
reports of death associated with this shut-down problem. The affected are:
Models 2M8151, 2M8151R, 2M8161, 2M8161R, 2M8153, 2M8153R, 2M8163, 2M8163R.
In addition to the shut-down problem, the device may exhibit two additional
failure modes: 1) Users may inadvertently press the on/off key instead of
the start key when attempting to start an infusion; 2) Disconnecting or
connecting the pump from the hospital monitoring system while the pump is
powered "on" can result in a failure code, requiring the infusion to be
restarted. These failures may occur during the infusion of therapy, so it is
imperative that health care institutions have a contingency plan to mitigate
any disruptions of infusions of life-sustaining drugs or fluids.
Approximately 255,000 Colleague Volumetric Infusion Pumps are currently in
use, including 206,000 distributed in the United States.

--------------------

7-29-05 Guidant notified healthcare professionals in an update letter issued July 22
that one of the safety recommendations made to physicians on June 17
regarding its VENTAK PRIZM, VITALITY, and CONTAK RENEWAL AVT implantable
cardioverter defibrillators (ICDs) may significantly increase the risk to
patients. Physicians are advised to schedule follow-up visits as soon as
possible for patients with devices reprogrammed as per original instructions
and for all patients with Atrial Episode Data Storage programmed to less
than 20%.

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8-01-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Disetronic Medical Systems and FDA notified healthcare professionals and
patients about a nationwide recall of D-TRON adapters, used with the
D-TRONplus insulin pump, because they can potentially over-deliver a maximum
amount of up to 1.8 I.U. of insulin. Use of these recalled adapters may pose
a potential life-threatening situation to certain children using the pump.
Other users who are insulin sensitive may also be at increased risk.

--------------------

8-02-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA alerted U.S. residents to the recent recall of a batch of counterfeit
"Lipitor" (atorvastatin) sold in the United Kingdom (U.K.). The medicine is
used to treat high cholesterol. The counterfeit Lipitor 20mg tablets were
recalled in the U.K. on July 28, 2005.  Health authorities in the U.K.
stated that initial results of tests performed on the counterfeit drugs do
not indicate that this product poses an immediate risk to patients. Some
U.S. residents may have obtained prescription drugs from the U.K. through
on-line or storefront operations that do not supply legitimate, FDA-approved
products, or through state-run drug importation programs that facilitate the
purchase of unapproved foreign drugs. Consumers who purchase drugs through
these arrangements may have received these counterfeit products. U.S.
patients who have the identified U.K. drugs should stop using them and
should consult their physician or pharmacist if they have any questions or
concerns.

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8-03-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a Public Health Notification to alert healthcare professionals to
serious complications associated with the use of metallic tracheal stents in
patients with benign airway disorders, and to recommend specific actions to
prevent or minimize the problem. This notification includes all covered and
uncovered metallic tracheal stents. These complications include obstructive
granulation tissue, stenosis at the ends of the stent, migration of the
stent, mucous plugging, infection, and stent fracture. This notification
focuses on patients with benign airway disorders because use of metallic
stents in this patient population may preclude them from receiving future
alternative therapies (such as tracheal surgical procedures or placement of
silicone stents) after a metallic stent is removed.

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8-03-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Perrigo and FDA notified healthcare professionals and consumers of the
recall of all lots of concentrated infants' drops that are packaged with a
dosing syringe bearing only a "1.6 mL" mark containing 1] acetaminophen,2]
acetaminophen, dextromethorphan HBr, and pseudoephedrine HCl, or 3]
dextromethorphan HBr, and pseudoephedrine HCl. The dosing syringe may be
confusing in determining the proper dose for infants under 2 years of age as
directed by a doctor and could lead to improper dosing, including
overdosing. The following products are being recalled:

    * Cherry Flavor Infant Pain Reliever 160 mg Acetaminophen (0.5oz. and
1.0oz)
    * Grape Flavor Infant Pain Reliever 160 mg Acetaminophen (0.5oz. and
1.0oz)
    * Cherry Flavor Cough and Cold Infant Drops (0.5oz)
    * Cherry Flavor Decongestant and Cough Infant Drops (0.5oz)

Read the complete MedWatch 2005 Safety summary, including a link to the FDA
Talk Paper and the firm press release, at:

--------------------

8-12-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and patients of the approval of a
strengthened risk management program, called iPLEDGE, for Accutane and
generic isotretinoin. The strengthened program requires registration of
wholesalers, prescribers, pharmacies and patients who agree to accept
specific responsibilities designed to minimize pregnancy exposures in order
to distribute, prescribe, dispense and use Accutane. In addition to
approving the iPLEDGE program, FDA has approved changes to the existing
warnings, patient information and informed consent document so that patients
and prescribers can better identify and manage the risks of psychiatric
symptoms and depression before and after prescribing isotretinoin.

Read the complete MedWatch 2005 Safety Summary, including a link to the FDA
Public Health Advisory and Press Release, FDA Drug Information Page,
Healthcare Professional Information Sheet, FDA Patient Information Sheet,
and the approved product labeling:

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8-19-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Gambro Dasco S.p.A notified healthcare professionals and consumers of a
safety alert for the Prisma continuous renal replacement system (all catalog
numbers). Gambro Dasco has become aware of several serious injuries and
deaths resulting from excessive ultrafiltration (fluid being removed from
the patient's body). This problem can occur when the user does not address
the cause of the "Incorrect Weight Change Detected" alarm. This alarm should
never be overridden without first identifying and removing the cause of the
alarm. The device remains appropriate for use when these directions are
followed.

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8-29-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Custom RX Compounding Pharmacy and FDA notified ophthalmologists, other
healthcare professionals, and consumers about a nationwide recall of Trypan
Blue 0.06% Ophthalmic Solution, intended for use in the eyes during cataract
surgery, because it may be contaminated with Pseudomonas aeruginosa, a
bacteria that, if applied to the eyes, might lead to serious injury,
including possible blindness. Custom Rx Pharmacy is asking that all
unexpired syringes be collected and returned to the pharmacy. The product
was distributed to hospitals and clinics in Maryland, Minnesota, Illinois,
Nebraska, North Dakota, Michigan, the District of Columbia, and
Pennsylvania. The recall includes, but may not be limited to the following
lot numbers: 05042005:86@17, 05252005:36@13, 06282005:91@27, 08012005:63@24,
and 08182005:43@17.

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8-29-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Medline and FDA notified healthcare professionals about a nationwide recall
of Alcohol-Free Mouthwash and Hygiene Kits containing mouthwash because of
potential contamination with Burkholderia cepacia. People who have certain
health problems such as weakened immune systems or chronic lung diseases,
particularly cystic fibrosis (CF), may be more susceptible to infections
with B. cepacia. The product was distributed to hospitals, medical centers,
and long term care facilities nationwide. There is no known distribution
through retail sales. The CDC has confirmed hospital illness associated with
the use of the affected mouthwash in Texas and Florida.

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8-31-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Genentech and FDA notified healthcare professionals of updated
cardiotoxicity information related to the use of Herceptin (trastuzumab),
obtained from the National Surgical Adjuvant Breast and Bowel Project
(NSABP) study (B-31), a randomized, Phase III trial that was conducted in
2043 women with operable, HER2 overexpressing breast cancer (IHC 3+ or
FISH+). This study demonstrated a significant increase in cardiotoxicity in
patients who were randomized to the Herceptin-containing arm as compared to
patients who received chemotherapy alone.

Preliminary analysis of safety data from Study NSABP B-31 and the North
Central Cancer Treatment Group (NCCTG) study (N9831) revealed a
statistically significant increase in the 3-year cumulative incidence of New
York Heart Association Class III and IV congestive heart failure and cardiac
death observed in patients who received the Herceptin-containing regimen
(4.1%) compared with control (0.8%). There were no cardiac deaths observed
in patients who received the Herceptin-containing regimen and one cardiac
death was observed in the control arm. Final analysis of the cardiac safety
data collected in Studies NSABP B-31 and NCCTG N9831 is ongoing.

--------------------

9-16-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

BioMerieux and FDA notified healthcare professionals of a recall of VeriCal
Calibrator Set, used to calibrate the Prothrombin Time (PT) and Activated
Partial Thromboplastin Times (APTT) on bioMerieux instrument platforms. This
recall only impacts INR determinations derived from Prothrombin Tim (PT)
results on the following instrument platforms: MDA Coag-A-Mate MTX and
Coag-A-Mate MAX. The recall is due to the mis-assignment of ISI values
associated with VeriCal use. These calibrated ISI values are currently
provided on Simplastin HFT and Simplastin L product labeling. The VeriCal
labeling currently contains PT time in seconds and is being revised to
include ISI assignment for specified reagents. The product recall notice
offers detailed recommendations for action by laboratory personnel using
these products.

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9-17-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA is notifying healthcare professionals and hospitals about a product
recall involving all injectable products manufactured by Central Admixture
Pharmacy Services, Inc. of Lanham, Maryland ("CAPS") due to concerns
regarding the sterility of these injectable products.    CAPS distributed
the affected injectable products to hospitals in Maryland, Delaware,
Washington, D.C., and Virginia. Gram negative rods have been identified in
two lots of Cardioplegia solution manufactured by CAPS.  Non-sterility of
injectable products could represent a serious hazard to health that could
lead to life-threatening injuries and death.  

--------------------

9-27-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

AstraZeneca and FDA notified healthcare professionals reports of medication
dispensing or prescribing errors between Toprol-XL (metoprolol succinate)
extended release tablets, indicated for the treatment of hypertension,
long-term treatment of angina pectoris, and heart failure NYHA Class II or
III, and Topamax (topiramate), a product of Ortho-McNeil Neurologics, Inc,
indicated for the treatment of epilepsy and migraine prophylaxis. There have
also been reports of medication errors involving confusion between Toprol-XL
and Tegretol or Tegretol-XR (carbamazepine), products of Novartis
Pharmaceuticals Corporation, indicated for the treatment of complex partial
seizures, generalized tonic-clonic seizures, and trigeminal neuralgia. These
reports include instances where Toprol-XL was incorrectly administered to
patients instead of Topamax, Tegretol, or Tegretol-XR, and vice versa, some
of them leading to adverse events.

--------------------

9-27-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

GlaxoSmithKline (GSK) and FDA notified healthcare professionals of changes
to the Pregnancy/PRECAUTIONS section of the Prescribing Information for
Paxil and Paxil CR Controlled-Release Tablets to describe the results of a
GSK retrospective epidemiologic study of major congenital malformations in
infants born to women taking antidepressants during the first trimester of
pregnancy. This study suggested an increase in the risk of overall major
congenital malformations for paroxetine as compared to other antidepressants
[OR 2.2; 95% confidence interval, 1.34-3.63]. Healthcare professionals are
advised to carefully weigh the potential risks and benefits of using
paroxetine therapy in women during pregnancy and to discuss these findings
as well as treatment alternatives with their patients.

--------------------

9-27-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

American Pharmaceutical Partners, Inc. and FDA notified healthcare professionals about a nationwide recall of Fluorouracil Injection 50 mg/mL   

(500 mg/10 mL Single Dose Vial) because of the potential for invisible glass particles containing silica and aluminum in vials of the product. The company states that only Product code 101710 is susceptible to this type of glass breakdown.

--------------------

9-29-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA directed Eli Lilly and Company (Lilly), the manufacturer of
Strattera (atomoxetine), to revise the prescribing information to include a
boxed warning and additional warning statements that alert health care
providers of an increased risk of suicidal thinking in children and
adolescents being treated with this medication. FDA also informed Lilly that
a Patient Medication Guide (MedGuide) should be provided to patients when
Strattera is dispensed. The MedGuide advises patients of the risks
associated with and precautions that can be taken when Strattera is
dispensed. Further, pediatric patients being treated with Strattera should
be closely observed for clinical worsening, as well as agitation,
irritability, suicidal thinking or behaviors, and unusual changes in
behavior, especially during the initial few months of a course of drug
therapy, or at times of dose changes, either increases or decreases.

--------------------

10-03-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and CDC notified consumers and health care providers of five reports of
Guillain Barre Syndrome following administration of Meningococcal Conjugate
Vaccine A, C, Y, and W135 (trade name Menactra), manufactured by Sanofi
Pasteur. It is not known yet whether these cases were caused by the vaccine
or are coincidental. FDA and CDC are sharing this information with the
public now and actively investigating the situation because of its
potentially serious nature. Guillain Barre Syndrome (GBS) is a serious
neurological disorder that can occur, often in healthy individuals, either
spontaneously or after certain infections. GBS typically causes increasing
weakness in the legs and arms that can be severe and require
hospitalization. Because of the potentially serious nature of this matter,
FDA and CDC are asking any persons with knowledge of any possible cases of
GBS occurring after Menactra to report them to the Vaccine Adverse Event
Reporting System <https://secure.vaers.org/VaersDataEntryintro.htm>  (VAERS)
to help the agencies further evaluate the matter.

--------------------

10-17-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Boston Scientific notified healthcare professionals and patients
about serious adverse events, including death, occurring in patients treated
with ENTERYX, a liquid chemical polymer which is intended to be injected
into the lower esophageal sphincter for treatment of gastroesophageal reflux
disease. The serious adverse events involve unrecognized transmural
injections of ENTERYX(r) into structures surrounding the esophagus. On
September 23, 2005, Boston Scientific issued a recall of all ENTERYX
Procedure Kits and ENTERYX Injector Single Packs from commercial
distribution.

--------------------

10-17-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Eli Lilly and FDA notified healthcare professionals of revision to the
PRECAUTIONS/Hepatotoxicity section of the prescribing information for
Cymbalta (duloxetine hydrochloride), indicated for treatment of major
depressive disorder and diabetic peripheral neuropathic pain. Postmarketing
reports of hepatic injury (including hepatitis and cholestatic jaundice)
suggest that patients with preexisting liver disease who take duloxetine may
have an increased risk for further liver damage. The new labeling extends
the Precaution against using Cymbalta in patients with substantial alcohol
use to include those patients with chronic liver disease. It is recommended
that Cymbalta not be administered to patients with any hepatic
insufficiency.

--------------------

10-27-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified health care providers and patients of a problem with blood
glucose meters made by Abbott Diabetes Care, Alameda, Calif. The meters can
unintentionally be switched from one unit of measurement to another,
resulting in an inaccurate blood glucose interpretation by the user. Users
in the United States should make sure that their meter reading is displayed
as mg/dL because an inaccurate reading can lead to taking the wrong dose of
insulin or dietary changes, resulting in higher levels of sugar in the blood
or hyperglycemia. Hyperglycemia can be a serious and even life-threatening
condition and several cases of hyperglycemia have been reported to FDA.

--------------------

10-28-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Biogen Idec and FDA notified healthcare professionals of revision to BOXED
WARNINGS, WARNINGS, and ADVERSE REACTIONS sections of the Prescribing
Information to describe severe cutaneous or mucocutaneous reactions, some
with fatal outcome, that have been reported in association with the Zevalin
therapeutic regimen in the post-marketing experience. Patients experiencing
a severe cutaneous or mucocutaneous reaction should not receive any further
components of the Zevalin therapeutic regimen and should seek prompt medical
evaluation.

--------------------

11-02-05 Omron Healthcare Inc. initiated a voluntary recall of certain Omron(r) 3-Way
Instant Thermometers - model numbers MC-600 and MC-600CAN - due to
overheating of the tip. Omron had received consumer complaints indicating
discomfort during and following use of the thermometers. Consumers who
continue using the affected thermometers are at risk of discomfort during
use, potentially resulting in redness or even a blister on the skin. Very
young children using this device are at an increased risk due to the
inability to express themselves and to their difficulty in pulling away from
the device held by an adult. The battery-operated, digital thermometers,
available through drug stores, the pharmacy sections of food stores and mass
merchandise chains, and internet retailers were sold in the United States
and Canada between Sept. 19, 2001, and October 21, 2005.

--------------------

11-04-05 Ligand Pharmaceuticals Inc. and FDA notified healthcare professionals of
revisions to BOXED WARNING, WARNINGS, PRECAUTIONS, CLINICAL PHARMACOLOGY,
and DOSAGE AND ADMINISTRATION sections of the prescribing information to
highlight and strengthen the warning that patients should not consume
alcohol while taking Avinza. Additionally, patients must not use
prescription or non-prescription medications containing alcohol while on
Avinza therapy.

--------------------

11-10-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified physicians, nurses, medical technologists, pharmacists and
other healthcare professionals of the potential for life-threatening falsely
elevated glucose readings in patients who have received parenteral products
containing maltose or galactose, or oral xylose, and are subsequently tested
using glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) based glucose
monitoring systems. There have been reports of the inappropriate
administration of insulin and consequent life-threatening/fatal hypoglycemia
in response to erroneous test results obtained from patients receiving
parenteral products containing maltose. Cases of true hypoglycemia can go
untreated if the hypoglycemic state is masked by false elevation of glucose
readings. A preliminary listing of U.S. products that may cause glucose test
interference is provided.

--------------------

11-10-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Biogen Idec and FDA notified healthcare professionals of revisions to
CONTRAINDICATIONS section of the prescribing information for Amevive,
indicated for the treatment of adult patients with moderate to severe
chronic plaque psoriasis who are candidates for systemic therapy or
phototherapy. Amevive should not be administered to patients infected with
HIV. Amevive reduces CD4+ T lymphocyte counts, which might accelerate
disease progression or increase complications of disease in these patients.
In addition, other sections of the product labeling were revised to reflect
additional safety information.

--------------------

11-14-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and patients of revisions to the label
for Ortho Evra, a skin patch approved for birth control, that includes a
bolded warning about higher exposure to estrogen for women using the weekly
patch compared to taking a daily birth control pill containing 35 micrograms
of estrogen. A woman on Ortho Evra may be exposed to approximately 60% more
estrogen than if she were taking a typical 35 microgram estrogen birth
control pill. Estrogen use is linked to blood clots in the legs and lungs
and other clotting problems such as strokes and heart attacks. It is not
known if women using Ortho Evra have a higher risk of serious side effects
than women taking the typical 35 microgram estrogen pills.

--------------------

11-16-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Risk of Electromagnetic Interference with Medical Telemetry Systems
Operating in the 460-470 MHz Frequency Bands
FDA issued a Public Health Notification regarding increased risk for
electromagnetic interference in any medical telemetry systems operating in
the 460-470 MHz frequency bands after December 31, 2005. This interference
could compromise patient safety. In January 2006 the Federal Communications
Commission will begin issuing new licenses for mobile radio transmitters to
operate in the 460-470 MHz band.

According to tests conducted by the FDA, the transmitters operating under
new licenses in this frequency band can interfere with medical telemetry
systems. This could lead to lapses in patient monitoring and missed alarm
events, putting patients at risk. The anticipated interference will not be
limited to urban areas. Any medical facility in the vicinity of a mobile
radio could be affected.

--------------------

11-18-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Novartis Nutrition Corporation notified healthcare professionals of
a recall of 2,712 bottles of an enteral feeding formula that was incorrectly
labeled as Diabetisource AC 1.5 Liter bottles lot 2135L. The affected
product was shipped nationwide and is only distributed to healthcare
institutional facilities. The bottles contain sodium and calcium caseinate,
components of milk. People with an allergy or severe sensitivity to milk may
run the risk of a serious or life threatening allergic reaction if they
consume this product. Healthcare professionals administering Diabetisource
AC to patients who have an allergy or sensitivity to milk should immediately
stop using this product.

--------------------

11-18-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified manufacturers of Advair Diskus, Foradil Aerolizer, and Serevent
Diskus to update their existing product labels with new warnings and a
Medication Guide for patients to alert health care professionals and
patients that these medicines may increase the chance of severe asthma
episodes, and death when those episodes occur. All of these products contain
long-acting beta2-adrenergic agonists (LABA). Even though LABAs decrease the
frequency of asthma episodes, these medicines may make asthma episodes more
severe when they occur. A Medication Guide with information about these
risks will be given to patients when a prescription for a LABA is filled or
refilled.

--------------------

11-22-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Boehringer Ingelheim and FDA notified healthcare professionals of revisions
to PRECAUTIONS and ADVERSE REACTIONS sections of the prescribing information
for Flomax, indicated for the treatment of the signs and symptoms of benign
prostatic hyperplasia (BPH). A surgical condition termed Intraoperative
Floppy Iris Syndrome (IFIS) has been observed during phacoemulsification
cataract surgery in some patients treated with alpha-1 blockers including
Flomax. Most of these reports were in patients taking the alpha-1 blocker
when IFIS occurred, but in some cases alpha-1 blocker had been stopped prior
to surgery. It is recommended that male patients being considered for
cataract surgery, as part of their medical history, be specifically
questioned to ascertain whether they have taken Flomax or other alpha-1
blockers. If so, the patient's ophthalmologist should be prepared for
possible modifications to their surgical technique that may be warranted
should IFIS be observed during the procedure.

--------------------

11-22-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis Ophthalmics and FDA notified healthcare professionals and patients
of a voluntary recall due to a lack of sterility assurance of seven lots of
two products, GenTeal Gel and GenTeal GelDrops, intended for use to relieve
dryness of the eye. While the risk of potential contamination is believed to
be very low, contaminated product could cause infections in susceptible
people.

The five lots of GenTeal Gel include about 142,500 tubes that were
distributed nationwide from March to November 2004. The two lots of GenTeal
GelDrops include about 12,000 dropper bottles that were distributed
nationwide in October 2005.

Test results for GenTeal Gel indicated the presence of mold in a small
number of samples, leading Novartis to initiate a recall of the five lots.
The species of mold that is suspected is generally not harmful, but has the
potential to cause an eye infection in susceptible people, especially in
those with compromised immune systems.

--------------------

11-30-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified consumers, caregivers, and healthcare professionals that MBI
Distributing, Inc. (MBI), also known as Molecular Biologics, an
over-the-counter [OTC] drug manufacturer of eye drops and other products
will cease manufacturing and distributing drugs until it corrects
manufacturing deficiencies and other violations. MBI's product line includes
eye drops sold under the brand names Oxydrops, Bright Eyes, Bright Eyes II,
Clarity Vision for Life, Visitein, and Can-C, as well as several OTC pain
relieving drugs. These products are sold by retailers nationwide.

FDA determined that the firm lacked manufacturing controls to ensure that
its eye drops were sterile. FDA has also determined that two of the firm's
eye drop brands, Visitein and Clarity Vision for Life, are unapproved drugs.
In addition, three of the firm's OTC pain relieving drugs, Biogesic,
Bio-Ice, and Bio-Heat, do not provide adequate warnings for their safe use.
FDA recommends that consumers, health care providers, and caregivers dispose
of the Oxydrops, Bright Eyes, Bright Eyes II, Clarity Vision for Life,
Visitein, and Can-C brands of eye drops and the Biogesic, Bio-Ice, and
Bio-Heat pain relieving drugs.

--------------------

12-01-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novo Nordisk and FDA notified healthcare professionals of revisions to the
WARNINGS and ADVERSE REACTIONS sections of the prescribing information for
NovoSeven, to provide updated safety information on thrombotic and
thromboembolic adverse events, based on clinical studies in non-hemophilia
patients and on post-marketing safety surveillance. A clinical study in
elderly, non-hemophiliac, intracerebral hemorrhage patients indicated a
potential increased risk of arterial thromboembolic adverse events with use
of NovoSeven, including myocardial ischemia, myocardial infarction, cerebral
ischemia and/or infarction.

--------------------

12-01-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Amgen, Ortho Biotech and FDA notified healthcare professionals of revision
to the WARNINGS, PRECAUTIONS, ADVERSE REACTIONS, and DOSAGE AND
ADMINISTRATION sections of the prescribing information for these three
products. The revised labeling provides updated safety information on
reports of pure red cell aplasia and severe anemia, with or without other
cytopenias, associated with neutralizing antibodies to erythropoietin in
patients treated with these products. This has been reported predominantly
in patients with CRF receiving these products by subcutaneous
administration. Recommendations for evaluation and treatment are provided in
the new prescribing information.

--------------------

12-02-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Mallinckrodt, Palatin Technologies and FDA notified healthcare professionals
of postmarketing reports of serious and life-threatening cardiopulmonary
events following the administration of NeutroSpec [Technetium (99m Tc)
fanolesomab],a radiodiagnostic agent consisting of a murine IgM monoclonal
antibody formulated to be labeled with technetium,indicated for
scintigraphic imaging of patients with equivocal signs and symptoms of
appendicitis who are five years of age or older. Onset of these events
generally occurred within minutes of injection and included two deaths
attributed to cardiopulmonary failure within 30 minutes of injection.
Additional cases of serious cardiopulmonary events including cardiac arrest,
hypoxia, dyspnea and hypotension required resuscitation with fluids,
vasopressors, and oxygen.

Any patient who receives NeutroSpec should be closely monitored for at least
one hour following product administration. Resuscitation equipment and
appropriately trained personnel must be readily available during this time.
Patients with underlying cardiopulmonary conditions may be at higher risk
for serious complication. NeutroSpec administration to these patients should
only follow careful consideration of the known and potential risks and
benefits, including the possibly higher risks.

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12-05-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

A correction has been made to the September 2005 Safety Labeling Changes
(posted on 11/30/05).

Avastin was removed from the list as no changes were made to the safety
sections of the Avastin labeling during September 2005.  The  labeling that
was provided, however, is the currently approved labeling for Avastin.

Safety-related drug labeling changes for September 2005 have been posted on
the MedWatch website. The September 2005 posting includes 37 drug products
with safety labeling changes to the CONTRAINDICATIONS, BOXED WARNING,
WARNINGS, PRECAUTIONS, or ADVERSE REACTIONS sections.

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12-08-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA has determined that exposure to paroxetine in the first trimester of pregnancy may increase the risk for congenital malformations, particularly cardiac malformations. At the FDA's request, the manufacturer has changed paroxetine's pregnancy category from C to D and added new data and recommendations to the WARNINGS section of paroxetine's prescribing information. FDA is awaiting the final results of the recent studies and accruing additional data related to the use of paroxetine in pregnancy in order to better characterize the risk for congenital malformations associated with paroxetine.

Physicians who are caring for women receiving paroxetine should alert them to the potential risk to the fetus if they plan to become pregnant or are currently in their first trimester of pregnancy. Discontinuing paroxetine therapy should be considered for these patients. Women who are pregnant, or planning a pregnancy, and currently taking paroxetine should consult with their physician about whether to continue taking it. Women should not stop the drug without discussing the best way to do that with their physician.

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12-13-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Bedford Laboratories, a division of Ben Venue Laboratories, Inc.,
Bedford, Ohio, announced that it is voluntarily recalling one lot of
Methotrexate for Injection (preservative free), USP 1 gram per vial (NDC
55390-143-01), Lot # 859142, exp 09/07, because the active drug substance
("ADS") used to manufacture Lot # 859142, contained low levels of ethylene
glycol. Preservative-free Methotrexate is the only formulation that is
acceptable for intrathecal administration. Healthcare professionals and
suppliers should not distribute these vials and should contact Bedford
Laboratories for return instructions. Consumers that have received this
product and have questions should contact their physicians.

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12-14-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA has classified Baxter Healthcare Corporation's Meridian Hemodialyis
(HD) Instrument (Product Codes 5M5576 and 5M5576R) as a Class I recall.
There have been reports of hemolysis related to kinks in the blood tubing
sets used with the Meridian. To date, there have been reports of one death
and at least one serious injury, associated with kinking of blood tubing
sets routed through both channels of the clips mounted on the front of the
Meridian.

This classification does not require the return of Meridian instruments
currently in the market. In the September 28, 2005 letter, Baxter directs
customers to route blood tubing through only one channel of the two channel
clips mounted on the front of the Meridian to reduce the risk of blood
tubing kinks.

Baxter also provided labels with the September 28, 2005, customer letter to
be affixed to Meridian instruments. The labels clearly display the proper
routing of the blood tubing sets. Further, Baxter asks that all care
providers be trained on this procedure. In addition, Baxter will be
providing modified tubing clips to eliminate related safety issues as soon
as possible.

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12-19-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a public health advisory to inform patients and health care
providers that Palatin Technologies, the manufacturer of Neutrospec
(Technetium (99m Tc) fanolesomab) is voluntarily suspending marketing of
Neutrospec effective immediately due to serious safety concerns. Neutrospec
is an antibody radio-labeled with technetium-99m, indicated for radiologic
imaging of patients with unclear signs and symptoms of appendicitis who are
five years of age and older. FDA received reports from Palatin Technologies
of 2 deaths and 15 additional life-threatening adverse events in patients
receiving Neutrospec.  These events occurred within minutes of
administration of Neutrospec and included shortness of breath, low blood
pressure, and cardiopulmonary arrest. A review of all post-marketing reports
showed an additional 46 patients who experienced adverse events that were
similar but less severe.  All of the reactions occurred immediately after
NeutroSpec was administered. The decision to suspend marketing was based on
the life-threatening nature of the events and the availability of other
means to diagnose appendicitis that do not carry these risks.  FDA urges
health care providers to discontinue use of existing stocks of Neutrospec
and to contact Palatin Technologies regarding their return.

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12-20-05 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Endologix and FDA notified healthcare professionals of the voluntary product
recall of selected Powerlink System delivery catheters marketed in the U.S.,
used to deliver minimally invasive treatment for abdominal aortic aneurysms.
Endologix initiated the recall as a result of an analysis of three recent
reports of tip separation from the catheter sheath inner core during
procedures. This action does not include the Powerlink stent grafts that
have been implanted in patients or the large diameter 34 mm Powerlink System
being evaluated under an investigational device exemption or Powerlink
Systems sold outside of the U.S.

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FDA-MedWatch - The Food and Drug Administration

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