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1-05-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

GlaxoSmithKline and FDA notified healthcare professionals about
post-marketing reports of new onset and worsening diabetic macular edema for
patients receiving rosiglitazone. In the majority of these cases, the
patients also reported concurrent peripheral edema. In some cases, the
macular edema resolved or improved following discontinuation of therapy and
in one case, macular edema resolved after dose reduction.

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1-06-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Cangene, Baxter Healthcare and FDA notified healthcare professionals of
revisions to the WARNINGS, PRECAUTIONS and ADVERSE REACTIONS sections of the
prescribing information to address two important safety concerns.

1] Postmarketing safety surveillance has shown rare, but severe and
sometimes fatal, intravascular hemolysis and potentially serious
complications, including disseminated intravascular coagulation in patients
with ITP.

2] Maltose in IVIG products, such as the liquid formulation of WinRho SDF,
has been shown to give falsely high blood glucose levels in certain types of
blood glucose testing systems. Due to the potential for falsely elevated
glucose readings, only testing systems that are glucose-specific should be
used to test or monitor blood glucose levels in patients receiving this
product.

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1-10-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Ortho-Clinical Diagnostics and FDA notified healthcare professionals and
clincal laboratory staff of a class 1 recall of the HBsAg Confirmatory Kit
due to an unknown component in the diluting solution used to test blood and
serum samples that may produce 'Not Confirmed' results for samples found to
be positive with the initial test. This can cause some results to be
classified as false negatives. False negative results may prevent some
patients infected with or carrying the hepatitis B virus from receiving
necessary treatment. This is especially true for pregnant women whose tests
show false negative results. The company recommends that previously reported
results be reviewed.

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1-13-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis and FDA notified healthcare professionals of revisions to the BOXED
WARNING, WARNINGS, CONTRAINDICATIONS, PRECAUTIONS (Information for Patients
and Pharmacokinetic-Related Interactions subsections), and ADVERSE REACTIONS
(Postmarketing Clinical Experience subsection) sections of the prescribing
information for Clozaril (clozapine) tablets. Recommendations from the FDA's
Psychopharmacological Drugs Advisory Committee regarding the white blood
cell monitoring schedule, required for all clozapine users, has resulted in
modification in the monitoring schedule. Additional labeling changes address
safety issues related to dementia-related psychosis, parlytic ileus,
hypercholesterolemia and pharmacokinetic interaction with citalopram.

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1-13-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA warned consumers not to use two unapproved drug products that are
being marketed as dietary supplements for weight loss. Emagrece Sim Dietary
Supplement, also known as the Brazilian Diet Pill, and Herbathin Dietary
Supplement may contain several active ingredients, including controlled
substances, found in prescription drugs that could lead to serious side
effects or injury. They contain chlordiazepoxide HCl (the active ingredient
in Librium), and fluoxetine HCl (the active ingredient in Prozac). Emagrece
Sim and Herbathin were also found to contain Fenproporex, a stimulant that
is not approved for marketing in the United States. Consumers are advised
not to use the Emagrece Sim and Herbathin products and to return them to the
suppliers. There may be other manufacturers or suppliers of imported
Emagrece Sim and Herbathin, and consumers should exercise caution in using
any of these imported products.

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1-19-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Roche Diagnostics and FDA notified healthcare professionals of a worldwide
voluntary recall of specific ACCU-CHEK Aviva Meters, used to measure blood
sugar levels, because of the potential for an electronic malfunction which
can cause the meter to report an erroneous result or shut down and no longer
be used. The recall includes U.S. serial numbers 52500000000 through
52510999999. This recall does not apply to meters with U.S. serial numbers
52511000000 and higher or ACCU-CHEK Aviva test strips.

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1-20-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The Food and Drug Administration announced the approval
of updated labeling for two topical eczema drugs, Elidel Cream
(pimecrolimus)and Protopic Ointment(tacrolimus). The labeling will be
updated with a boxed warning about a possible risk of cancer and a
Medication Guide (FDA-approved patient labeling) will be distributed to help
ensure that patients using these prescription medicines are aware of this
concern. The new labeling also clarifies that these drugs are recommended
for use as second-line treatments. This means that other prescription
topical medicines should be tried first. Use of these drugs in children
under 2 years of age is not recommended.

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1-20-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Annals of Internal Medicine published an article reporting three patients
who experienced serious liver toxicity following administration of Ketek
(telithromycin). These cases were also reported to FDA MedWatch.
Telithromycin is marketed and used extensively in many other countries,
including countries in Europe and Japan. While it is difficult to determine
the actual frequency of adverse events from voluntary reporting systems such
as the MedWatch program, the FDA is continuing to evaluate the issue of
liver problems in association with use of telithromycin in order to
determine if labeling changes or other actions are warranted. As a part of
this, FDA is continuing to work to understand better the frequency of
liver-related adverse events reported for approved antibiotics, including
telithromycin.

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1-30-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Vapotherm, Inc. and FDA notified healthcare professionals about the class 1
recall of the Vapotherm 2000i and 2000h products, which deliver moisture to
and warm breathing gases through a flexible nasal tube for patients
receiving supplemental oxygen in home, hospital or sub-acute institutional
settings. FDA received reports of Vapotherm units becoming contaminated with
Ralstonia spp and other bacteria. Exposure to these bacteria may cause
patients to develop tracheitis, sepsis, pneumonia, or other serious
infections. There is a reasonable probability that immunocompromised
patients or premature newborms could develop pneumonia or sepsis. FDA
recommends the use of alternative devices until the source of the
contamination has been identified. Patients who have been exposed to the
Vapotherm system should be monitored for signs and symptoms that may suggest
infection and clinicians may want to consider Ralstonia infection in the
differential diagnosis of symptomatic patients even if the organism has not
been isolated.

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1-30-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The First Years and FDA notified consumers and healthcare professionals of
the voluntary recall of liquid-filled teethers due to possible bacterial
contamination. The liquid inside the teethers may contain pseudomonas
aeruginosa and pseudomonas putida which can cause serious illness in
children if the teether is punctured and the liquid from the teether is
ingested. The teethers were sold nationwide including major retailers,
grocery, drug and specialty stores from July 2005 to January 2006. This
recall is for 6 different styles of liquid-filled teethers for infants (3+
months old) to soothe gums. Consumers should stop using the recalled
products immediately. No illnesses have been reported to date in connection
with this problem.

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2-06-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and patients about a Public Health
Notification on continued risk of bacterial meningitis in children with
cochlear implants. The notification provides new information about the risk
of meningitis in children with cochlear implants with positioner beyond
twenty-four months post-implantation. This new information is based on a CDC
study that published in this month's issue of Pediatrics and updates
previous FDA notifications from 2002 and 2003.

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2-08-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a public health advisory and other advisory information to notify
both healthcare professionals and consumers of recently published studies of
serious renal and cardiovascular toxicity following Trasylol administration
to patients undergoing coronary artery bypass grafting surgery (CABG). An
observational study published in The New England Journal of Medicine
reported that Trasylol may be associated with increased risk of myocardial
infarction, stroke and renal dysfunction. Another publication (Transfusion,
on-line edition, January 20, 2006) has reported that Trasylol administration
may increase the risk for renal toxicity.

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2-13-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a Public Health Advisory to notify healthcare professionals and
patients about adverse events, including methemoglobinemia, associated with
the use of benzocaine sprays used in the mouth and throat. Benzocaine sprays
are used in medical practice for locally numbing mucous membranes of the
mouth and throat for minor surgical procedures or when a tube must be
inserted into the stomach or airways.  On February 8, 2006, the Veterans
Health Administration (VA) announced the decision to stop using benzocaine
sprays for these purposes. The FDA is aware of the reported adverse events
and is reviewing all available safety data, but at this time is not planning
action to remove the drugs from the market. The FDA is highlighting safety
information previously addressed by the Agency (see link below), has
provided other information for the consideration of clinicians in the PHA
and will make further announcements or take action as warranted by the
ongoing review.

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2-14-06

MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and patients of the request for recall
of all brands and sizes of Balanced Salt Solution (BSS) manufactured by
Cytosol Laboratories, Inc. because product lots were found to have elevated
and dangerous levels of endotoxin. BSS is a drug used by health
professionals to irrigate a patient's eyes, ears, nose and/or throat during
a variety of surgical procedures including cataract surgery. FDA has
received reports of a serious and potentially irreversible eye injury called
Toxic Anterior Segment Syndrome (TASS) which occurs when a contaminant, such
as endotoxin, enters the anterior segment of the eye during surgery and
causes an inflammatory reaction.  FDA has also received complaints relating
to injuries in over 300 patients who were given BSS manufactured by Cytosol
Laboratories The BSS products subject to the recall order were manufactured
by Cytosol Laboratories, Inc. for distribution under three labels:

"AMO Endosol" distributed by Advanced Medical Optics, Inc. (AMO), Santa Ana,
Calif.;
"Cytosol Ophthalmics" distributed by Cytosol Ophthalmics, Lenoir, NC; and
"Akorn" distributed by Akorn, Inc., Buffalo Grove, Ill.

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2-15-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Bayer and FDA notified healthcare professionals of changes to the
prescribing information for nimodipine (Nimotop), including a boxed warning
to notify prescribers about medication administration errors. Nimodipine is
approved for oral administration to improve neurological outcome after
subarachnoid hemorrhage. When administered intravenously or parenterally, it
can cause serious adverse events, including death. Nimodipine must not be
administered intravenously or by any parenteral route.

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2-22-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Mead Johnson and FDA notified consumers and healthcare professionals of a
recall of one lot, lot # BMJ19, of GENTLEASE powdered infant formula, found
to contain metal particles up to 2.7 millimeter in size. If an infant were
to inhale the infant formula into the lungs, the presence of these particles
could present a serious risk to the infant's respiratory system and throat.
There were approximately 41,464 24-ounce cans of this lot of recalled
product distributed, beginning on December 16, 2005, through many major
retail stores across the country, so the consumer should concentrate on the
code on the can rather than on the place of purchase. The affected products
can be identified by the lot number and expiration/use by date embossed on
the bottom of the can of BMJ19, use by 1 Jul 07. Consumers who have a can of
this batch of GENTLEASE powdered infant formula should not use the product
and should contact Mead Johnson at 888-587-7275 immediately.

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3-01-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Hanford Pharmaceuticals and FDA notified healthcare professionals about the
recall of four lots (379,975 vials) of Cefazolin for Injection, USP, 1 g/10
mL vials, an antibiotic used in a hospital environment to treat skin and
skin structure, respiratory and other infections.The product was distributed
by Sandoz, Inc. of Broomfield, CO and Watson Pharmaceuticals, Inc. of
Corona, CA. Certain lots of the active ingredient used to manufacture the
product have been shown to contain microbial contamination (Bacillus
pumilus, Staphylococcus hominis, Propionibacterium acnes, or Micrococcus
luteus) which may pose a serious or life-threatening risk for some patients.
Hospitals, clinics, and users should stop using the affected lots
immediately.

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3-02-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA has issued an update to its August 2005 preliminary public health
notification for the Gambro Prisma(r) Continuous Renal Replacement Therapy
(CRRT) device, used for continuous solute and/or fluid removal in patients
with acute renal failure or fluid overload. Approximately 1,900 units have
been distributed to hospitals  in the United States. This device has caused
or contributed to a number of serious adverse events by removing excessive
amounts of fluid from patients undergoing CRRT. FDA is aware of 9 deaths and
11 serious injuries associated with the excessive fluid removal problem.
Special caution must be used and caregivers must adhere strictly to the
labeled operating instructions, including the Manufacturer's Instructions
for Use, Operator's Manual, and the User Interface on the Prisma(r) System
control panel.

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3-02-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Actelion and FDA notified healthcare professionals of changes to the
Tracleer(bosentan) prescribing information based on cases of hepatotoxity
reported. Tracleer is indicated for the treatment of pulmonary arterial
hypertension. The notification underscored the need to continue monthly
liver function monitoring for the duration of Tracleer treatment and the
need to adhere to the recommended dosage adjustment and monitoring
guidelines described in the product labeling.

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3-02-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals of an update to the October 26, 2005
information paper on human tissues recoved by BioMedical Tissue Services
(BTS). The tissue, including human bone, skin, and tendons, was recovered by
BTS from human donors who may not have met FDA donor eligibility
requirements and who may not have been properly screened for certain
infectious diseases. As part of its ongoing investigation, FDA has become
aware of additional information regarding the reliability of donor blood
samples that is important for health care providers to consider. FDA
strongly recommends that health care providers inform their patients who
received tissue implants prepared from BTS donors that they may be at
increased risk of communicable disease transmission and to offer them
testing. While FDA believes the risks from these tissues are low because the
tissues were routinely processed using methods to help to reduce the risk of
infectious disease, the actual infectious risk is unknown.

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3-03-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Bard/Davol and FDA notified healthcare professionals of a class 1 recall of
Bard Composix Kugel Mesh X-Large Patch Oval with ePTFE, used to repair
ventral (incisional) hernias caused by thinning or stretching of scar tissue
that forms after surgery. The "memory recoil ring" that opens the Composix
Kugel Mesh Patch after it has been inserted into the intra-abdominal space
can break. This can lead to bowel perforations and/or chronic intestinal
fistulae (abnormal connections or passageways between the intestines and
other organs).

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3-10-06  MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The Food and Drug Administration (FDA) warned several manufacturers and distributors of unapproved drugs containing steroids that are marketed as dietary supplements and promoted for building muscle and increasing strength that the products may cause serious long-term adverse health consequences in men, women, and children.  These products claim to be anabolic and problems associated with anabolic steroids include: liver toxicity, testicular atrophy and male infertility, masculinization of women, breast enlargement in males, and short stature in children.  Anabolic steroids are also associated with causing adverse effects on blood lipid levels, and a potential to increase the risk of heart attack and stroke.

Consumers who have any of the following products should stop taking them and return them to their place of purchase:

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3-30-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program


Valeant Pharmaceuticals and FDA notified healthcare professionals of
complaints the company received concerning small cracks at the base of the
plastic tip of the applicators with resulting leakage of the medication when
the plunger is depressed, preventing full dosing and potentially resulting
in a sub-optimal therapeutic response. Diastat is indicated for rectal
administration in the management of selected refractory patients with
epilepsy on stable regimens of anti-epileptic drugs, who require
intermittent use of diazepam to control bouts of increased seizure activity.
Healthcare professionals should advise patients using the product of this
issue and to return any product with a cracked tip to their pharmacy for
immediate replacement. Pharmacists should inspect all product on their
shelves and contact Rx Hope at 1-800-511-2120 for replacement product.

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4-01-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Ossur and FDA notified healthcare professionals of a voluntary worldwide
recall of the 1100, 1900, 2000 and 2100 models of its Total Knee
prosthetic device. The company's initiation of the recall is based on a
finding that some units of the Total Knee device may contain faulty pins
based in the axis of the knee. At this time, there have been no
incidents or injuries resulting from this situation that have been
reported to the company.

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4--01-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Bard/Davol and FDA notified healthcare professionals of an expanded
class 1 recall of Bard Composix Kugel Mesh Patch, used to repair ventral
hernias caused by thinning or stretching of scar tissue that forms after
surgery. The recall now includes Oval, Large Oval and Large Circle Kugel
mesh patches. The "memory recoil ring" that opens the Composix Kugel
Mesh Patch after it has been inserted into the intra-abdominal space can
break and lead to bowel perforations and/or chronic intestinal fistulae
(abnormal connections or passageways between the intestines and other
organs). Bard also issued letters to hospitals and health care
professionals providing updated Instructions for Use, clarifying the
proper insertion technique and offering supplemental patient management
information.

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4-04-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Disetronic Medical Systems, Inc. announced a voluntary nationwide recall of all ACCU-CHEK Ultraflex Infusion Sets because of a potential that tubing could fully or partially separate at the luer lock-tubing connection. In the event a full or partial separation occurs, insulin may leak from the infusion set tubing causing an interruption of insulin delivery, which can cause hyperglycemia.

The symptoms of hyperglycemia include nausea/vomiting, blurred vision, excessive thirst or hunger, frequent urination, fatigue/tiredness/sleepiness, headache, fruity acetone breath and abdominal pain. Patients experiencing these symptoms are advised to check their blood glucose to ensure that the blood glucose level is within an acceptable range as defined by the patient's healthcare team and follow the medical advice given by the healthcare professional or contact their physician.

Under this recall, customers have the option of replacing their ACCU-CHECK Ultraflex infusion sets, or using the ACCU-CHEK Tender or ACCU-CHEK Rapid-D infusion sets. For additional customer advice regarding this recall, please see the Disetronic Medical Systems, Inc. recall notice.

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4-07-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Pfizer Pharmaceuticals notified healthcare professionals of important
changes in the approved product labeling for Macugen (pegaptanib sodium
injection), including changes to the CONTRAINDICATIONS, PRECAUTIONS,
ADVERSE EVENTS Post-Marketing, and DOSAGE and ADMINISTRATION sections.
Rare reports of anaphylaxis/anaphylactoid reactions, including
angioedema following the administration of Macugen along with various
medications administered as part of the injection preparation, were
described. Macugen is indicated for the treatment of neovascular (wet)
age-related macular degeneration, and is administered once every six
weeks by intravitreous injection. Healthcare professionals should
evaluate the patient's medical history for hypersensitivity reactions to
Macugen prior to using this product.

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4-11-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Fungal Keratitis Infections Related to Contact Lens Use
Audience:  Ophthalmologists, Optometrists, pharmacists, other healthcare
practitioners, and consumers

The FDA and CDC notified all healthcare practitioners and consumers of
an increase in the number of reports in the United States of a rare but
serious fungal infection of the eye in soft contact lens wearers.  The
infection, a fungal keratitis caused by the Fusarium fungus, may cause
vision loss requiring corneal transplants.

Both the FDA and CDC are investigating these occurrences.  The CDC
received reports of 109 cases of suspected fungal keratitis in 17
different States.  Twenty-eight of the 30 cases reported wearing soft
contact lenses.  The majority of the individuals (26) reported using a
Bausch & Lomb ReNu brand contact lens solution in the month prior to the
onset of infection.

Healthcare practitioners should refer patients presenting with a
microbial keratitis immediately to an ophthalmologist for immediate
treatment and report cases of fungal keratitis in contact lens wearers
to FDA.  Contact lens wearers should use good hygiene practices, e.g.,
wash hands with soap and water, and dry (lint free method) before
handling lenses; wear and replace lenses according to the prescribed
schedule; follow the specific lens cleaning and storage guidelines from
the doctor and the solution manufacturer; keep the contact lens case
clean and replace every 3-6 months; and remove lens immediately if the
wearer experiences symptoms such as redness, pain, tearing, increased
light sensitivity, blurry vision, discharge or swelling.

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4-17-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Boca Medical Products and FDA notified consumers and healthcare
professionals of a recall of Ultilet Insulin Syringe 30g 1/2cc (Lot # -
5GEXI, NDC # - 08326-3002-50) because of possible bacterial presence of
Bacillus Cereus and Staphylococcus Intermedius.  This presents a risk of
local infection due to soft tissue injection with a contaminated syringe
as well a risk of introduction of contaminating organisms into a
previously sterile vial.  The introduced contamination may degrade the
insulin, which could lead to problems maintaining insulin levels. This
product has been distributed to the following states: FL, NY, MA, AL,
SC, NC, CO, TX, MI, AR.  For any question related to the case consumers
should call 1-800-354-8460.

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4-17-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Blackstone Medical, Inc. and FDA notified healthcare professionals about
a recall of its ICON Modular Fixation System, a collection of components
that allows the surgeon to assemble a construct including screws,
connectors and rods. The construct is implanted in and near the
patient's spine, and is intended to immobilize and stabilize spinal
segments at the site of spine surgery.  The recall was initiated because
components in the system may fail after the devices have been implanted.
The potential for injury due to failure of the implant will depend on
the specific condition being treated, and the degree of postoperative
healing. There may be potential for serious injury in specific patients.
Blackstone Medical, Inc. is requesting that hospitals and surgeons
review their records to identify patients who have the recalled
products, and to contact these patients.  Patients who may have concerns
regarding their ICON fixation devices should contact the physician who
is providing postoperative care.

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4-18-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Ortho-Clinical Diagnostics and FDA notified healthcare professionals of
a Class 1 recall of this reagent, a special chemical used with the
VITROS Immunodiagnostic ECi/ECiQ System to screen patient samples and
diagnose more than 40 diseases and conditions including cardiac disease,
hepatitis (A, B or C), thyroid disorders, HIV and pregnancy. A decreased
signal in the reagent may produce inaccurate results in some cases,
affecting the outcome of the diagnostic tests.

Customers with the affected lot numbers should discontinue using any
remaining reagent and should follow the enhanced Quality Control (QC)
procedure provided by Ortho-Clinical Diagnostic for each pack in all
lots of VITROS Signal Reagent until further notice. Patients who have
had diagnostic testing performed for any of these medical conditions
within the last 60 days and are concerned with their test results should
discuss them with their physicians - cardiac disease, hepatitis (A,B, or
C), thyroid disorders, HIV and pregnancy.

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4-25-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and NIOSH (National Institute for Occupational Safety and Health)
notified healthcare professionals that twelve incidents have been
reported in which regulators used with oxygen cylinders have burned or
exploded, in some cases injuring personnel. Some of the incidents
occurred during emergency medical use or during routine equipment
checks. FDA and NIOSH believe that improper use of gaskets/washers in
these regulators was a major factor in both the ignition and severity of
the fires, although there are likely other contributing factors. FDA and
NIOSH recommend that plastic crush gaskets never be reused, as they may
require additional torque to obtain the necessary seal with each
subsequent use. This can deform the gasket, increasing the likelihood
that oxygen will leak around the seal and ignite.

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4-25-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and patients that cases of
breathing problems, some causing death, have been reported to the FDA
when the drug was used in children less than two years old. Parents and
caregivers should also be careful and get a doctor's advice about giving
promethazine HCl in any form to children age two and older. The labeling
on all products, brand name and generic, has been changed to reflect
these strengthened warnings.

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4-28-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA is recommending that all healthcare providers take important
safety steps when using the COLLEAGUE Volumetric Infusion Pump
manufactured by Baxter Healthcare Corporation. The COLLEAGUE pump has
exhibited a variety of problems, including under-infusion, battery
failures, false alarms and failure to alarm. Over the past year, Baxter
has issued four urgent safety notices and recalls for COLLEAGUE infusion
pumps.

In addition to the recommendations made by Baxter Healthcare Corporation
when using the COLLEAGUE Volumetric Infusion Pump, FDA is strongly
recommending the following measures:

- Do not use the COLLEAGUE pumps in situations where delaying or
interrupting therapy in order to reprogram or replace a malfunctioning
pump may be life threatening, if possible.

- Have a contingency plan to mitigate any disruption of infusion therapy
(e.g., have a back-up pump available).

- Monitor patients and check the pumps frequently.

- Report any problems as soon as possible to Baxter and FDA.

- Consider evaluating other options for infusion therapy if your
facility relies primarily or entirely on COLLEAGUE Pumps.

Other short-term options that may be appropriate for certain IV
therapies include gravity drip and flow control devices (e.g., buretrol,
volutrol, micro tubing, and flow control tubing devices). FDA is mindful
of concerns about the availability of replacement units and is working
with Baxter to resolve problems with the COLLEAGUE pump as quickly as
possible. 

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4-28-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

NeutraGard 0.05% and NeutraGard Plus 0.2% Neutral Sodium Fluoride
Anticavity Treatment Rinse
Audience:  Dentists, dental hygienists, and consumers

Pascal Company, Inc. recalled all lots and all flavors of NeutraGard
0.05% Neutral Sodium Fluoride Anticavity Treatment Rinse and NeutraGard
Plus 0.2% Neutral Sodium Fluoride Anticavity Treatment Rinse packaged in
clear 160z plastic bottles.  The products were recalled because they may
be contaminated with Burkholderia cepacia and Pseudomonas aeruginosa
bacteria.

Burkholderia cepacia (B. cepacia) bacteria poses little medical risk to
healthy people.  However, the bacteria may affect individuals with
certain health problems like a weakened immune system or chronic lung
diseases, such as cystic fibrosis.  The effects of B. cepacia range from
no symptoms to serious respiratory infections, especially in patients
with cystic fibrosis.

Pseudomonas aeruginosa may cause urinary track infections, respiratory
system infections, dermatitis, soft tissue infections, bacteremia, bone
and joint infections, gastrointestinal infections and a variety of
systemic infections, particularly in patients with severe burns and in
cancer and AIDS patients.

Dental offices and consumers who have the product should discontinue use
and destroy it or return the product to the place of purchase for
further processing.

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5-03-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and IVAX Pharmaceuticals, Inc. notified healthcare professionals of
a recall of Goldline brand Extra Strength Genapap 500mg (Acetaminophen)
Caplets and Tablets and Extra Strength Genebs 500mg (Acetaminophen)
Caplets and Tablets due to a labeling error. Specifically, the product
label should indicate that usage should not exceed 8 tablets or caplets
in a 24 hour period. The erroneous label indicates not to exceed 12
tablets or caplets in a 24 hour period. In the event the maximum dosage
of 8 tablets or caplets in a 24 hour period is exceeded, there may be an
increased risk of acetaminophen toxicity to the liver, which may cause
adverse health effects. There have been no reports of serious illness or
injury relating to this labeling matter.

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5-05-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and consumers of reports of acute
phosphate nephropathy, a type of acute renal failure, that is a rare,
but serious adverse event associated with the use of oral sodium
phosphates (OSP) for bowel cleansing.  Documented cases of acute
phosphate nephropathy include 21 patients who used an OSP solution (such
as Fleet  Phospho-soda or Fleet ACCU-PREP) and one patient who used OSP
tablets (Visicol). Individuals at increased risk of acute phosphate
nephropathy include: those of advanced age, those with kidney disease or
decreased intravascular volume, and those using medicines that affect
renal perfusion or function [diuretics, angiotensin converting enzyme
(ACE) inhibitors, angiotensin receptor blockers (ARBs), and possibly
nonsteroidal anti-inflammatory drugs (NSAIDs)]. Recommendations were
offered for providers and patients when choosing and using a bowel
cleanser.

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5-05-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Respironics and FDA notified healthcare professionals about the Class 1
recall of this device, a mechanical ventilator used to control or assist
breathing. The ventilator is intended for home, institutional and
portable settings and may be used for invasive as well as noninvasive
ventilation. A design flaw can cause lead wires in the air flow valve to
break during use. When this happens the ventilator stops providing
mechanical ventilation. Customers should safely transition patients in
their care from the PLV Continuum Ventilator onto other comparable
patient support devices. If customers do not have a suitable ventilator
to use for their patients, they should contact Respironics at
760-918-7328 to make suitable substitute arrangements.

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5-12-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

GlaxoSmithKline (GSK) and FDA notified healthcare professionals of
changes to the Clinical Worsening and Suicide Risk subsection of the
WARNINGS section in the prescribing Information for Paxil and Paxil CR.
These labeling changes relate to adult patients, particularly those who
are younger adults.

A recent meta-analysis conducted of suicidal behavior and ideation in
placebo-controlled clinical trials of paroxetine in adult patients with
psychiatric disorders including Major Depressive Disorder (MDD), other
depression and non-depression disorders. Results of this analysis showed
a higher frequency of suicidal behavior in young adults treated with
paroxetine compared with placebo. Further, in the analysis of adults
with MDD (all ages), the frequency of suicidal behavior was higher in
patients treated with paroxetine compared with placebo. This difference
was statistically significant; however, as the absolute number and
incidence of events are small, these data should be interpreted with
caution. All of the reported events of suicidal behavior in the adult
patients with MDD were non-fatal suicide attempts, and the majority of
these attempts (8 of 11) were in younger adults aged 18-30. These MDD
data suggest that the higher frequency observed in the younger adult
population across psychiatric disorders may extend beyond the age of 24.


It is important that all patients, especially young adults and those who
are improving, receive careful monitoring during paroxetine therapy
regardless of the condition being treated.

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

5-19-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Spectrum Laboratory Products Tacrolimus Active Pharmaceutical Ingredient
[API]
Audience: Pharmacists and organ transplantation healthcare professionals

Spectrum Laboratory Products and FDA notified healthcare professionals
of the recall of the active pharmaceutical ingredient tacrolimus, an
immunosuppressive drug used to prevent rejections of transplanted solid
organs such as heart or kidney, after learning that some lots of the
ingredient are subpotent.  Spectrum tacrolimus API has been used by
pharmacies for compounding purposes. The use of sub-potent tacrolimus in
compounded drugs for transplant recipients may lead to sub-therapeutic
tacrolimus blood levels and an unacceptable increased risk of solid
organ transplant rejection. Patients receiving tacrolimus for solid
organ transplant should not stop taking their medication, but rather
should check with their physician or pharmacist. This recall does not
apply to tacrolimus marketed in finished dosage form as Prograf(r)
(Astellas Pharma, US) or to Prograf(r) oral capsules that have been used
for compounding.

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

5-23-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Boca Medical Products and FDA notified consumers and healthcare
professionals of an extension of an earlier recall of Ultilet insulin
syringes and the additional recall of Closercare insulin syringes
because of bacterial contamination with Paenibacillus. This presents a
risk of local infection due to soft tissue injection with a contaminated
syringe as well a risk of introduction of contaminating organisms into a
previously sterile vial.  The introduced contamination may degrade the
insulin, which could lead to problems maintaining insulin levels. The
recall includes Closercare Insulin Syringe 29g 1cc product lot number
5JCZ1 as displayed on the inner case and Ultilet Insulin Syringe 30g
1/2cc, product lot number 5KEO1 as displayed on the inner case. The
earlier recall of Ultilet syringes included lot number 5GEXI. This
product has been distributed to the following states: FL, NY, MA, AL,
SC, NC, CO, TX, MI, AR. 

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

6-06-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals of the resumed marketing, with a
special restricted distribution program of Tysabri (natalizumab), a
monoclonal antibody for the treatment of patients with relapsing forms
of multiple sclerosis. Tysabri was initially approved by the FDA in
November 2004, but was withdrawn by the manufacturer in February 2005
after three patients in the drug's clinical trials developed progressive
multifocal leukoencephalopathy (PML), a serious viral infection of the
brain. Tysabri will be available only through the Risk Management Plan,
called the TOUCH Prescribing Program. In order to receive Tysabri,
patients must talk to their doctor and understand the risks and benefits
of Tysabri and agree to all of the instructions in the TOUCH Prescribing
Program.

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

6-08-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The New England Journal of Medicine published an article reporting that
infants whose mothers had taken an angiotensin-converting enzyme
inhibitor (ACE inhibitors) drug during the first trimester of pregnancy
had an increased risk of major congenital malformations, compared with
infants who had not undergone first trimester exposure to ACE inhibitor
drugs. The FDA-approved labels recommends discontinuing the ACEI as soon
as possible if a patient becomes pregnant. ACE inhibitor drugs are
labeled pregnancy category C for the first trimester of pregnancy, and
are labeled pregnancy category D during the second and third trimesters.
Healthcare professionals should take these findings into consideration
with other information about a patient's medical situation when
prescribing ACE inhibitors.

    At this time, based on this one observational study, the FDA does
not plan to change the pregnancy categories for ACE inhibitors. FDA will
work with the Agency for Healthcare Quality and Research to identify
other potential sources of data that will help determine the degree of
risk associated with first trimester exposures to these drugs.

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

6-08-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and consumers that it is
evaluating important safety information about gadolinium-containing
contrast agents and a disease known as Nephrogenic Systemic Fibrosis or
Nephrogenic Fibrosing Dermopathy (NSF/NFD) that occurs in patients with
kidney failure. New reports have identified a possible link between
NSF/NFD and exposure to gadolinium containing contrast agents used at
high doses for a procedure called Magnetic Resonance Angiography (MRA).
The FDA has learned of 25 cases of NSF/NFD in patients with kidney
failure who received Omniscan, a gadolinium-containing contrast agent,
and took the MRA test.


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

6-13-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Hamilton Medical, Inc. and FDA notified healthcare professionals of a
recall of certain RAPHAEL model ventilators with older generation
software, due to a software algorithm designed to suppress false
positive alarms that may preclude any alarm (no visible or audible
alarms are triggered).

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

6-16-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

MRL, Inc. and FDA notified healthcare professionals of a voluntary
worldwide Class I recall of 580 AED20 automatic external defibrillators.
An intermittent electrical connection within the device may result in
failure or unacceptable delay in analyzing the patient's ECG, failure to
deliver appropriate therapy and failure to resuscitate the patient. FDA
defines a Class I recall as one in which there is reasonable probability
that the use of or exposure to the product will cause serious adverse
health consequences or death.

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

6-20-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis Consumer Health and FDA notified patients, pharmacists and
other healthcare professionals that the sponsor is conducting a
nationwide voluntary recall of all Triaminic Vapor Patch products due to
reports of serious adverse events associated with accidental ingestion
by children. Triaminic Vapor Patch is labeled as a cough suppressant for
children two (2) years of age and older and is sold over the counter at
pharmacies and retail outlets nationwide. The directions on the label
indicate the patch is to be applied to the throat or chest to allow the
vapors to reach the nose and mouth. FDA is warning consumers not to use
the Triaminic Vapor Patch and is also advising consumers who have used
the product and have concerns or questions to contact their physician or
health care practitioner.

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

6-20-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA issued a Public Health Notification regarding the proper cleaning
and sterilizing of reusable ultrasound biopsy transducer assemblies
(i.e., transducer device and associated accessories). If these devices
are not correctly reprocessed between patients, residual material from a
previous patient may contaminate the biopsy needle and needle guide when
the system is reused for biopsies. This could lead to patient
infections. Therefore, the biopsy needle and its containing guide must
always be sterilized. This should apply even if a sterile barrier sheath
is used on the transducer assemblies during a biopsy procedure, as the
sheath is compromised by the penetration of the needle. The Public
Health Notification also provides recommendations for cleaning the
devices.

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

6-26-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Sage Products and FDA notified healthcare professionals of a recall of
specific lots of Comfort Shield Perineal Care Washcloths . Burkholderia
cepacia can cause serious infections including pneumonia and bacterial
sepsis in immuno-compromised persons, persons with cystic fibrosis (CF),
in hospitalized patients in general as well as certain other patient
groups. The product was distributed to hospitals, medical centers and
long-term care facilities in the U.S. and Canada. There was no known
distribution through retail sales.

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

6- 26-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Guidant and FDA notified healthcare professionals and patients that a
subset of implantable pacemakers, cardiac resynchronization therapy
pacemakers and implantable cardioverter defibrillators [ICDs] is
associated with five reports of device malfunction due to the failure of
a low-voltage capacitor from a single component supplier. Patients with
affected pacemakers may experience intermittent or permanent loss of
output or telemetry or premature battery depletion. Patients with
affected ICDs may experience inappropriate sensing or premature battery
depletion. Physicians are asked to perform an exam as soon as possible
to assess device function for all patients with implanted devices from
this subset.

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

6-30-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The Food and Drug Administration notified healthcare professionals and
patients that it completed its safety assessment of Ketek
(telithromycin), indicated for the treatment of acute exacerbation of
chronic bronchitis, acute bacterial sinusitis and community acquired
pneumonia of mild to moderate severity, including pneumonia caused by
resistant strep infections. The drug has been associated with rare cases
of serious liver injury and liver failure with four reported deaths and
one liver transplant after the administration of the drug. FDA
determined that additional warnings are required and the manufacturer is
revising the drug labeling to address this safety concern. FDA is
advising both patients taking Ketek and their doctors to be on the alert
for signs and symptoms of liver problems. Patients experiencing such
signs or symptoms should discontinue Ketek and seek medical evaluation,
which may include tests for liver function.

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

8-21-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and GlaxoSmithKline notified healthcare professionals of changes to
the BOXED WARNING, WARNINGS and PRECAUTIONS sections of the prescribing
information for Dexedrine (dextroamphetamine sulfate), approved for the
treatment of Attention-Deficit Hyperactivity Disorder and narcolepsy.
The warnings describe reports of sudden death in association with CNS
stimulant treatment at usual doses in children and adolescents with
structural cardiac abnormalities or other serious heart problems.

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

8-25-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Luitpold Pharmaceuticals, Inc. and FDA notified healthcare professionals
of a voluntary recall of additional lots of Hydralazine HCl Injection
(20 mg/mL, 1 mL single dose vials) because the products may contain
particulates.

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

8-30-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA informed consumers and healthcare professionals that all dietary
supplements containing ephedrine alkaloids are illegal to market in the
United States. Dietary supplements containing ephedrine alkaloids,
regardless of the dosage, are considered adulterated and pose an
unreasonable risk of illness or injury to users, especially those
suffering from heart disease and high blood pressure. FDA conducted an
exhaustive evaluation of relevant scientific data evidence on ephedrine
alkaloids before issuing this decision in a final rule in 2004. On
August 17, 2006, a Court of Appeals ruling upheld this final rule,
reversing an earlier decision by the District Court of Utah.

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

8-30-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Alaris Products notified healthcare professionals of a recall of
defective infusion pumps due to a design defect called "key bounce" that
may cause potential over-infusion of medications and result in an
infusion rate at least 10 times the intended infusion rate. Infusion
pumps are electronic devices intended for controlled delivery of
intravenous solutions and medications to patients. Key bounce occurs
when a number pressed once on the pump registers twice and not detected
during programming verification. The products included in this recall
(model numbers 7130,7131, 7230, and 7231) are distributed by Cardinal
Health Care 303 Inc. The manufacturer provided recommendations to pump
users on steps they can take to minimize key entry errors until the
problem can be corrected. Healthcare facilities can continue to use
pumps in their possession, guided by the company's instructions.

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

8-31-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Steris and FDA notified hospital and long term care facility managers of
a fire risk with use of Amsco Sonic Energy Cleaner and/or an Amsco Sonic
Energy Console, used for cleaning reusable medical equipment. The
affected products were manufactured from November 2000 until January
2005 bearing serial numbers 0432000018 to 0403105051. The location of
the lid switch cable wiring harness in these units makes them
susceptible to water damage to the electrical connections. If this
occurs, it can cause overheating of the electrical system in the unit
and lead to damage of the wiring harness(s) resulting in smoking,
sparking, and fire.

Healthcare professionals are instructed to follow proper safety
precautions to prevent water from contacting the electrical wiring while
using this device. A Steris technician will visit account holders to
replace the wire harness and associated components of the affected
units.

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

8-31-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals that human tissues recovered by
Donor Referral Services (DRS) may not have met FDA requirements for
donor eligibility. While no adverse reactions associated with these
tissues have yet been reported, and subsequent processing should reduce
the potential risks of infectious disease transmission, healthcare
providers who were supplied with these tissues are being notified of the
potentially increased risk for infectious disease transmission.

FDA and the Centers for Disease Control and Prevention (CDC) are
strongly recommending that healthcare providers inform their patients
who received tissues initially recovered by DRS that they may have
received tissue from donors for whom adequate donor eligibility
determinations were not performed, and offer patients access to
appropriate infectious disease testing. The relevant communicable
diseases for which a tissue donor is required to be tested are HIV-1 and
2, hepatitis B virus, hepatitis C virus, and syphilis. Further
recommendations for testing are posted on the CDC website at:
http://www.cdc.gov/ncidod/dhqp/tissueTransplantsFAQ.html. FDA will
continue its investigation into this matter and will issue further
public health updates, as needed.

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

9-07-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and consumers of the seizure of
Ellagimax capsules, Coral Max capsules, Coral Max without Iron capsules,
and Advanced Arthritis Support capsules distributed by Advantage
Nutraceuticals, LLC, because the products, labeled as dietary
supplements, are being promoted to treat serious disease conditions,
including but not limited to cancer, arthritis, fibromyalgia, and
seizures.  The products have not been shown to be safe and effective to
treat these conditions and have not been approved by the FDA and are
therefore in violation of the new drug and misbranding provisions of the
Federal Food, Drug and Cosmetic Act.

FDA advises consumers who may be taking these products to consult their
physicians.

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

9-20-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Ortho and FDA notified healthcare professionals and patients about
revision to the prescribing information to inform them of the results of
two separate epidemiology studies that evaluated the risk of developing
a serious blood clot in women using Ortho Evra compared to women using a
different oral contraceptive.  The first study found that the risk of
non-fatal venous thromboembolism (VTE) associated with the use of Ortho
Evra contraceptive patch is similar to the risk associated with the use
of oral contraceptive pills containing 35 micrograms of ethinyl
estradiol and norgestimate. The second study found an approximate 2-fold
increase in the risk of medically verified VTE events in users of Ortho
Evra compared to users of norgestimate-containing oral contraceptives
containing 35 micrograms of estrogen.  Although the results of the two
studies differ, the results of the second study support FDA's concerns
regarding the potential for Ortho Evra use to increase the risk of blood
clots in some women.

Prescribing information for Ortho Evra continues to recommend that women
with concerns or risk factors for thromboemboli disease talk with their
healthcare professionals about using Ortho Evra versus other
contraceptive options.

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

9-25-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Genentech and FDA notified healthcare professionals about revisions to
the WARNINGS and ADVERSE REACTIONS sections of the prescribing
information to inform healthcare professionals of 1] cases of a rare
brain-capillary leak syndrome [reversible posterior leukoencephalopathy
syndrome (RPLS)] and 2] postmarketing reports of nasal septum
perforation. 

RPLS is a neurological disorder associated with hypertension, fluid
retention and cytotoxic effects of immunosuppressive drugs on the
vascular endothelium. The syndrome can present with headache, seizure,
lethargy, confusion, blindness and other visual and neurologic
disturbances. Mild to severe hypertension may be present, but is not
necessary for diagnosis. The onset of symptoms has been reported to
occur from 16 hours to 1 year after initiation of Avastin. Magnetic
Resonance Imaging (MRI) is necessary to confirm the diagnosis of RPLS.

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

9-29-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

The FDA notified healthcare professionals and patients of new
preliminary information from the North American Antiepileptic Drug
Pregnancy Registry that suggests that babies exposed to Lamictal,
indicated to treat seizures and bipolar disorder, during the first three
months of pregnancy may have a higher chance of being born with a cleft
lip or cleft palate.

Women who are pregnant and taking Lamictal or who are thinking about
taking this medication are urged to not start or stop taking the
medication without first talking to their physician. More research is
needed to be sure about the possibility of the increased chance of cleft
lip or cleft palate developing in babies of pregnant women who take
Lamictal.

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

9-29-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program


[UPDATE 09/29/06 of original 2/8/06 alert] FDA held a public advisory
committee meeting 9/21/06 to discuss the safety and overall risk-benefit
profile for Trasylol. The committee discussed the findings from the two
published observational studies, the Bayer worldwide safety review, and
the FDA review of its own post-marketing database. On 9/27/06, Bayer
told FDA that it had conducted an additional safety study of Trasylol.
The preliminary findings from this new observational study of patients
from a hospital database reported that use of Trasylol may increase the
chance for death, serious kidney damage, congestive heart failure and
strokes. While FDA conducts its evaluation of this new safety study, it
is recommended that physicians should consider limiting Trasylol use to
those situations where the clinical benefit of reduced blood loss is
essential to medical management and outweighs the potential risks.
Physicians should carefully monitor patients for the occurrence of
toxicity, particularly to the kidneys, heart, or brain, and promptly
report observed adverse event information to FDA's MedWatch program or
Bayer.

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

10-06-2006 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and the iPLEDGE program notified healthcare professionals and
patients of an update to iPLEDGE, a risk management program to reduce
the risk of fetal exposure to isotretinoin, that will eliminate one
element of the program, the 23 day lock-out period for males and females
of non-child bearing potential. This change does not affect female
patients of child-bearing potential.

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

10-06-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Bristol-Myers Squibb notified pharmacists and physicians of
revisions to the labeling for Coumadin, to include a new patient
Medication Guide as well as a reorganization and highlighting of the
current safety information to better inform providers and patients.

The 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.

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

10-14-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

LifeScan and FDA notified healthcare professionals and the public of
counterfeit blood glucose test strips being sold in the United States
for use with various models of the One Touch Brand Blood Glucose
Monitors used by people with diabetes to measure their blood glucose.
The counterfeit test strips potentially could give incorrect blood
glucose values--either too high or too low--which might result in a
patient taking either too much or too little insulin and lead to serious
injury or death.

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

10-19-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Novartis and FDA notified healthcare professionals about revisions to
the PRECAUTIONS section of the prescribing information, describing the
occasional occurrence of severe congestive heart failure and left
ventricular dysfunction in patients taking Gleevec. Most of the patients
with reported cardiac events had other co-morbidities and risk factors,
including advanced age and previous medical history of cardiac disease.
Patients with cardiac disease or risk factors for cardiac failure should
be monitored carefully and any patients with signs or symptoms
consistent with cardiac failure should be evaluated and treated.

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

10-20-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Roche Diagnostics and FDA informed consumers and healthcare
professionals of the recall of CoaguChek PT test strips used to
determine blood clotting time of patients taking anti-coagulant
medication to prevent blood clots.  The recall was due to the potential
for a test strip defect that may cause falsely elevated test results,
resulting in an incorrect dose of anti-coagulant medication or
unnecessary corrective measures being taken to reduce the effect of
circulating anti-coagulants.  Healthcare professionals who use CoaguChek
PT test strips should institute 'duplicate testing', or use two strips
with different lot numbers, on each patient to reduce the risk of bias.
Home users of CoaguChek PT test strip should immediately discontinue use
of the product and contact their healthcare provider.

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

10-23-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and CDC updated an October 2005 alert to consumers and health care
providers regarding reports of Guillain Barre Syndrome (GBS) following
administration of Meningococcal Conjugate Vaccine A, C, Y, and W135,
manufactured by Sanofi Pasteur. To date a total of 15 confirmed cases of
GBS among individuals 11-19 years of age occurring within six weeks of
vaccination with Menactra have been reported to the Vaccine Adverse
Event Reporting System (VAERS). Two additional cases have been confirmed
in persons 20 years of age and older. All individuals are reported to be
recovering or have recovered.

While the cases reported suggest a small increased risk of GBS following
immunization with Menactra, the limitations in VAERS, and the
uncertainty regarding background incidence rates for GBS require that
these findings be viewed with caution. At this time, CDC and FDA cannot
determine with certainty whether Menactra does increase the risk of GBS
in persons who receive the vaccine and, if so, to what degree. At the
present time, there are no changes in recommendations for vaccination
and individuals should continue to follow their doctors'
recommendations. FDA asks any persons with knowledge of possible cases
of GBS occurring after receiving Menactra to report them to VAERS at
http://www.vaers.hhs.gov or by phone at 1-800-822-7967.

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

10-25-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Wyeth and FDA notified healthcare professionals of revisions to the
OVERDOSAGE/Human Experience section of the prescribing information for
Effexor (venlafaxine HCl), indicated for treatment of major depressive
disorder. In postmarketing experience, there have been reports of
overdose with venlafaxine, occurring predominantly in combination with
alcohol and/or other drugs. Published retrospective studies report that
venlafaxine overdosage may be associated with an increased risk of fatal
outcome compared to that observed with SSRI antidepressant products, but
lower than that for tricyclic antidepressants. Healthcare professionals
are advised to prescribe Effexor and Effexor XR in the smallest quantity
of capsules consistent with good patient management to reduce the risk
of overdose.

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

10-25-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Heartland Repack Services and FDA notified healthcare professionals of a
voluntary recall of all products containing a lot number beginning with
"K" (example: K12345). Drugs repackaged by Heartland Repack Services are
distributed through their own pharmacy services to Omnicare nursing
homes and other institutional facilities. Omnicare is responsible for
1.4 million nursing home and healthcare patients in 47 states and
Canada. These product lots are distributed in 30, 60, 90 count size
boxes and 250 count bags. Both the boxes and bags contain unit dose
strips of five tablets per strip. This recall was initiated because
there is the potential for mislabeling and packaging mix-up.

Due to incomplete accounting of product subject to this recall, on
October 20, 2006 Heartland Repack Services issued a follow-up notice of
the July 2006 recall.

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

11-13-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

Roche and FDA notified healthcare professionals of revisions to the
PRECAUTIONS/Neuropsychiatric Events and Patient Information sections of
the prescribing information for Tamiflu, indicated for the treatment of
uncomplicated acute illness due to influenza infection in patients 1
year and older who have been symptomatic for no more than 2 days and for
the prophylaxis of influenza in patients 1 year and older. There have
been postmarketing reports, mostly from Japan, of self-injury and
delirium with the use of Tamiflu in patients with influenza. People with
the flu, particularly children, may be at an increased risk of
self-injury and confusion shortly after taking Tamiflu and should be
closely monitored for signs of unusual behavior. A healthcare
professional should be contacted immediately if the patient taking
Tamiflu shows any signs of unusual behavior.

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

11-17-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals of a newly published clinical
study showing that patients treated with an erythropoiesis-stimulating
agent (ESA) and dosed to a target hemoglobin concentration of 13.5 g/dL
are at a significantly increased risk for serious and life threatening
cardiovascular complications, as compared to use of the ESA to target a
hemoglobin concentration of 11.3 g/dL. The "Correction of Hemoglobin and
Outcomes in Renal Insufficiency" study, published November 16, 2006 in
the New England Journal of Medicine, reports the adverse cardiovascular
complications as a composite of the occurrence of one of the following
events: death, myocardial infarction, hospitalization for congestive
heart failure, or stroke.

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

11-22-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Advanced Medical Optics, Inc. informed healthcare professionals
and consumers of a nationwide recall of 18 lots of Complete (R)
MoisturePLUS multipurpose contact lens care solution and Active Packs
distributed in the United States.  Certain lots were found to have
bacterial contamination which compromised sterility.  Non-sterility of a
contact lens solution may have serious health consequences, including
eye infection and microbial keratitis.

Contact lens users who have the recalled product should discontinue use
immediately and individuals who experience symptoms of an eye infection
such as redness, pain, tearing, increased light sensitivity, blurry
vision, discharge or swelling, should remove their lenses and consult
their eye care provider immediately.

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

11-27-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals of reports of death and
life-threatening adverse events such as respiratory depression and
cardiac arrhythmias in patients receiving methadone.  These adverse
events are the possible result of unintentional methadone overdoses,
drug interactions, and methadone's cardiac toxicities (QT prolongation
and Torsades de Pointes).

The reports underscore the importance of knowing methadone's toxicities
and unique pharmacologic properties, including dosing and monitoring
recommendations.

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

12-08-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA notified healthcare professionals and consumers about the serious
public health risks related to compounded topical anesthetic creams. FDA
issued warning letters to five firms to stop compounding and
distributing standardized versions of topical anesthetic creams,
marketed for general distribution. Exposure to high concentrations of
local anesthetics, like those in compounded topical anesthetic creams,
can cause grave reactions including seizures, irregular heartbeats and
death. Compounded topical anesthetic creams are often used to lessen
pain in procedures such as laser hair removal, tattoos, and skin
treatments. They may be dispensed by clinics and spas that provide these
procedures, or by pharmacies and doctors' offices.

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

12-08-06 MedWatch - The FDA Safety Information and Adverse Event Reporting Program

FDA and Baxter notified healthcare professionals of revisions to the
WARNINGS section of the prescribing information for Heparin to inform
clinicians of the possibility of delayed onset of heparin-induced
thrombocytopenia (HIT), a serious antibody-mediated reaction resulting
from irreversible aggregation of platelets. HIT may progress to the
development of venous and arterial thromboses, a condition referred to
as heparin-induced thrombocytopenia and thrombosis (HITT). Thrombotic
events may be the initial presentation for HITT which can occur up to
several weeks after the discontinuation of heparin therapy. Patients
presenting with thrombocytopenia or thrombosis after discontinuation of
heparin should be evaluated for HIT and HITT.


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