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ARTICLE |

Use of Terfenadine and Contraindicated Drugs

David Thompson, PhD; Gerry Oster, PhD
JAMA. 1996;275(17):1339-1341. doi:10.1001/jama.1996.03530410053033.
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Objective.  —To assess changes in concurrent use of products containing terfenadine and contraindicated macrolide antibiotics (erythromycin, clarithromycin, troleandomycin) and imidazole antifungals (ketoconazole, itraconazole) following reports of serious drug-drug interactions and changes in product labeling.

Design.  —Retrospective review of computerized pharmacy claims.

Setting.  —A large health insurer in New England.

Patients.  —Health plan members with 1 or more paid pharmacy claims for products containing terfenadine between January 1990 and June 1994.

Main Outcome Measures.  —Among persons with paid claims for terfenadine in any given month, percentage with a prescription for any contraindicated drug that alternatively was dispensed on the same day as ("same-day dispensing") or had therapy days that overlapped those of ("overlapping use") a prescription for terfenadine.

Results.  —Concurrent use of terfenadine and contraindicated drugs declined over the study period. The rate of same-day dispensing declined by 84%, from an average of 2.5 per 100 persons receiving terfenadine in 1990 to 0.4 per 100 persons during the first 6 months of 1994, while the rate of overlapping use declined by 57% (from 5.4 to 2.3 per 100 persons). Most cases involved erythromycin.

Conclusions.  —Despite substantial declines following reports of serious drug-drug interactions and changes in product labeling, concurrent use of terfenadine and contraindicated macrolide antibiotics and imidazole antifungals continues to occur.(JAMA. 1996;275:1339-1341)

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