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Use of Terfenadine and Contraindicated Drugs

Andrew D. Zechnich, MD; Jerris R. Hedges, MD, MS
JAMA. 1996;276(12):953. doi:10.1001/jama.1996.03540120031024.
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To the Editor.  —In their article on the use of terfenadine and contraindicated drugs in the New England area,1 Drs Thompson and Oster conclude by noting several limitations of their study, including the absence of information related to the prescribing physician or dispensing pharmacist.This limitation prohibited the authors from "determining how frequently terfenadine and a contraindicated drug were prescribed by the same physician or dispensed by the same pharmacy." They noted that another recent publication found that 16 of 50 pharmacies in the Washington, DC, area coprescribed these products.2 We have reported3 that in the Oregon Medicaid population, the frequency of concurrent use of terfenadine or astemizole with contraindicated agents increased more than 3-fold from 1991 to 1992. Furthermore, although these Oregon Medicaid patients received prescriptions from different physicians in 48% of these episodes, they used different pharmacies only 3% of the time. Hence, in addition


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