We recently heard about four cases of community pharmacists dispensing the central nervous system stimulant Metadate ER instead of Metadate CD. Both are extended-release formulations of methylphenidate HCI. The CD product, a daily capsule, has an initial rapid release of methylphenidate HCl followed by continuous release to control symptoms of attention-deficit hyperactivity disorder throughout the school day. The ER product, a tablet, is given two to three times a day. None of the pharmacists involved in the errors knew that the Metadate CD product existed.
Some products, such as diltiazem, have numerous suffixes to differentiate various formulations. But prescribers sometimes write orders for extendedrelease products without the appropriate name or suffix.
When you receive an order or prepare to administer a drug, pay attention to whether the order specifies an extended-release or regular formulation. Check too that the frequency of the prescribed dosing is appropriate for the form prescribed.
Michael R. Cohen is president of the Institute for Safe Medication Practices (ISMP), a nonprofit organization that derives its reports from the USP-ISMP Medication Errors Reporting Program. To report medication errors, call the USP at 1-800-23-ERROR (233-7767). You can reach the ISMP at 215-947-7797 or via E-mail at ismpinfo@ismp.org
Copyright Springhouse Corporation Mar 2002
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