Tequin And Elderly Patients
Older people who take Bristol-Myers Squibb’s Tequin are nearly 17 times more likely than those not taking it to be hospitalized for high blood sugar (hyperglycemia) and four times as likely to be hospitalized for low blood sugar (hypoglycemia).
Older people who take Tequin are much more likely to be hospitalized for hyperglycemia or hypoglycemia.
Blood sugar problems
Overall, 1% of patients who took Tequin were hospitalized. Both hyperglycemia and hypoglycemia can induce serious health problems, such as coma and even death. The Tequin symptoms usually begin within five to 10 days.
Because these abnormal blood sugar conditions can be fatal they must be treated promptly. Fortunately, in most cases the Tequin symptoms go away when use of the drug is halted.
Within two years of being approved by the FDA, more than 3 million prescriptions were being written annually for Tequin. By 2003, however, the FDA had received reports of 17 deaths in patients who took Tequin, and the number of prescriptions fell to about 1.7 million per year.
Some elderly at risk, or all?
Bristol-Myers Squibb sent a “dear doctor” letter that emphasized the addition of diabetes mellitus as a contraindication and urged special care in the use of Tequin among elderly patients.
According to the company’s letter, older patients “may have unrecognized diabetes, age-related decrease in renal function, underlying medical problems, and/or are taking concomitant glucose-altering medications.” Such circumstances can place an elderly person at risk for harmful changes in blood sugar levels.
Advice from Drs. Juurlink and Wolfe
All older patients were at risk, not just those who were diabetic. Dr. David Juurlink of the Institute for Clinical and Evaluative Sciences in Toronto, one of the lead researchers for the studies, has urged doctors to stop prescribing Tequin. “Speaking as a clinician, I would never prescribe this drug,” says Dr. Juurlink.
Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group, is advocating a recall of Tequin. “This represents a unique danger in the absence of a unique benefit,” Dr. Wolfe says. “There is more than enough reason to think about petitioning the FDA to ban [Tequin], and we probably will.”
Both the FDA and Health Canada have issued drug-safety alerts about Tequin in connection with the findings from the two Canadian studies.
