Health Product InfoWatch – October 2017
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Pub. no 160256
Health Products and Food Branch
Marketed Health Products Directorate
Health Product InfoWatch Editorial Team
- Monthly recap
- New information
Health products mentioned in this issue
Pharmaceuticals and Biologics
- Atypical antipsychotics
- Dexilant (dexlansoprazole)
- Erythrocin I.V. (erythromycin lactobionate)
- Invokamet (canagliflozin and metformin)
- Invokana (canagliflozin)
- Levonorgestrel-releasing intrauterine systems
- Losec (omeprazole)
- Nexium, Nexium 24 hr (esomeprazole)
- Panto IV (pantoprazole sodium for injection)
- Pantoloc (pantoprazole sodium)
- Pariet (rabeprazole)
- Prevacid, Prevacid FasTab (lansoprazole)
- Solu-Medrol Act-O-Vial 40 mg
- Tecta (pantoprazole magnesium)
- Vimovo (naproxen/esomeprazole)
Monthly recap of health product safety information
Apo-Nitroglycerin sublingual spray
Apotex Inc. recalled one lot (lot 6G07) of its Apo-Nitroglycerin sublingual spray (0.4 mg/metered dose) as the spray pump may malfunction and not deliver the drug.
This safety review evaluated the risk of sleep walking and sleep-related eating disorder (SRED) associated with atypical antipsychotics (aripiprazole, asenapine, clozapine, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, and ziprasidone). Health Canada's safety review has found a link between sleep walking and SRED and the use of atypical antipsychotics. Health Canada has recommended to update the Canadian product monographs for all atypical antipsychotics to include these adverse reactions.
Invokana (canagliflozin) and Invokamet (canagliflozin and metformin)
An approximately two-fold increased risk of surgical lower limb amputation has been observed in two long-term clinical studies in type 2 diabetes patients with established cardiovascular disease (CVD) or at least two risk factors for CVD treated with Invokana. Healthcare providers are reminded to follow established diabetes care practice guidelines in patients treated with canagliflozin. The Canadian product monographs of Invokana and Invokamet will be updated to reflect this safety information.
Levonorgestrel-releasing intrauterine systems
This safety review evaluated the risk of suppressed lactation associated with levonorgestrel-releasing intrauterine systems (Mirena, Jaydess and Kyleena). Health Canada's review concluded that there is currently limited evidence to suggest a link. Health Canada is considering updating the Canadian product monographs for these products to mention that cases of decreased breast milk production have been reported.
Solu-Medrol Act-O-Vial 40 mg
Solu-Medrol Act-O-Vial 40 mg is the only formulation of methylprednisolone in Canada that contains bovine-sourced lactose as an excipient. Serious allergic reactions have been reported in patients allergic to cow's milk proteins who were treated with Solu-Medrol Act-O-Vial 40 mg. Solu-Medrol Act-O-Vial 40 mg is contraindicated in patients with a known or suspected hypersensitivity to cow's milk. The Canadian product monograph has been updated to reflect this new safety information.
Health Canada reminded Canadians that thermograms (which use thermal imaging) are not a substitute for mammograms used for routine monitoring and screening for breast cancer. While thermography devices are available in Canada, these devices have not been licensed in Canada to screen for breast cancer.
Unauthorized health products
Health Canada advised Canadians about various unauthorized health products being sold at retail locations across Canada or online that may pose serious health risks.
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