The reality is we've had so many new drugs in the last 20 years that we have no real idea of what they interact with or their long-term side effects. Yes, we are all guinea pigs, but I sure hope nobody was ever under the delusion it was otherwise.

Was it a coincidence that the photo looks like Heath Ledger?

I'm not sure how much this relates but I'm all for doctors making the decisions on which medicines to try. I may be alone in this but I don't think drug manufacturers should be allowed to advertise their products to the general populace. I also don't think insurance companies should be allowed to have non-doctors decide what procedures are covered.

Just looked at the list, as linked via the Guardian. I've taken a number of medications, and not that that gives me any sort of medical authority, but I have never even heard of a lot of these medications.

So, I suppose the fact that Cialis is not on the list might limit hysteria.

I'd feel bad for anyone overdosing on Seroquel. Even normal doses tend to make people drowsy. This can be both a bug and a feature. When i was hospitalized last year, seroquel is what they liked putting everyone on the ward on because it kept people so groggy it shut them up.

"Tumor Necrosis Factor (TNF) Blockers - Cancers in children and young adults"

Humira. It says that right in the few pages after the two page ad...

Also, "purple glove syndrome"? My goodness.

"(Oxycontin) Drug misuse, abuse and overdose"

Wow, really?

Yeah I REALLY could have gone though life w/o finding out about "Purple Glove Syndrome." It was curious enough to Google... OMFG...

Whenever I get my prescriptions it comes with 2 pages of information and warnings. Is this unique to MN, or is it everywhere? I always read through to see what the usual side effects are, the warnings, and what NOT to do.

(I'm a doctor, but not your doctor, there's no medical advice in this post. I'm not a lawyer, so I don't know if this disclaimer means anything)
Most of the drugs on this list are fairly uncommon. A lot of these things are only used in hospital settings, like desflurane (an inhaled anesthetic used during surgery).

I'm curious about the dosing confusion risks with Seroquel, Nitrostat, and Humulin R, because I don't think they are well publicized.

Name confusion issues like Carac and Kuric have always bothered me. One's a chemotherapy cream, the other's for athlete's foot.

AriellaFaerie: The sedation dose of Seroquel is usually 25-100 at night. The dose for someone with psychosis can be up to 750 a day. I'm guessing the dosage confusion may come from giving a psychosis dose to someone who is mildy anxious and unable to sleep.

@ReidFleming: I'm with you. I bet drug prices would fall if we totally banned direct-to-consumer marketing of prescription drugs. There is no reason it should be allowed.

@Wubbytoes: When Oxycontin came out, it was marketed as being safer and having less abuse risk than older opiods.

Purdue Pharm was convicted of fraud for it, although I don't think anybody served any jail time.

The past couple years, I've made it a habit to ask whether I truly needed a certain prescription and what the side effects are. I usually don't bother with any that's just "so you'll feel better" ... not having to pay $$$ for more pills makes me feel better automatically!

Wearing this last time I visited was a good reminder to the doc too.
[www.illwillpress.com]

(Yes, I too rather have a little snot on my upper lip rather than seeing Elvis in my refrigerator.)

Is it kind of sick that that guy in the picture looks like Heath Ledger to me? I mean, given the circumstances.

@mwshook:

Thank you.

Outside of Insulin (one the list), I suspect less than 1% of the population is taking or ever has taken any of the drugs on the list.

And yet, weed is still illegal...

@Corporate-Shill: Several of those are quite common drugs.

@The_IT_Crone: That is pretty standard. In fact, I'm on one of those drugs from the list, and in addition to the 2 pages I get from the pharmacy, I also get mailing from the pharmacy, paid for by the drug manufacturer.

I'm on one of those drugs. JOY.

So, heparin could cause anaphylactic-type reactions? Funny, I thought just about any drug which has never been taken by a patient before could cause allergic reactions.

And ivermectin and warfarin are the only drugs that could cause drug interaction problems? Hmm. My grandmother's doctors were quite surprised when I pointed out that they had her on metformin, digoxin, amiodarone, coumadin, metoprolol, Lipitor, a diuretic, Advil, Tylenol PM, AND aspirin, plus two or three others I can't remember. Lots of these don't play nice with each other, and every doctor started pointing fingers at all the other doctors.

And it's so nice to know that oxycodone is the only drug which might run the risk of "drug misuse, abuse and overdose." Guess I don't have to worry that my doctor keeps prescribing large doses of Vicodin for me.

IANAPharmD, but this list seems grossly incomplete to me.

If you believe all the media stories about what might potentially kill you, you'll be stuck drinking water and eating parsley leaves for the rest of your life.

You have to know which warnings to take seriously and which are just fear mongering.

@dragonfire81: Some parsley will kill you.

And don't get me started about water.

I guess this is one of those things where people have to use common sense. (We're doomed.)

@nsv:
"I guess this is one of those things where people have to use common sense. (We're doomed.)"

I'm all for a Darwinism in action right about now.

@dragonfire81: Water and parsley seems to be just fine as snacks for my rabbit.

The oxycodone struck me as odd too. Seriously, we haven't known that there's a risk of abuse and dependency for a while? Was it necessary to place on a list?

Actually, I think it's more necessary for the FDA to...oh I don't know...explain what each drug does, and who might take it? I searched the list for the one prescription drug I take, and it's not on there (I don't think) but how the heck am I supposed to know if it goes by multiple names?

@dragonfire81: Watch out for the di-hydrogen monoxide in water. It can kill you/maim you.

hooray for the new face of the fda! approve everything & leave it up to the consumer to decide what's best (with official guidance of course).

hell, it worked for the mortgage industry, why not try it with pharmaceuticals, right?

@nsv:

I AM a PharmD. You cannot have a true (Type I) allergy to a substance the first time you take it, you need to develop antibodies to it. It's that second (or third, or fourth) exposure that will get you.

A lot of the ones on here about dose confusion are related to drugs that choose to express their amount in non-standard ways: Arginine in % rather than grams, U-500 insulin (which is 5x more concentrated than U-100, which is used 99.9999999% of the time), nitroglycerin (expressed in grains rather than milligram), etc. All could be easily avoided if the FDA would make everybody label their drugs in mg/gm and not Apothecary or other bizaare units of measure.

The purple glove syndrome w/ phenytoin is hilarious as the FDA made a big stink about this with IV promethazine about 2 years ago, only to realize at the last minute that it wasn't common after all and drop the whole damn thing.

Some of these are not news to anyone who is involved with med safety work - the OxyContin stuff, heparin, and suprane issues are documented. What's most interesting to me are the associations with the TNF alpha blockers and CA (they just expanded the warning on these to include increased incidence of fungal infections, and they're already known to increase pneumonias and cause re-activation of TB). The issues with Definity are also concerning, but too soon to tell what will come of it.

I find this stuff fascinating, guess I'm a huge nerd.

@mwshook: I'm curious about the dosing confusion risks with ... Humulin R, because I don't think they are well publicized.
i can tell you that the confusion with the insulin stems from the fact that this particular insulin is a U-500 insulin (most others are U-100; this one is 5 times as potent)
it is usually prescribed to people who are highly insulin resistant, so it is rather rare. If someone is used to taking U-100 insulin and winds up with a vial of U-500 (and are unaware of the switch), they can fall into hypoglycemia very quickly (they thought they were taking 5 units of insulin, but were actually taking 25)

@MBPharmD:

There was supposed to be a ;-) after the I am a pharmd bit. Trying to be funny, not trying to be a dick. My bad.

@SybilDisobedience:It probably sick that the consumerist chose a photo that resembles heath ledger.

@junkmail: I thought it WAS him at first! I was like "uhhh, that's kind of insensitive." Haha.

@MBPharmD: Could you develop an allergy to one drug, and then have an allergic reaction when you take a similar drug for the first time?

@IHaveAFreezeRay: Google the drug you take. It should be pretty easy to find the different names for it.

@Nick1693: Knew about it. Would rather take the small risk than be crippled in all my joints.

@junkmail: I was coming here to say the same thing.

I really, really wish the FDA would take a better look at Ultram. Right now Ultram is touted to have no physical dependency issues, and that is flat-out bullsh*t. I was on 100mg of Ultram every 6 hours for five months, and when I quit taking them, I puked my guts out for four days and felt like hell. Not even a prescription for clonidine subsided the withdrawal.

@mwshook: That's hilarious, considering that now its "hillbilly heroin".

I used to work for "undisclosed big pharma company X" in their "global command center" and I used to receive tons of calls daily about negative side effects of drugs that aren't listed in the packet that Walgreen's gives you with your Rx. The most scary one was when a 5 yr. old boy was hallucinating and having seizures from a child's anti-biotic.

@nerdychaz: I believe it. It's all about the money.

@junkmail: Way to call it, man. That's pretty sad if it was deliberate.

@mwshook:
"Name confusion issues like Carac and Kuric have always bothered me. One's a chemotherapy cream, the other's for athlete's foot."

That's what I was going to mention! Is that really a fault of the drug or the people who administer it? If you take away the 'health risks' that are actually human error/abuse, that takes away 6 right there. Everything's fine!

How about the actual list Consumerist editors?

Consumerist, thank you for trying to highlight reasons to keep the haddocks from panicking. Let's hope it works.

Wow FDA, thanks for being so concerned with my potential death. I'm glad to know you're not in bed with the drug industry at /all/ and that the revolving door policy you and major drug manufacturers have hasn't gotten in the way of the demands of your charter.

@johnva: but banning direct-to-consumer pharma ads wouldn't stop all ads/promos to doctors & hospitals, and patients wouldn't have *any* information on what goes on outside of the exam room. I think the system now is terrible, but at least we get a glimpse of it. If I see certain drugs pushed hard on TV, mags, or online, I get the feeling that they're being pushed just as hard at the medical community. Keeps me suspicious, which is a sad but realistic way to approach medical care, imo.

I'm pointing my finger at a lot of conflicts of interests among FDA advisory committee members & researchers ([www.cspinet.org]). There is a lot of big money changing hands and very little of it gets noticed, but I'm sure it has a big impact on what kinds of data are produced and which drugs ultimately get approved.

The new, 'stricter' FDA guidelines on COI (from Aug 4) allow you to have up to $50,000 in personal financial interest from a company and still be seated on a panel to review their drugs. Not cool.

[www.fda.gov]

"The most scary one was when a 5 yr. old boy was hallucinating and having seizures from a child's anti-biotic."

Isn't it possible that the kid had, like, an infection that was causing these things?

Part of the problem is that people who take medications are sick. It's very hard to figure out which things are caused by the medication and which are just part of being sick. Adverse event reporting is notoriously difficult to interpret.

It takes a lot of data to figure out whether 1 in 10,000 people taking drugs for Obscure Condition X (OCX) are getting sweaty palms because of the medication or because sweaty palms is an unknown symptom of OCX or because, well, 1 in 10,000 healthy people have sweaty palms. Once you start asking people to report "anything unusual" they start reporting a lot of stuff.

That doesn't mean that there's nothing to worry about, though. :)

@oneandone: Banning DTC advertising would not eliminate all of people's information about drugs outside of their doctors' office. It would just eliminate the overtly BIASED source of information that advertising represents. We now have the Internet, etc where people can look up reliable information about drugs without needing advertisement.

Lenalidomide (Revlimid) apparently can cause Stevens Johnson Syndrome. Whoever Steven is, apparently you do NOT want his johnson.

Shit! Better stock up on my crazy meds before they stop making them!