BNF Caution Labels :: Time for new ones?

[Pharmanaut]

Might have suggested this before, but its now 2009, a new year for patient safety.

Now that we have the attention of the PJ and some of the staff read this forum. How about discussing updating the BNF caution labels.
We need to keep the wording short and sweet like a slogan, as many products end up with > 1 'continuation labels' if we start to get too pedantic with our wording.

I'm sure our computer suppliers have extended them "unofficially" over the years, as I notice that Pharmacy Manager prints the following.

Contains Ibuprofen.
Contains a penicillin

Further suggestions would be
Avoid grapefruit juice and whole fruit.
Limit consumption of grapefruit juice
If blurred wait until vision clears before driving/operating machinery
Alert - may cause serious damage to babies if used in pregnancy. (Thalidomide)
Important : usually weekly dosage. Check with your pharmacist. (methotrexate)

Any more from the forum?

[DavidS]

Any more from the forum?

Its always amazed me that gliclazide etc. don't have "Caution: only to be taken by diabetics" on them, as we have to keep them on a seperate shelf, etc.

When I managed my own place that was the first amendment I made to the supplied warnings.

The second was to delete "Warning: contains paracetamol" from Paracetamol tablets.

Another might be to have on methadone "Warning: extremely dangerous if taken by young children" as that was quite a major worry at one time, and - showing my age - the first time CRCs were recommended for use on liquids. I think some addicts used to slip their kids a bit to make them sleep.

[Pharmanaut]

Its always amazed me that gliclazide etc. don't have "Caution: only to be taken by diabetics" on them, as we have to keep them on a seperate shelf, etc.

When I managed my own place that was the first amendment I made to the supplied warnings.

The second was to delete "Warning: contains paracetamol" from Paracetamol tablets.

Another might be to have on methadone "Warning: extremely dangerous if taken by young children" as that was quite a major worry at one time, and - showing my age - the first time CRCs were recommended for use on liquids. I think some addicts used to slip their kids a bit to make them sleep.

I don't particularly agree with removing contains paracetamol for liability reasons. Some "no win no fee" firm would jump on that.

Rest of your suggestions are great.

That use of methadone is frightening, but it used to be done with Laudanum (spelling?).
I usually add "replace cap tightly" if it is more than one dose.

Forum members : please keep them coming.

[Nik]

Just out of curiosity I noticed that BNF-C has aspirin labels 32 and 33 - could anyone clarify this please ?

[Rafael]

which version are you using? BNF-C 2008 has 32 only which makes sense.

[Nik]

Yeah label 33 (contains an aspirin like medicine) is included in appendix 3 in BNF-C 2008 but i can't seem to find any product which would have that as a label - suppose label 32 is relevant if prescribing aspirin for anti-platelet effect.

[Pharmanaut]

Yeah label 33 (contains an aspirin like medicine) is included in appendix 3 in BNF-C 2008 but i can't seem to find any product which would have that as a label - suppose label 32 is relevant if prescribing aspirin for anti-platelet effect.

Wasn't that aloxiprin.
Memory of it at the back of my mind for some reason.

[Nik]

Hmm... if considering adding "caution: only to be taken by diabetics" on antidiabetic drugs, why not include a similar label on boxes of insulin ?

I know this will sound bizarre but what about including keep out of reach of pets ? Dogs running around house + open bottles of tablets =...

[jaymags]

Some people don't even read the labels let alone the cautions, even when we highlight them.

[DavidS]

Hmm... if considering adding "caution: only to be taken by diabetics" on antidiabetic drugs, why not include a similar label on boxes of insulin ?

Its if they get given it by mistake. In a recent PJ someone got glibenclamide (I think) in error, and this woud perhaps help them not to take it.

I know this will sound bizarre but what about including keep out of reach of pets ? Dogs running around house + open bottles of tablets =...

Yeah, that sounds bizarre.