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Before "Adverse Reactions" was a buzz word, there was a problem as revealed in this ground-breaking feature article.  Revolution and other drugs come to you with no information other than what the vet tells you or writes on the pill bottle.  Often, your vet doesn't even know that drug can have deadly side effects because the truth is hidden from him, unlike your pharmacist who gets those "inserts" on his computer.

Prescription Inserts

by Mike Murray (2000 Project)

With all the controversy surrounding the use of the drug Revolution (and others) I'd like to take an opportunity to propose a solution. One that benefits everyone, but ultimately our pets most of all.

I started out by doing a little research on the drug.  The drug manufacturer states under Adverse Conditions: (<=0.5% of 1763 treated cats and dogs reported symptoms) which means if you treat 1,000 dogs, five might have adverse reactions. Now I know that no drug is 100% safe 100% of the time.

Penicillin changed the world, yet some people will die if given penicillin for a scratch. Every night on TV I see ads for Rogaine, Propecia, Prozac, etc. and they always have the disclaimer - some people may exhibit certain side effects such as vomiting, nausea, etc., be sure to check with your doctor. So it seems to me to become a question of what is acceptable risk. Add to this the fact that you are using a substance that by it's very nature you know is a toxin to at least some organisms, and is seems that there has to be an understandable level of risk. 

The fault here, in my opinion, is one of education. The vet should explain to the dog owner the possibility of side effects, and what to look for. With every prescription I get, they always put a page of instructions in the bag.  It lists possible side effects, what medications should not be taken together, and what to do if I do have an adverse reaction. And certainly, the vet should recognize the possibility of side effects, and know how to promptly treat them.

I don't think you can expect a drug company to make a drug that is 100% safe. Even if they handed out placebo's, a diabetic will react to the sugar pills. But they do have a responsibility to make it as safe as they can, and then to educate the veterinarians that will be dispensing the product. Then it becomes the vets responsibility to inform the pet owner.

Though pharmacies have been taking heat lately for incorrectly filling prescriptions, they do perform one added service. They are a safety check for busy doctors who don't take the time to fully inform the patient about the drug they just prescribed.  The reputable ones will at least give you a fact sheet on the drug.

Maybe vets should do the same thing because pet owners need to be better educated about the drugs their pets are receiving, and the vet is the front man for the drug companies. If a vet doesn't know or understand a drug, they have no business prescribing it.

Prescription inserts seem to be the logical answer. In the long run, it would be cheaper for the drug companies to provide fact sheets on their product than to settle numerous lawsuits, and they are providing a service to the end users of their products. If consumers are better educated about a prescription drug, that drug in turn becomes a safer product.

So when your pet is prescribed a medication, ask for a fact sheet just like my pharmacist gives me. In print that I can read, and terms that I can understand. Drug companies save on litigation, I'm happier, and my pet is safer and healthier.

EDITOR'S NOTE: Within one week after this article was published, Pfizer issued a widely disseminated press release stating that they were going to start issuing product information with every prescription. The release was also sent out on all related internet lists.  Coincidentally (?) the release used very similar wording and even employed the same 'local pharmacy' analogy as an example. We are glad to see them taking this first step but this will remain a TDP PROJECT until pharmaceutical company dissemination of potential side effects and adverse reactions become common practice in veterinary medicine.

Update: as of Feb. 2005 many vets still say there is no insert info available to them whereas the drug companies claim, understandably, that is not so. 

Legislative steps are underway in some states to force compliance of  Prescription Inserts - just one more step in preventing Bad Medicine.  Other informative links  Adverse Reactions  Recalls Pro Heart 6 and Rimadyl Settles