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Translated from Rev Prescrire November 2012;
Translated from Rev Prescrire November 2012;
Translated from Rev Prescrire November 2012;
32 (349): 831
32 (349): 830
32 (349): 828
An initiative to prevent
Methylphenidate:
Benfluorex and cardiac
the adverse effects
abuse in Europe
valve disease: long delay
of metformin
in publication
In Europe, methylphenidate con-
Collaboration between clinicians
sumption is rising at an alarming rate.
Unresponsive authorities.
and a pharmacovigilance centre
Reports of abuse and addiction are
results in practical benefits for
also increasing.
In 1998, the Italian health
patients.
Methylphenidate, an amphe -
Lactic acidosis is a well-
larly, in 1999, the French drug regulato- Metformin accumulation increases the (1,2), as a last-resort symptomatic treat- vascular effects of benfluorex (1). A dou- risk of lactic acidosis. Other risk factors include: dehydration, cardiac or respira- tory failure, recent myocardial infarction, itoring of diabetic patients treated with liver failure, severe acute alcohol intoxi- reported in France and elsewhere (2,3).
benfluorex or pioglitazone (2). Prelimi- analysed methylphenidate consumption reviewed morbidity and mortality resulting and 33 patients on pioglitazone (27% from the adverse effects of metformin phenidate consumption rose sharply in (2). This process is one way of improving (42 patients treated with benfluorex, ver- sus 3 treated with pioglitazone; p<0.0001).
valvular regurgitation was generally con- tion, but the authors did not specify the metformin, the number of reports of lac- ed after only one year of benfluorex treat- mortality fell from 43% to 23%, as did the In practice. These European data are
proportion of patients requiring intensive in line with previous observations made in In practice. The ensuing benfluorex
tion must be taken into account when con- disaster revealed a lack of responsiveness sidering methylphenidate prescription.
In practice. Collaboration between
Selected references from Prescrire’s literature
Prescrire Rédaction “Méthylphénidate: un amphétaminique à ne manier qu’avec beaucoup de précautions” Rev Prescrire 2011; 31 (330): 263. Selected references from Prescrire’s literature
2- Prescrire Editorial Staff “Methylphenidate: abuse
and addiction” Prescrire Int 2012; 21 (131): 241.
1- Inspection générale des affaires sociales “Enquête
Selected references from Prescrire’s literature
3- Prescrire Editorial Staff “Methylphenidate”
sur le Mediator°” Rapport définitif, tome annexes, Prescrire Int 1997; 6 (31): 126-130.
1- Prescrire Rédaction “4-1-3. Patients sous met-
4- Micallef J et al. “Detection and magnitude of
2- Derumeaux G et al. “Echocardiographic evidence
formine” Rev Prescrire 2011; 31 (338 suppl. interac-
methylphenidate abuse and misuse using Vigibase for valvular toxicity of benfluorex: a double-blind and correlation with data from drug utilisation stu- randomised trial in patients with type2 diabetes 2- Gillet I et al. “Metformin: from pharmacovigilance
dies” 33rd Pharmacovigilance Meeting, Dijon: 4- mellitus” Plos One 2012; 7 (6): 12 pages.
to medical practices improvement ! A morbimor- 6 April 2012. Fundamental Clin Pharmacol 2012; 26
3- Afssaps “Commission nationale de pharmaco-
tality review (MMR)” 33rd Pharmacovigilance Meet- vigilance, compte rendu de la réunion du mardi ing, Dijon: 4-6 April 2012. Fundamental Clin 29 Septembre 2009” 24 November 2009: 12 pages.
Pharmacol 2012; 26 (suppl. 1): 39 (abstract 457).
4- Prescrire Editorial Staff “France’s Mediator° scan-
3- Prescrire Editorial Staff “Analysing an adverse
dal: take the high road” english.prescrire.org.
event in primary care: a multidisciplinary, collabo-
rative process” Prescrire Int 2011; 20 (121): 274-278.
PRESCRIRE INTERNATIONAL FEBRUARY 2013/VOLUME 22 N° 135 • PAGE 47 Downloaded from english.prescrire.org on 2/7/2013 Copyright(c)Prescrire. For personal use only.

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