E-drug: Re: Phenylbutazone availability (cont)
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[2 messages in one. KM]
In the UK phenylbutazone is marketed as Butacote. Here's the licensed
indication for the product taken from the summary of product characteristics
(revised in November 1998):
<<Ankylosing spondylitis. Butacote should only be used where other therapies
have been found unsuitable.>>
The British National Formulary (http://BNF.org) considers phenylbutazone
'less suitable for prescribing' (i.e. it should not generally be used as a
first-line treatment). The BNF draws attention to the possibility of blood
dyscrasias with this drug. It includes the following information on it:
<<PHENYLBUTAZONE
Indications: ankylosing spondylitis when other therapy unsuitable
Cautions: blood counts before and during treatment if for more than 7 days;
elderly (reduce dose); breast-feeding; allergic disorders (see also under
Contra-indications), withdraw if acute pulmonary syndrome including fever
and dyspnoea; see also notes above; interactions: Appendix 1 (NSAIDs)
COUNSELLING. Warn patient to tell doctor immediately if sore throat, mouth
ulcers, bruising, fever, malaise, rash, or non-specific illness develops
Contra-indications: cardiovascular disease, pulmonary, renal and hepatic
impairment; pregnancy; history of peptic ulceration, of gastro-intestinal
haemorrhage, inflammatory bowel disease, or of blood disorders (including
coagulation defects); history of hypersensitivity precipitated by aspirin or
other NSAIDs (see also below); porphyria (section 9.8.2); Sj�gren's
syndrome; thyroid disease; children under 14
HYPERSENSITIVITY. NSAIDs are contra-indicated in history of hypersensitivity
to aspirin or to any other NSAID--which includes those in whom attacks of
asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin
or any other NSAID
Side-effects: see notes above; also parotitis, stomatitis, goitre,
pancreatitis, hepatitis, nephritis, visual disturbances; rarely leucopenia,
thrombocytopenia, agranulocytosis, aplastic anaemia, Stevens-Johnson
syndrome, toxic epidermal necrolysis, pulmonary toxicity
Dose: initially 200 mg 2 - 3 times daily for 2 days, with or after food,
then reduced to minimum effective, usually 100 mg 2 - 3 times daily; CHILD
under 14 years not recommended>>
Dinesh Mehta
BNF
dinesh@easynet.co.uk
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UK Availability:
Phenylbutazone restricted for use in ankylosing spondylitis.
No limit on duration of treatment, but only available from hospital
consultants.
Alistair Bolt
Norfolk & Norwich Hospital
UK
Norfolk and Norwich NHS Trust
alistair.bolt@norfolk-norwich.thenhs.com
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