Correspondence

Losec or Lasix?

N Engl J Med 1990; 322:1674June 7, 1990

Article

To the Editor:

Since the release of Losec (omeprazole) by Merck Sharp and Dohme some months ago, we have noted two incidents in which patients received furosemide instead of omeprazole.

In the first incident, an inpatient with renal failure and erosive esophagitis received Lasix (furosemide, 20 mg daily by mouth) instead of Losec in the same dose. It is unclear whether the error occurred in transcribing the order or in dispensing or administering the drug. The patient received only a few doses, without ill effects, but did have transient eosinophilia and an increase in her poor urine output.

In the second incident, an outpatient with reflux esophagitis refractory to H2 antagonists was given a prescription for Losec (20 mg per day by mouth). During a telephone conversation with her physician four weeks later, she stated that she had discontinued taking the medicine after two weeks because of a lack of efficacy. The physician discovered that the medicine dispensed was furosemide (20 mg daily by mouth).

Such problems are due in part to the relatively recent introduction of Losec to the medical community. However, the similarities in the spelling of Losec and Lasix (especially if the handwriting is poor) and in the dose (20 mg per day by mouth) clearly contribute to these errors. Given the potential for problems, we recommend that physicians refer to Losec as omeprazole when prescribing this drug.

Steven N. Fine, M.D.
Robert M. Eisdorfer, M.D.
Paul F. Miskovitz, M.D.
Ira M. Jacobson, M.D.
The New York Hospital—Cornell Medical Center, New York, NY 10021

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   S. M. Breathnach. 2010. Drug Reactions. , 1-177.
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   S. M. Breathnach. 2010. , 1.
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   John Raffalli, John Nowakowski, Gary P Wormser. (1997) “Vira something”: a taste of the wrong medicine. The Lancet 350:9081, 887
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   MICHAEL G. SPENCER, ANDREW P. SMITH. (1993) A multicentre study of dispensing errors in British hospitals. International Journal of Pharmacy Practice 2:3, 142-146
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   M.D. Page, C. Stephenson, R.M. Pope, H.J. Bodansky. (1992) Prescribing and Dispensing of Insulin: Margins for Error?. Diabetic Medicine 9:10, 938-941
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   Jean Faber, Mohamed Azzugnuni, SilvanaDi Romana, Michel Vanhaeverbeek. (1991) Fatal confusion between 'Losec' and 'Lasix'. The Lancet 337:8752, 1286-1287
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