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The Food and Drug Administration is requiring stronger safety warnings for a popular treatment to prevent pregnant women from prematurely giving birth.

Women should not be given injections of the drug terbutaline for more than three days "because of the potential for serious maternal heart problems and death," the FDA said Thursday. It is now requiring a boxed warning — the FDA's most serious type of warning — be added to the drug's label.

The FDA also warned doctors against prescribing a pill form of the drug for "any treatment of preterm labor" because it has not been shown to be effective and carries similar risks.

The FDA has approved terbutaline only to treat specific respiratory conditions, but doctors have widely prescribed the drug as a treatment for preterm labor. Once a drug has been approved by the FDA, doctors can prescribe the drug for any use they deem appropriate.

Many women receive it continuously for weeks through a terbutaline pump. Its use is strongly supported by some advocates for women carrying twins and triplets, who are at higher risk of giving birth prematurely.

"It would be alarming to me to see it become unavailable," said Janet Bleyl, president and founder of the Triplet Connection, a national support group for parents of multiples. "It has made a life-or-death difference for many, many of our families."

More About Warning for Terbutaline


Depuy Reimbursement of Costs and Revision Surgery
Depuy advises that approximately 93,000 patients worldwide have received Depuy ASR Hip System components.  Depuy has stated it “intends to cover reasonable and customary costs of testing and treatment for patients who need services, including revision surgery, associated with the ASR recall. DePuy will also pay for reasonable expenses related to receiving care, such as lost wages and travel costs.”

Depuy Communicating with Doctors
Depuy is actively communicating with surgeons using the ASR hip device and has hosted surgeon-focused webcasts and distributed ASR recall information, including letters Depuy has asked surgeons to send to their patients..

Depuy ASR Reimbursement Process
DePuy hired several law firms and a third party reimbursement company to defend and assist the company in legal claims and reimbursement requests.   The third party reimbursement company evaluates ASR recipient claims and considers whether to reimburse ASR patients for certain costs or expenses incurred in the event or revision surgery and treatment.  In the case of  Insured ASR Patients, DePuy has directed patients “to submit the costs of their testing and treatment to their insurer for coverage as they normally would. DePuy will then work with the insurer through established channels to handle reimbursement.”  In the case of Uninsured ASR Patients, DePuy has directed patients to collect surgeon or doctor bills and “submit claims for reimbursement of medical services.”


On August 26, 2010, Johnson & Johnson announced their eleventh recall since September 2009. This recall stems from DePuy Orthopaedics Inc., which is a subsidiary of Johnson & Johnson..

DePuy Orthopaedics Inc., announced that it would be recalling its ASR Hip Resurfacing System and its ASR XL Acetabular hip-replacement system. According to the company, the recall took place because of new data from the National Joint Registry (NJR) of England and Wales which shows that within five years, one in eight patients needed a revision surgery, with the risk being highest amongst women. This translates to a five-year revision rate of approximately 12% for the ASR Hip Resurfacing System and approximately 13% for the ASR XL Acetabular System.

Besides this device, Johnson & Johnson has recalled many over-the-counter drugs such as Children’s Tylenol, Junior Strength Motrin, Children’s Benadryl, Zyrtec Eye Drops, and Rolaids soft chews.


As of December 2010, the FDA has changed the labels of 58 products.

More About Label Changes


With so many drugs on pharmacy shelves, many adverse events occur leaving uninformed consumers in danger.  According to the Los Angeles Daily Journal, the U.S. Supreme Court will soon hear oral arguments “in a case that asks the court to determine when companies and their lawyers should craft disclosures about adverse event reports.” 

This current issue stems from an incident involving Matrixx Initiatives Inc.  According to plaintiffs,  the company hid the fact that their cold medication, Zicam, caused insomnia.  Lawsuits totaling $15.5 million have recently been settled by Matrixx involving 2,231 people who claimed that they lost their sense of taste and/or smell following their use of Zicam. 

In 2009, Matrixx recalled intranasal versions of Zicam following the FDA’s warning to consumers about Zicam’s association with insomnia.  Opponents state that pharmaceutical companies receive information about their products continuously and that the FDA’s mandated clinical trials do an efficient job of testing the safety of a product.

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