Tube Talk
Medication Clogging Tubes
According to an FDA Safety Alert issued April 15, 2011, the FDA has received reports that lansoprazole delayed-release orally disintegrating tablets (ODT) by Teva Pharmaceuticals “have clogged and blocked oral syringes and feeding tubes, including both gastric and jejunostomy types, when the drug is administered as a suspension through these devices.” Lansoprazole is a protein pump inhibitor (PPI) medication that is manufactured by several companies, and sold as a generic or as Prevacid®.
The Teva ODT tablets, the alert continues, “may not fully disintegrate when water is added to them and/or they may disintegrate but later form clumps. These clumps can adhere to the inside walls of…feeding tubes. In some cases, patients have had to seek emergency medical assistance and their feeding tubes have had to be unclogged or removed and replaced.”
If you have this product, you are advised not to administer it through a feeding tube. Teva Pharmaceuticals has voluntarily withdrawn its lansoprazole delayed-release ODT.
A Personal Experience
One Oley member, responding to an e-mail we sent out about this issue, describes her experience with lansoprazole:
Thanks for sharing the FDA notices with us. As the prime caregiver for my husband who has a feeding tube and Alzheimer’s disease, I encountered the lansoprazole delayed-release tablet problem last fall when the pharmacy said that the generic lansoprazole would be substituted for the Prevacid® delayed-release tablet that we had been using for over six months.
When another caregiver and I experienced the problems described in the FDA article, I contacted the pharmacist, who insisted that it was the same as Prevacid. In order for the pharmacist to reissue the Prevacid, I would need to get a special request form completed by our physician. I talked to the physician and insisted that the chemical composition of the two may be the same, but perhaps a different manufacturing process was used. Fortunately, he listened to me and did all the essential paperwork to make the change.
As a result of our prompt actions, we avoided having to replace the feeding tube and having other problems. I will share the article with our physician as it affirms our earlier concerns.
Thank you,
Valerie S.
The FDA urges health care professionals and consumers to report adverse events or side effects related to the use of medications or medical devices to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program. You can obtain a form online at www.fda.gov/MedWatch/report.htm or by calling (800) 332-1088.
LifelineLetter, May/June 2011
Send your tips, questions, and thoughts about tube feeding to: Tube Talk, c/o The Oley Foundation, 214 Hun Memorial MC-28, Albany Medical Center, Albany, NY 12208; or e-mail metzgel@mail.amc.edu. Information shared in this column represents the experience of that individual and should not imply endorsement by the Oley Foundation. The Foundation strongly encourages readers to discuss any suggestions with their physician and/or wound care nurse before making any changes in their care.