Don't be ashamed-two drugs might be same

House Calls

By Gerald W. Deas, M.D.

Mrs. G. was a 76-year-old patient with a five-year history of adultonset diabetes. She was well controlled on oral diabetic medication and was followed by a private physician as well as a physician in the local hospital clinic.

During a Sunday church service, she began to experience cold sweats, weakness and a tremor in her hands. She left church and was taken home by a friend. Her symptoms increased on severity. Her private doctor was unavailable and I was called to evaluate her condition.

Upon examining Mrs. G., it was evident that she was experiencing a hypoglycemic (low blood sugar) reaction. Upon evaluating her medication which I found on her night table, it was evident that she was taking a double dose of the same medication that was used to control her blood sugar. I am sure that she did not realize that the drug Dibinese (250 mg) was the same chemically as the generic Cholorpropamide (250 mg), which she also was taking. Looking at the labels on the bottles, it was evident that each drug had been prescribed by a different doctor. Mrs. G literally was taking a double dose of diabetic medication, which caused her to become dangerously hypoglycemic.

I immediately gave her a glass of orange juice with a few tablespoons of sugar, whereupon, her symptoms gradually subsided. I explained to her that her symptoms were due to a double dose of the same drug by another name. I also instructed her that a diabetic should always carry several cubes of sugar in case she or he experiences symptoms of low blood glucose.

Other diabetic drugs that are the same but have different names are Glucotrol (Glipizide), Glucophage (Metoformin) and Avandia (Rosiglitazone).

The above case is only one of many scenarios that I have observed where a patient is double dosing themselves because they are unaware that the generic drug is the same as the brand name. A few common examples of drugs easily confused are the following: Lasix and Furosemide are water pills; Benadryl and Diphenhydramine are the same antihistamines. Aldomet and Methyldopa are the same anti hypertension drugs. Lanoxin and Digoxin are the same heart pills. There are hundreds of examples such as these.

To avoid this double dosing, patients should take their medications with them, when they visit a doctors office so that none are duplicated. Remember, a double dose can be a double whammy!

This is part of the November 7, 2007 online edition of Frost Illustrated.

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