A recent FDA article describes another case of mix-ups between two drugs whose names look and sound alike. Mucinex is an OTC extended-release guaifenesin tablet used as an expectorant. Mucomyst (acetylcysteine) is approved in its inhaled form as a mucolytic agent and orally to treat acetaminophen overdoses. However, Mucomyst has also been prescribed off-label to prevent acute renal failure associated with radiographic contrast media.
These mix-ups can occur because of illegible handwriting, mistakes in order transcribing the order, selecting the wrong product during computer order entry, or even selecting the wrong product in the pharmacy.
Part of the problem is that the first part of the names "Mucinex" and "Mucomyst" both look and sound similar, and the ending of each name may not be distinguishable if not written clearly on an order. Errors have also occurred when selecting a drug from a computerized listing. In several reports, the first three letters of the drug name were typed into the computer, but the wrong drug name was inadvertently selected from the list.
Adding to the probability of an error is the problem of overlapping doses. The dose of the extended-release Mucinex, which is given twice a day, is 600 or 1200 mg. The dose of Mucomyst, when it's used off-label, has also been 600 or 1200 mg. In this case, it is taken orally twice on the day before and on the day when the radiographic contrast media is administered.
The FDA article suggests that facilities educate the staff about the potential for confusion between these two drugs. Shortcuts or mnemonics for these products should be removed from the computer, or an alert should be added to ensure that the correct drug is being ordered. The article also says that Mucomyst and Mucinex should not be stored close together on pharmacy shelves, or at a minimum, alerts should be placed on shelves to help ensure that the right product is selected.
Tags: Mucomyst Mucinex FDA Confusion Patient Safety
