Published: 1 March 2018

Gathering Knowledge from Adverse Reaction Reports: Mar 2018

Prescriber Update 39(1): 13
March 2018

Adverse reaction reporting is an important component of medicine safety monitoring. Case reports can highlight significant safety issues concerning therapeutic products and their use.

A selection of recent informative cases from the Centre for Adverse Reactions Monitoring (CARM) database is presented below.

CARM ID: 125952
Age: 60
Gender: Female
Medicine(s): Ciprofloxacin
Reaction(s): Anxiety, Agitation, Paranoid thoughts
A 60-year-old patient experienced anxiety, agitation and paranoid thoughts one day after taking ciprofloxacin.
The Cipflox data sheet ( states that psychiatric reactions may occur even after the first administration of fluoroquinolones, including ciprofloxacin. In these cases, ciprofloxacin should be discontinued and the appropriate measures instituted.
CARM ID: 125838
Age: 23
Gender: Male
Medicine(s): Paracetamol
Reaction(s): Steven Johnson Syndrome (SJS)
A 23-year-old male took several medicines and experienced wide spread ulcers on the tongue, mouth, lips with angioedema. Upon dermatologist review, paracetamol was identified as the most likely cause.
The data sheet for Panadol ( lists Stevens-Johnson Syndrome as a very rare adverse reaction.
CARM ID: 125845
Age: 70
Gender: Female
Medicine(s): Zoledronic acid and others
Reaction(s): Osteonecrosis of both ear canals
The patient was being treated with zoledronate infusions and was found to have osteonecrosis of both ear canals that was successfully treated.
The data sheet for Aclasta ( states that cases of osteonecrosis of bones other than the jaw have been reported.