Excedrin: Headache for aspirin-sensitive
From the July 30,1997 Issue
PROBLEM:An 18-year-old female was admitted to the hospital
with an anaphylactic reaction to aspirin. She required intubation
and treatment with epinephrine, methylprednisolone and diphenhydramine.
She was resuscitated and admitted to the respiratory ICU where
she eventually recovered. The patient knew she was allergic
to aspirin but she was unaware that it was in the Excedrin®
Extra Strength tablets she took for her headache. Although
the product does list aspirin as an ingredient on the carton
label and bottle itself, and does warn allergic patients not
to take it, the word "aspirin" appears below the brand name
in very small print which may not be easily seen by people
in a hurry or those with poor eyesight.
Figure 1. In proportion to brand name, aspirin
content on label is not visible in this scaled-down scan.
"Acetaminophen, aspirin, and caffeine" is listed between "Excedrin"
and bar labeled "EXTRA STRENGTH."
SAFE PRACTICE RECOMMENDATION:: Based on new data proving
effectiveness of the product, an FDA advisory panel recently
recommended approval of Excedrin Extra Strength for treatment
of migraines in people 18 years and older. If this is approved,
it would become the first OTC migraine remedy and will probably
become widely used by many of the estimated 23 million people
in the US who suffer this condition. Patients must be aware
that the product contains aspirin. Patient education will
help, but improved labeling and label warnings would facilitate