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Theme of the Week: Withdrawn Drugs

Think about this: how often does a medication get withdrawn from the Canadian market? Not often, but when it does, there is a good reason for it. Not all adverse effects are detected in clinical trials, which is why we have pharmacovigilance after a new medication is approved. Here are five notable drugs which were removed from the Canadian market:

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1) Cisapride (Prepulsid) - used for nausea and vomiting, this 5HT4 receptor agonist was associated with QT prolongation, which led to fatal cardiac arrhythmias. Today, we only have prucalopride and metoclopramide in the class of 5HT4 agonists.

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2) Rofecoxib (Vioxx) - a non-steroidal anti-inflammatory drug used for pain and inflammation, this COX-2 inhibitor was associated with myocardial infarctions and stroke. The Rofecoxib withdrawal triggered many lawsuits and made headlines around the world. Today, we only have celecoxib on the market.

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3) Ulipristal (Fibristal) - recently withdrawn in September 2020, this medication was used for treating uterine fibroids as an alternative to surgery. It was withdrawn due to hepatotoxicity. Note that the emergency contraception version (Ella) is still available as a one-dose tablet.

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4) Pergolide (Prascend) - used for Parkinson’s Disease, this ergot-based dopamine agonist was linked to valvular heart disease. Today, we only have bromocriptine as the ergot-based agent on the market.

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5) Cerivastatin (Baycol) - used for dyslipidemia, this cholesterol reducing agent caused fatal rhabdomyolysis, resulting in muscle breakdown and kidney damage. Today, we have many safer alternatives in the statin class.





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