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Executive Summary

Rx AND OTC DRUG GERIATRIC LABELING DEFICIENCIES are the subject of a joint hearing scheduled for April 28 by House Small Business/Regulation Subcommittee Chairman Wyden (D-Ore.) and Aging/Consumer Interests Subcommittee Chairman Lloyd (D-Tenn.). The hearing will include testimony on the sparcity of label information pertaining to kidney and liver effects of prescription and nonprescription products, particularly on elderly patients with impaired renal and hepatic function. Witnesses are expected to include representatives from FDA, the Nonprescription Drug Manufacturers Association, the General Accounting Office, elderly patients and independent drug information experts. GAO's Kwai-Cheung Chan is scheduled to testify on an agency report regarding the laxity of FDA regulation of OTC products relative to prescription drugs ("The Pink Sheet" March 2, T&G-11). Testimony on OTC labeling will focus on information about adverse drug reactions that is not currently provided in product labeling. Such information might include interactions between OTC nonsteroidal anti-inflammatory drugs, like American Home Products' Advil and Bristol-Myers Squibb's Nuprin, and prescription antihypertensives. ADRs associated with the OTC weight loss aid phenylpropanolamine and antacids also are likely to be discussed. Regarding prescription products, Wyden and Lloyd are said to be concerned that, of the 50 drugs purchased most frequently by the elderly, only Glaxo's anti-ulcer drug Zantac (ranitidine) and Merck's Pepcid (famotidine) include warnings specific to geriatric use. In addition, notwithstanding FDA's efforts in recent years to require companies to generate information on the effects of their drugs in geriatric populations, the subcommittees reportedly are puzzled that the U.S. Pharmacopeia's patient labeling compendium USP-DI contains far more geriatric information than FDA-required labeling for physicians. The joint hearing will be the third House hearing in recent weeks to address OTC drugs. Rep. Weiss (D-N.Y.) held a hearing on OTC antihistamines before his Government Operations/Intergovernmental Relations Subcommittee ("The Pink Sheet" April 13, p. 6), and a hearing before Rep. Waxman's (D- Calif.) Energy & Commerce/Health Subcommittee discussed the slowness of the OTC Review, cardiovascular uses of aspirin and phenylpropanolamine ("The Pink Sheet" April 6, p. 15 and April 13, T&G-5).

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