Do you check?
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Extract from ST Forum
Feb 23, 2006
Doctor prescribed unsuitable rash cream
I AM writing to highlight a very unpleasant experience I had with Thomson Paediatric Centre at Thomson Medical Centre.
On Feb 1, I brought my then four-month-old baby to see the pediatrician for a rash on his cheeks. The consultation with the doctor was over in about five minutes as he had to rush off elsewhere.
The doctor prescribed Elidel (pimecrolimus) cream 1% for the rash and told me to apply it twice daily on the affected area. Although this cream cost me $50, I did not mind as I thought it should be good for my son. But this was not the case.
Imagine my shock when I found out through the Internet that Elidel is not approved for use for children below two-years-old.
The possibility of carcinogenicity of Elidel aside, our Health Sciences Authority (HSA) and the US Food and Drug Administration concur in the recommendation against the use of Elidel for children younger than two-years-old.
In addition, both authorities recommend that Elidel should be used only if other creams have not worked.
It was my baby's first visit to the doctor concerning the rash on his face. Yet he was given a cream that is not meant for babies of his age. The doctor also did not caution me on the use of the cream.
I e-mailed Thomson Medical Centre my complaint on Feb 11. To date, it has not responded.
I am disturbed by the lack of consideration in prescribing Elidel for babies against the HSA's recommendations and the medical centre's slow response in this matter.
Are there any measures to ensure that such strong medication is not prescribed carelessly? I hope the relevant authorities can look into this matter to protect other babies and parents who may be none the wiser about this.
Ruth Tan Yueh Herng (Ms)
How many of us here will check if the prescripition is indeed the correct medication?
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i always check wat im popping in my mouth.....
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the doctor cannot be sued?
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The medication already says can be used for 2 years old and below if other medication don't work. It is not cannot be used. It says not recommended. Maybe doctor want to save time of prescribing another medication.
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it depends on how irritated U are...
a bit irritated...write to newpaper.
very irritated...seek legaL advice. -
doctors always prescribe cream for me that causes allergy.
My eyes swell as a result.
I nv take it against them, juz let them know.
For ur case, u have not applied it on ur baby right?
Thomson Medical Centre.. is it a clinic or what? -
Not recommended doesn't mean it cannot be used.
Look what they said about fibre aiding in bowel health, ah phooey. -
elidel can be use by infants. the clinic nurse's baby child opp' my hse is using oso. i was once using it oso. found out tat it doesnt wrk on me. the super old doctor at selegi's peace centre better lo.
p.s.: i was oso shocked tat theres once i saw in scv ch54 news tat elidel MAY BE carcinogenic. but nt 100% cfm yet. only less than 0.1% of elidel users got cancer. -
You should ask for a refund, then HIGHLIGHT this incident to MOH (Ministry of Health).Originally posted by LinYu:Extract from ST Forum
Feb 23, 2006
Doctor prescribed unsuitable rash cream
I AM writing to highlight a very unpleasant experience I had with Thomson Paediatric Centre at Thomson Medical Centre.
On Feb 1, I brought my then four-month-old baby to see the pediatrician for a rash on his cheeks. The consultation with the doctor was over in about five minutes as he had to rush off elsewhere.
The doctor prescribed Elidel (pimecrolimus) cream 1% for the rash and told me to apply it twice daily on the affected area. Although this cream cost me $50, I did not mind as I thought it should be good for my son. But this was not the case.
Imagine my shock when I found out through the Internet that Elidel is not approved for use for children below two-years-old.
The possibility of carcinogenicity of Elidel aside, our Health Sciences Authority (HSA) and the US Food and Drug Administration concur in the recommendation against the use of Elidel for children younger than two-years-old.
In addition, both authorities recommend that Elidel should be used only if other creams have not worked.
It was my baby's first visit to the doctor concerning the rash on his face. Yet he was given a cream that is not meant for babies of his age. The doctor also did not caution me on the use of the cream.
I e-mailed Thomson Medical Centre my complaint on Feb 11. To date, it has not responded.
I am disturbed by the lack of consideration in prescribing Elidel for babies against the HSA's recommendations and the medical centre's slow response in this matter.
Are there any measures to ensure that such strong medication is not prescribed carelessly? I hope the relevant authorities can look into this matter to protect other babies and parents who may be none the wiser about this.
Ruth Tan Yueh Herng (Ms)
How many of us here will check if the prescripition is indeed the correct medication? -
i thought the topic is about checking lan jiao or cb..
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Doctor replies to 'Doctor prescribed unsuitable rash cream' (ST, Feb 23)
Feb 28, 2006
Safe to use rash cream on young infants
I APPRECIATE Ms Ruth Tan Yueh Herng's vexation over her child's skin condition in 'Doctor prescribed unsuitable rash cream' (ST, Feb 23). But her letter contains a few misperceptions.
First, this was not the first time Ms Tan had visited our clinic for her child's eczema. It was their third visit for the same condition.
A steroid cream prescribed in a previous visit was obviously ineffective. In fact, Ms Tan had mentioned that the rash was not responding to treatment elsewhere.
As the eczema was severe, a second line medication like Elidel 1% or Protopic 0.03% is in order. This was a considered prescription and not a careless one as mentioned.
The question is: Is Elidel safe in the dosage and duration prescribed? Elidel is an approved drug in Singapore, USA and other countries.
When the US Food and Drugs Administration approved the drug in 2001, the studies were based on children two years and older. Since then, there have been published studies showing that Elidel is safe for use as a topical skin medication in children three months and older.
As a result, the following countries have approved Elidel for use in children three months and older: Australia, Hong Kong, Indonesia, Malaysia, New Zealand, Pakistan, Philippines, and Thailand.
In Singapore, a multicentre trial involving the National Skin Centre, Changi General Hospital and National University Hospital has been initiated to establish the efficacy and safety of Elidel 1% cream in infants.
Perhaps this is why the Health Sciences Authority has not yet updated its recommendation for the use of Elidel 1% in young infants.
Both steroids and Elidel work by suppressing the immune system. Theoretically, both could cause cancer.
Indeed, oral and injectable steroids and Elidel have been implicated in studies to be carcinogens.
However, the topical forms of these drugs have been found to be very safe in large-scale use.
Topical steroids have been in use for decades while there are over seven million users of Elidel 1%. Studies have shown that such creams have minimal penetration beyond the skin and are not well absorbed into the body.
I understand Ms Tan's frustration when her email went unanswered. But she had chosen to email Thomson Medical Centre instead of our clinic.
We could have clarified the matter and saved her unnecessary worry. We would also have told her that I was called to attend to an emergency Caesarean section immediately after the consultation.
It was unfortunate but my patients who have further queries will wait for my return, which takes up to 15 minutes. If this had upset her, I apologise.
Dr Ang Poon Liat