Use of Neo-melubrina, a banned antipyretic drug, in San Diego, California: a survey of patients and providers

Abstract

Background: Dipyrone is an antipyretic drug that has been associated with agranulocytosis. It is banned in the United States but is available in Mexico under the name Neo-melubrina.

Objectives: To define the use of Neo-melubrina in the Hispanic population of 2 San Diego, California, community clinics and to determine local physicians' and nurse practitioners' awareness of the drug and its risks.

Design: Patient survey and provider survey.

Patients: 200 parents of Hispanic pediatric patients. Providers: members of San Diego chapters of the American Academy of Pediatrics, the American Academy of Family Physicians, and the California Coalition of Nurse Practitioners.

Main outcome measures: Self-reported use of Neo-melubrina by patients, and provider awareness of Neo-melubrina and its most significant side effects.

Results: Of the 200 patients, 76 (38.0%) reported a lifetime use of Neo-melubrina. Most (56%) used it for both pain and fever. Most providers were unable to correctly identify why Neo-melubrina might be used or its adverse effects. Physicians answered correctly more often than nurse practitioners and pediatric providers more often than family medicine providers. Providers who trained within 75 miles of the US-Mexico border, who reported a patient population of more than 50% Hispanic, and who were resident physicians at the time of the survey were most likely to answer correctly.

Conclusions: Neo-melubrina has been used by a substantial percentage of Hispanic patients in the community clinics surveyed. Many San Diego health care providers are unaware of this medication and may, therefore, miss opportunities to educate patients about safer alternatives.

Figure 1

Knowledge of indications by practice type. Asterisk indicates P≤0.05 for community clinic providers compared with every other type of provider for knowledge of indications only. Dagger indicates P≤0.05 for residents compared with every other type of provider for knowledge of both indications and adverse effects.