August 2009: A Reported Concern that Xarelto Looks and Sounds Like Xatral
ISMP Canada has received a report of concern about the look-alike, sound-alike potential between the newly marketed Xarelto (brand name for rivaroxaban) and Xatral (brand name for alfuzosin hydrochloride). Rivaroxaban is an anticoagulant, specifically a direct factor Xa inhibitor, and is indicated for the prevention of venous thromboembolic events in patients who have undergone elective total hip replacement or total knee replacement surgery. Alfuzosin hydrochloride is an alpha-1-adrenoreceptor antagonist indicated for the treatment of signs and symptoms of benign prostatic hyperplasia (BPH) and as adjunctive therapy with urethral catheterization following acute urinary retention related to BPH and management following catheter removal. Both products are available in 10 mg tablets, and both have a recommended daily dosage of 10 mg once daily. The reporter expressed concerns about the possibility of a mix-up.ISMP Canada has notified Health Canada and the manufacturers of this reported concern. The following strategies are suggested as measures to reduce the risk of a mix-up:
• use the generic name in addition to the brand name where applicable;
• physicians are encouraged to include the indication for the medication when prescriptions are communicated;
• verify the indication for the drug with the patient whenever possible;
• clearly distinguish the 2 drugs in the product selection screen of computerized order entry systems; and
• add a warning where these drugs are stored.
