Fansidar Warning

Fansidar, a drug usually used to prevent or treat malaria, is also being used as a preventive for pneumocystis. Physicians and patients should be aware of rare but sometimes fatal side effects, and of the need to stop using Fansidar immediately in case a skin rash develops or in certain other situations. Recently we heard from the lover of someone who died from a reaction to the drug.
The 1987 Physicians Desk Reference includes the following in bold text in a separate box--reproduced twice on the same page for additional emphasis:
"Fatalities associated with the administration of fansidar have occurred due to severe reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Fansidar prophylaxis should be discontinued at the first appearance of skin rash, if a significant reduction in the count of any formed blood elements is noted, or upon the occurrence of active bacterial or fungal infections."
A long list of additional warnings and precautions urges that "patients should be warned that at the first appearance of a skin rash, they should stop the use of Fansidar and seek medical attention immediately. Adequate fluid intake must be maintained in order to prevent crystalluria and stone formation. Patients should also be warned that the appearance of sore throat, fever, pallor, purpura, jaundice or glossitis may be early indications of serious disorders which require prophylactic treatment to be stopped and medical treatment to be sought."
The fatal reaction described above is extremely rare; and fansidar also has important benefits. Our next issue will
include more information on weighing the risks and benefits.
You can look up prescription drugs yourself in the Physician's Desk Reference; most public libraries have it, or you
can buy it for $32.95 in bookstores. A new edition comes out each March. Note that this book emphasizes dangers and problems; the texts are written by pharmaceutical manufacturers which must cover themselves legally, and some of the drug descriptions may be unduly alarming. The value is that if side effects do occur, patients will know to consider the drug as a possible cause, and take appropriate precautions.
A number of other drug reference books, including some written for the general public, may also serve this purpose.
(NOTE: For another viewpoint on fansidar, see the next issue (AIDS Treatment News #43.)
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