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Early signal of diverted use of tropicamide eye drops in France
Author(s) -
Ponté Camille,
Pi Christian,
Palmaro Aurore,
Jouanjus Emilie,
LapeyreMestre Maryse
Publication year - 2017
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13272
Subject(s) - tropicamide , medicine , medical prescription , reimbursement , optometry , emergency medicine , pediatrics , medical emergency , ophthalmology , pharmacology , psychology , pupil , health care , neuroscience , economics , economic growth
Aims Tropicamide is a mydriatic drug used as eye‐drops for diagnostic or therapeutic purposes. From 2013, a diverted use by intravenous route has been suspected in Eastern Europe in opioids users. To date, no signal of misuse has been identified in France. The aims of this study were to investigate any early signals of a diverted use of tropicamide eye drops and to collect information regarding motives for the misuse and tropicamide‐induced effects. Methods Information was obtained at three levels: (1) at regional level (Midi‐Pyrénées area), from reimbursement data and pharmacists’ reports on suspicious requests; (2) at national level: from reimbursement data and prescriptions suggesting possible abuse from the OSIAP (Ordonnances Suspectes, Indicateur d'Abus Possible) survey; and (3) at international level: from VigiBase ® reports and Web sources. Beta‐blocker eye‐drops were used as comparators. Results In France, in 2014–2015, 17 (0.91%, 95% CI [0.53–1.46%]) falsified prescriptions involving tropicamide were identified in the OSIAP survey (compared with 0%, 95% CI [0–0.19%] for beta‐blockers). Moreover, 37 other suspicious prescriptions were presented in 2015 (notified in 2016). In Midi‐Pyrénées, seven patients aged 35–49 were reimbursed for 19–45 vials of 10 ml, in a year. Since September 2014, the regional Addictovigilance Centre has received 91 notifications of suspicious requests to obtain tropicamide. In VigiBase ® , two cases were identified but none in France. An increased interest in tropicamide‐related Internet searches was observed from Russia and Ukraine. Conclusions These results represent the first early warnings of a tropicamide diverted use in France. Tropicamide abusers would seek euphoria or hallucinations. The high doses involved in intravenous administration could lead to serious complications.