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To the Editor: In their article about the codispensing of cisapride with contraindicated drugs, Dr Jones and colleagues¹ conclude that "[p]rescriptions dispensed by the same pharmacies accounted for a far higher proportion of contraindicated medication pairs than prescriptions from the same physicians." This conclusion seems to point a very large finger at physicians and at pharmacists, implying that neither are doing their job reviewing and intervening in drug-drug interactions.

What is not made clear, except deep within the article, is the possibility that pharmacists intervened in some of these alleged oversights. In the study, 91% of the conflicting prescriptions were for an anti-infective agent (ie, clarithromycin, erythromycin, or fluconazole). Given an average 10-day or less supply for these drugs, it is possible that the pharmacist recognized the contraindication, consulted with the patient's physician, and instructed the patient to stop taking the cisapride while taking the anti-infective drug, and to resume . . . [Full Text of this Article]

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RELATED LETTER

Coprescribing and Codispensing of Cisapride and Contraindicated Drugs
Judith K. Jones, Daniel Fife, Suellen Curkendall, Earl Goehring, Jr, Jeff Jianfei Guo, and Marjorie Shannon
JAMA. 2001;286(13):1607-1609.
ABSTRACT | FULL TEXT