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Michael S. Gelfand, MD; Danny J. Lancaster, MD
Methodist Hospital of Memphis (Tenn)

JAMA. 1993;270(11):1316.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—We enjoyed reading the articles by Honig et al,¹ Woosley et al,² and the accompanying Editorial by Peck et al³ in the March 24/31,1993, issue of JAMA. The articles and the Editorial brought to the attention of the practicing physician the cardiotoxic potential of certain antihistamines (terfenadine and astemizole) when combined with the antifungal agents ketoconazole and itraconazole and with macrolide antibiotics. A few days later while visiting a pharmaceutical display in our hospital lounge, we noticed a ballpoint pen being offered to the residents and interns by a representative of Janssen Pharmaceutica Inc. The pen prominently displayed the names Hismanal (astemizole) and Nizoral (ketoconazole). This cost-effective advertising vehicle (reminding physicians of both products with one pen) may, unfortunately, result in simultaneous prescribing of both products, with a potentially lethal drug interaction. To the credit of the company representative, he did point out the . . . [Full Text PDF of this Article]

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