Watch for New Look-Alike/Sound-Alike Med Errors
September 2019
Recent mishaps will serve as reminders to use strategies for preventing confusion with look-alike/sound-alike med names.
Trexall and Paxil. An order for Paxil 10 mg once daily was misheard...leading to a patient getting Trexall (methotrexate) 10 mg once daily. The patient died after taking Trexall for about a week.
Watch for confusion among meds with similar names AND strengths. Overlapping strengths of Paxil and Trexall may have made this error harder to detect...since the dose was less likely to seem off.
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