Practitioners are warned that it is astonishingly easy to make dosing
errors with the oral suspension of Tamiflu (oseltamivir).
This is a product that is mostly given to kids, although it
could be used for adults who have difficulty swallowing, or for anyone
if there is a shortage of the capsules.
The reason: usually, doctors write prescriptions for liquid medications
by specifying the number of milliliters, or sometimes teaspoons, to
administer. But the dispenser that comes with the product is
marked in milligrams, not milliliters.
This came to attention when a doctor got a prescription for his kid,
that said to give 3/4 teaspoons. If the prepackaged syringe
had been marked in milliliters, it would have been a straightforward
conversion. Google could do that easily. But the
darned thing was marked with lines denoted 30, 45, and 60 mg.
Granted, the conversion still is not terribly difficult. But
you get people who’ve been up at night with a sick kid, stressed by
missing work, then had to screw
around with insurance preauthorization, then ask them to
convert teaspoons to milliliters, then milliliters to milligrams (based
on a particular ratio), it obviously is not a good situation.
What may not be obvious is this: the doctor who is writing the
prescription may never have seen the product that the patient actually
will get. They don’t know what it looks like, or how
it is packaged, or what kind of dispenser comes with it. So
it is not obvious to the doctor, what kind of instructions would be
most helpful. And it is not obvious to the patient, upon
getting the prescription or the product, that it would be good to ask
for different instructions. In this situation, patients
should call the pharmacist if there is the slightest doubt about how to
dose the product. But that is inconvenient, sometimes not
possible (of the pharmacy is closed), and may not occur to someone who
is stressed or otherwise not thinking clearly.
What IS obvious, is that the USA should adopt the metric system. Today.