Pat Gima posted,

<< One line that bothers me is "Janssen Pharmaceutica, the manufacturer of
 Propulsid recently announced that it would stop marketing the drug in the
 US in July."  Obviously, they will still import it to other countries with
 the same dire outcomes.

 I wonder how many other cases of "SIDS" could be traced to medications of
 some kind.  >>

Probably lots.  Bottom line, SIDS is still a diagnosis of "I dunno why," so
anything that causes death we don't understand gets chucked it.  As our
habits of treating babies change, so does this (invisible) list, right?

On the other hand, it didn't say why the baby was getting cisapride to start
with, and I don't know whether there might be some reasons that would be
riskier than the drug -- that is, where the risks might be worth taking.   In
my neighborhood there seem to be millions of kids on Zantac syrup for reflux
(including one of mine), which is technicallly not researched for children
either; but the only child I know of who was prescribed cisapride was a
newborn who had had a tracheo-esophageal fistula repaired, and the docs felt
he needed very low acid in his system for the first weeks to make sure that
that the patch healed appropriately.    I am not anything like knowledgeable
enough to say whether cisapride was the right drug to effect that, but it
doesn't seem beyond the realm of possibility that in some few cases like this
one the potential benefits of the drug might balance its potential risks --
the fistula was life-threatening too, after all, and the potential for its
rupture ditto.

And certainly we have seen cases where insurance liability or politics or etc
caused the pulling of drugs in the US that should have remained available to
some patients.   Let's not forget that we can't get domperidone in the US
either...

Elisheva Urbas, NYC

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