In a statement issued May 23 by Administrator John H. Hill, he would not go so far as to specifically prohibit the use of Chantix for interstate truck and bus drivers, saying the FMCSA would not “name any medications, such as Chantix, in FMCSA regulations.”

However, the FMCSA does prohibit the use of prescribed substances or drugs that adversely affect the driver’s ability to safely operate a commercial vehicle, and said “it appears that medical examiners should NOT certify a driver taking Chantix,” because the medication may do just that.

The FDA advisory on Chantix (varenicline) indicated that patients taking the popular stop-smoking medication are at risk for serious neurpsychiatric symptoms that may include changes in behavior, agitation, depressed mood, suicidal ideation, and attempted and completed suicide.

Hill stopped short of issuing an outright ban on Chantix, saying FMCSA’s rules “defer to the physicians and health care professionals to determine driver medical fitness for duty.”

The Federal Aviation Administration firmly banned Chantix for use by either pilots or air traffic controllers in May following the FDA’s public health advisory announcement.

While the drug is not officially banned by name, Land Line Magazine, the official publication of the Owner-Operator Independent Drivers Association (OOIDA), said in its August issue that medical certification of truckers using Chantix is “not likely.”

SOURCE: Chantix Recall › FMCSA stops short of Chantix ban

Journal editor Dr. Jeffrey M. Drazen says the litigation process and the court system is a “key defense mechanism” to insure drug safety and to obtain justice if drug manufacturers have not made the risks involved with its product clear.

The doctors say the FDA is incapable of being the sole guardian of drug safety and that without the information supplied by liability litigation, “the American public would be deprived of a vital deterrent against pharmaceutical company misconduct.”

The opinion was submitted to the Supreme Court as a friend-of-the-court brief in the matter of Wyeth v. Levine, a case expected to be heard later this year. According to the AP story, the case involves Diana Levine, a guitarist who lost her right arm below the elbow after an injection of Phenergan. She sued the drug’s manufacturer, Wyeth, alleging the company had not adequately warned consumers of the risks associated with its product. The case was tried in Vermont, and the court agreed, awarding Levine $7 million.

Wyeth is appealing the case, saying the FDA had approved the drug, and that the state court could not overrule the FDA’s judgment.

However, the editors of the New England Journal of Medicine sided with 47 state attorneys general and two former FDA commissioners in supporting Levine’s position, the AP report states.

SOURCE: Chantix Recall › Doctors support drug safety litigation

Chantix, manufactured by Pfizer, was approved in 2006 and since that time has been prescribed to more than 4 million patients. However, not long after its release, the drug was linked to psychiatric problems including depression, suicidal thoughts and actions, and aggressive behavior. The drug also has been linked to serious physical side effects including heart problems, diabetes and serious allergic reactions such as Stevens Johnson Syndrome.

According to the Stars & Stripes, the drug was removed from the military pharmacy at Yokota Air Base in Japan. The decision came after a May 21 report by the Institute for Safe Medication Practices, which says Chantix has had more serious adverse incident reports in the fourth quarter of 2008 than any other drug in this time period.

In response to the ISMP report, the Federal Aviation Administration banned pilots and air traffic controllers from using the drug. The Stars & Stripes reports that the Defense Department’s Office of the Chief Medical Officer also recommended that “varenicline should not be used by personnel operating aircraft (including aircrew and air traffic controllers) and missile crew members.”

The paper says the DOD safety notice also had recommendations for “vehicle operators, operational personnel, and other DOD personnel” under consideration.

Stars & Stripes says the Yokota base has not reported any adverse reactions to Chantix, but seems to be banning the drug as a precautionary measure, and has suspended refills of Chantix until patients review the drug use with their physician. Other base hospitals overseas have not banned the drug, but air crewmembers cannot take the drug, and other Chantix patients are required to discuss their use of the product with their physician. Pharmacies can special-order the drug based on those prescriptions.

According to the report, when Chantix was first licensed in 2006, it was prescribed 262 times in military treatment facilities. By fiscal year 2007, there were 67,580 prescriptions written for Chantix in military facilities.

SOURCE: Chantix Recall › Military pharmacy pulls Chantix

As a result of its study, the ISMP is recommending the FDA strengthen warnings on the drug, which has been prescribed to more than 3 million people since it was approved in May 2006. Also as a result of the report, the Federal Aviation Administration banned use of Chantix by pilots and air traffic controllers.

The Bloomberg story cites FDA spokesperson Susan Cruzan as saying the ISMP study will prompt the FDA to conduct immediate further research to confirm numbers. Because the FDA’s adverse event reporting system is voluntary, she is cited as saying, there are no controls in place to determine if the reported side effects are the result of Chantix use, or if they are coming from another drug that reporters may be using.

SOURCE: Chantix Recall › More than 3,000 side effect reports

Factoring into the decision was the fact that Smith did not have any prior record of criminal activity or psychiatric disorders, the AP report says.

This incident is the latest in a crop of reports that Chantix is responsible for serious psychiatric problems, including depression, suicidal thoughts, suicide, and aggressive behavior. On Feb. 1, the FDA issued a public advisory about the possibility for these adverse serious side effects.

SOURCE: Chantix Recall › Charge dropped due to Chantix use

As a result of these reports, the FDA issued a public advisory, and required new safety warnings on the label. However, the FDA said it is still not sure if the side effects are attributable to Chantix, or may stem from nicotine withdrawal itself, which may worsen underlying existing psychiatric symptoms.

The Star-Ledger report says the FDA was spurred to more closely examine Chantix after a case in Dallas, Texas, involving musician Carter Albrecht, who was fatally shot after a night of “uncharacteristically violent behavior,” which his family attributed to his Chantix use.

According to the Star-Ledger, Pfizer said there were no suicides attributed to the drug during clinical trials, and they did not note any differences in behavior in clinical test subjects. However, the company also says that no people with known existing psychiatric disorders were used in the trials.

The drug is currently undergoing further study.

SOURCE: Chantix Recall › Dark side of Chantix comes to light