Acupuncture Side Effects

Common Minor Adverse Events – Acupunture Side Effects

Paresthesias were the most common minor adverse(unfavourable or harmful) event observed, occurring in 57 (51%) patients, and often described as an increased digital sensitivity to hot or cold temperature. Paresthesias were reversible in all cases and were not sufficiently severe to instruct cyclosporine dose reduction in any patient. Hypomagnesemia was frequent, occurring in 47 (42%) patients, and easily reversible with parental magnesium sulfate. One patient with hypomagnesemia experienced a tonic-clonic being seized, which did not recur after correction of serum magnesium levels (described above in Seizures). Hyperkalemia developed in 14 (13%) patients: none developed electrocardiographic changes. Abnormal liver function tests developed in 21 (19%) patients. Only one patient hadlifted up liver function tests sufficiently high to warrant further evaluation; sonogram and ERCP revealedof the bile thick greasy mud, which did not require therapeutic intervention. Hypertension occurred in 43 (39%) patients. In 33 (77%) of these patients, the hypertension was mild, short duration, and required no treatment. Ten patients (23%) required treatment: all improved with a single antihypertensive drug, which was usually a calcium-channel blocking drug (diltiazem in 3 patients, verapamil in 4 patients, nifedipine in 1 patient). After discontinuation of cyclosporine, 5 patients did not require antihypertensive medication, 1 patient with a history of hypertension returned to the pre-cyclosporine drug dose, and 4 continued on medication at the same dose.

Top Ten Adverse Events to Sumatriptan in the IMMP:
Adverse reactions to sumatriptan are common, but usually minor and transient, and many patients find them acceptable because of the rapid relief they get from their headache often with nausea. In order to avoid alarm it is wise to inform patients prescribed sumatriptan for the first time that unusual symptoms may occur. Practitioners should be aware that sumatriptan is contraindicated in the presence of ischaemic heart disease and Prinzmetal’s angina, and that it should not be co-prescribed with ergotamine preparations.

• 16% of sumatriptan users reported an adverse event; most minor
• The 10 most frequently reported adverse events to sumatriptan
• Sensory disturbances most frequently reported adverse event
• Nausea/vomiting most likely due to migraine not sumatriptan
• Recurrence of headache common due to short half life
• Contraindications includes IHD & Prinzmetal’s angina
• No serious cardiac dysrhythmias reported

Reference
Sumatriptan (Imigran), a medicine used in the acute treatment of migraine and cluster headache, has been monitored in the IMMP since marketing began in April 1991. Being an expensive medicine, its growth in the market was slow until the cost of the injection was partially subsidized in September 1992. Imigran injection was fully controlled by another in April 1996, but the patient must meet the full cost of the tablets. As at 30 June 1997 there were 10608 patients in the IMMP cohort, 7966 (75%) of whom were women. The age and gender distribution is shown in the graph. The peak frequency of use for all patients is in the 40-49 year age group (33.8%), and the ratio of women to men is much greater around the years of the menopause(period of women’s life). Over the whole period, twice as many patients have used the injections as have used the tablets.