Pharmacist Counseling Can Prevent Unintentional Errors with Thin Strip Dosage Forms
Novartis Consumer Health®, Inc. has released the first systemic-acting medication in a thin strip form with the production of two popular cough/cold products: TheraFlu® and Triaminic®. Designed to 'melt on the tongue,' there is no need for water or measuring, with the dose of medication being swallowed upon melting. The thin strip technology was initially introduced and popularized by Pfizer's Listerine® breath fresheners. The popularity of this dosage form was then incorporated into a local-acting anesthetic with the release of Chloraseptic® sore throat strips. With the advancement to a systemic-acting medication, the latest thin strips provide consumers with some of the most sought-after aspects of a cough/cold product:
- Better portability
- Ease of dosing
- Better dosing accuracy
- Overall convenience
The Triaminic brand of thin strips comes in two choices: Long Acting Cough, which contains 7.5mg of dextromethorphan per strip/dose, and Cough & Runny Nose, which contains 12.5mg of diphenhydramine per strip/dose. The TheraFlu brand also offers a Long Acting Cough strip, but contains 15mg of dextromethorphan per strip/dose, as well as a Multi-Symptom strip, which contains 25mg of diphenhydramine per strip/dose.
The strips are individually wrapped in child-resistant laminated film pouches, and are labeled as the first thin strip package designed to protect children from opening. However, patients should be counseled to treat these strips like any other medication and keep them out of the reach of children. The strips are designed with a "taste-masking system" to help mask the negative taste associated with the active ingredients, and are available in either grape or cherry flavors. Nevertheless, they point out that the strips still taste like medicine, which should help as a deterrent to young children.
Although these products offer increased convenience, as with every medication, there are certain dangers. The increased portability and convenience does indeed make it a more desirable product, but those patients taking diphenhydramine-containing products should be counseled regarding the drowsiness effects it is likely to produce, and cautioned about driving. One additional key counseling point: the TheraFlu Multi-Symptom strips are the only TheraFlu product to contain diphenhydramine; the antihistamine used in all others is chlorpheniramine.
These products are designed to address consumers' demands for convenience, while also increasing compliance. The overall convenience of these products is arguably unsurpassed, given the ease and accuracy of dosing, as well as the portability. However, they are still a systemic-acting medication and should be treated as such. Since patients will now be able to carry the medication with them at all times and these products resemble similar dosage form breath fresheners, patients may be tempted to go above and beyond the normal recommended dose. Patients should be counseled not only regarding possible side effects, but also cautioned about using the product incorrectly.
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