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Maalox Mess-up Signals Brand Name Problem

Having a brand name that consumers trust is like money in the bank. Drug companies put a lot of effort into building brand name recognition.

Over the years companies have advertised products like Maalox and Tylenol so aggressively that they have become household names. But even though people rely on these familiar brands, they need to be increasingly vigilant if they purchase one of these products.

The manufacturers have cashed in on their trusted names to expand their markets. This brand name creep may confuse consumers who don’t read or understand labels.

When Tylenol was initially introduced, for example, it meant just one thing: acetaminophen. This pain reliever is easier on the stomach than aspirin. Now the Tylenol name appears on over 30 different products, some of which don’t even contain acetaminophen.

You can still find the old familiar regular strength Tylenol with 325 mg of acetaminophen in each tablet. But Extra Strength Tylenol has 500 mg of acetaminophen and Tylenol Arthritis Pain has 650 mg per pill. Unless you read dosing instructions carefully, you might get too much acetaminophen. Tylenol products to help you sleep, ease your sinus congestion or relieve your cold, flu and allergy symptoms have different ingredients.

The FDA has just issued a warning to consumers about another familiar brand. Originally Maalox was a simple antacid containing aluminum and magnesium hydroxide. These ingredients are still found in Maalox Advanced Regular Strength and Maalox Advanced Maximum Strength.

The trouble is that you can also purchase Maalox Total Relief, which looks very similar at first glance. But this product contains bismuth subsalicylate, the same ingredient found in Pepto-Bismol. It has aspirin-like properties and could interact dangerously with blood thinners such as Coumadin (warfarin) or Plavix. People who take NSAID pain relievers such as ibuprofen or naproxen should also avoid this compound.

Several years ago we heard about a scary mix-up with these products. An older man recovering from surgery had nausea and an upset stomach. His daughter gave him Maalox to ease the symptoms. A few days later, his stool blackened and she became alarmed. Black stools can signal intestinal bleeding.

A pharmacist helped her find the cause. She had inadvertently bought Maalox Total Relief instead of Maalox Regular. The bismuth subsalicylate in Maalox Total Relief causes black stools without bleeding. Luckily, the patient recovered and did not have to undergo complicated tests.

The FDA has received reports of at least five other cases that did not go so well. In those situations, the bismuth subsalicylate caused nasty reactions. That is why the agency is warning that it should not be given to people with ulcers.

The maker of Maalox has agreed to remove its familiar brand name from the Total Relief product by fall of 2010. It will also help educate consumers and health care professionals about the differences between its various products.

Other drug companies might want to follow this example. The Maalox Total Relief mishap demonstrates how important it is for consumers to consult with pharmacists so they understand what is in the OTC products they buy.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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