• Toplexil° syrup and sugar-free oral solution (oxomemazine) Sanofi Aventis (Rev Prescrire n° 387)
The brand name Toplexil° printed in large, bold characters on the box overshadows the international nonproprietary name (INN). It is liable to confusion with the herbal preparation Toplexil Phyto°, as its box is also printed with the name Toplexil° in the same typographic style. Patients who mistake the oxomemazine-containing drug Toplexil° for the plant extract-containing preparation Toplexil Phyto° would be exposed to the sedative and antimuscarinic adverse effects of this phenothiazine antihistamine.

 • Fervex Rhume Jour et Nuit°  tablets (paracetamol + vitamin C + pseudoephedrine + chlorphenamine) and • Fervex État Grippal° granules in sachets (paracetamol + vitamin C + pheniramine) UPSA (Rev Prescrire n° 389)
These two products are liable to confusion due to the close visual resemblance between their boxes: both are printed in the same combination of colours and display the umbrella
brand name Fervex° in extremely large, bold characters. Furthermore, the INNs are difficult to read on the boxes and overshadowed by the brand name. The fact that a variety of herbal preparations are also sold under the Fervex° brand only adds to the confusion.

 • Lysopaïne Maux de Gorge Ambroxol° lozenges (ambroxol) and • Lysopaïne Maux de Gorge Cétylpyridinium Lysozyme° compressed lozenges (cetylpyridinium + lysozyme) Boehringer Ingelheim (Rev Prescrire n° 397)
These products are liable to confusion due the resemblance between their boxes: both display the umbrella brand name Lysopaïne° in large, bold characters, but also the indication, "Maux de Gorge" (meaning sore throat). Undue promotion is given to the various flavours of the lozenges rather than to important information such as the INNs of the drugs they contain.
This labelling makes it difficult for patients to tell that these similar-looking products have different compositions, and that some Lysopaïne° products contain ambroxol, which can cause allergies.

 • Ibupradoll° 200 mg and 400 mg tablets and soft capsules (ibuprofen) Sanofi Aventis (Rev Prescrire n° 398).
The patient leaflets contain insufficient information about the harms of nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy. They fail to warn patients about concerns that NSAIDs may increase the risk of spontaneous abortion and provoke malformations when taken during the first trimester of pregnancy, or about the sometimes irreversible renal damage or pulmonary arterial hypertension reported in children following exposure to an NSAID during the second trimester. These leaflets only state that the product is contraindicated from the sixth or seventh month of pregnancy. NSAIDs should be avoided throughout pregnancy until evidence is obtained that they are safe to use before the sixth month of pregnancy.

 • Eucalyptine Le Brun° syrup (codeine + cineole) Hepatoum  • Néo-Codion  nfants° syrup (codeine + sodium benzoate) Bouchara-Recordati  • Tussipax° oral solution (codeine + ethylmorphine) Bailleul (Rev Prescrire n° 391)
None of the bottles used for these 3 products has a child-proof cap. Children who ingest the contents unnoticed by family members and carers would be exposed to the serious adverse effects of codeine, including respiratory depression. These products also all have a high ethanol content.

 • Ascabiol°  cutaneous emulsion (benzyl benzoate) Zambon (Rev Prescrire n° 392)
The bottle lacks a child-proof cap, yet the contents could provoke seizures in children who ingest the contents unnoticed by family members and carers. It has also a significant amount of ethanol.

 • Brintellix° 5 mg, 10 mg, 15 mg and 20 mg tablets (vortioxetine) Lundbeck
(Rev Prescrire n° 391)
The labelling of the blister packs is ambiguous: the packs are divided into pairs of tablets by perforations, and the international nonproprietary name (INN) and dose strength are printed just once across each pair of blister pockets. Patients could mistakenly understand that in order to take the dose printed across the two blister pockets, they must swallow the contents of both pockets (2 tablets), whereas in fact the labelling refers to the dose contained in each tablet.

 • Spagulax° granules in multidose bags (ispaghula) Almirall (Rev Prescrire n° 397)
The primary packaging is a multidose bag containing 700 grams of granules. The transparent plastic bag is labelled with brief information, omitting the international
nonproprietary name (INN). This multidose bag will be opened several times and is difficult to close properly after use. And its resemblance to bags commonly used for food
trivialises the drug’s use. It is better to choose the version supplied in single-dose sachets.

 • L-Thyroxine Serb°  150 microg/ml oral solution (levothyroxine) SERB
(Rev Prescrire n° 389)  • Contramal° Grünenthal and Topalgic° Sanofi Aventis, 100 mg/ml oral solutions (tramadol) (Rev Prescrire n° 397)
The dosing device supplied with the bottles of these drugs for dose preparation is a dropper, a device known to cause dosing errors, especially when a large number of drops must be counted. These solutions are highly concentrated, increasing the risk of an overdose or underdose if the drops are miscounted. Given that the adverse effects of tramadol are dose-dependent and levothyroxine has a narrow therapeutic index, it is particularly important to count the number of drops of these drugs accurately.

 • Tarka LP° 240 mg/2 mg tablets, 240 mg/4 mg tablets (verapamil + trandolapril) Mylan Medical (Rev Prescrire n° 389)
The two dose strengths resemble each other so closely that one could be confused for the other, resulting in an overdose or underdose of trandolapril.