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March 20, 1967

Some Problems With Drug Admixtures

Author Affiliations

Food and Drug Administration Washington, DC

JAMA. 1967;199(12):948. doi:10.1001/jama.1967.03120120136042

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To the Editor:—  The medical news item (198, Oct 31, 1966, adv p 37) concerning adverse effects produced by mixing local anesthetics, points up a recurring problem of the Food and Drug Administration.From time to time we receive inquiries as to why the FDA does not require the manufacturers of injectables to indicate in their brochures the various other parenterals with which they can be mixed and, conversely, those with which they are incompatible.As your item points out, mixtures of drugs may have effects which are quite different from those which would be anticipated from the actions of the individual ingredients.Drug products are tailored specifically to provide definite chemical and biological effects. Admixture of two or more of these drug products may cause physical, chemical, and biological changes, resulting in drug incompatabilities with the possibility of toxic or inert substances being administered to the patient. For these