Table 3 The ten drug classes (with their drug substances and ADRs) most frequently suspected in older adults and younger adults
Rank | older adults(> 65) % most frequently reported drug classes (number of reports) [(%) three most frequently reported suspected drug substances within the respective drug class] | OR with Bonferroni adjusted CI (older adultsvs.younger adults) | % three most frequently reported ADRs (number of reports) within the respective drug class | OR of reported ADRs with Bonferroni adjusted CI (older adultsvs.younger adults) |
1. | 19.8% (13,831) antithrombotic agents (B01) [32.0% rivaroxaban, 12.7% phenprocoumon, 11.8% acetylsalicyclic acid] | 4.6 [4.3–4.9]a | 7.6% (1051) gastrointestinal haemorrhage 5.9% (812) cerebral haemorrhage 4.9% (677) haemorrhage | 2.3 [1.7–2.9]a 2.3 [1.7–3.1]a 1.3 [1.0–1.7] |
2. | 9.1% (6336) antineoplastic agents (L01) [7.4% paclitaxel, 6.1% oxaliplatin, 5.6% imatinib] | 1.3 [1.2–1.3]a | 7.3% (463) dyspnea 6.8% (428) diarrhoea 5.9% (375) nausea | 1.0 [0.8–1.2] 1.4 [1.1–1.8]a 1.2 [0.9–1.5] |
3. | 6.9% (4831) antiphlogistics and antirheumatics (M01) [46.6% rofecoxib, 17.1% diclofenac, 9.3% ibuprofen] | 1.7 [1.6–1.8]a | 16.5% (797) hypertension 15.5% (748) cerebral infarction 12.2% (588) death | 2.9 [2.3–3.6]a 6.3 [4.6–8.7]a 13.3 [8.0–21.9]a |
4. | 6.4% (4454) systemic antibiotics (J01) [15.6 levofloxacin, 13.7% ciprofloxacin, 11.4% moxifloxacin] | 0.8 [0.8–0.9]a | 9.1% (406) diarrhea 5.0% (221) nausea 4.9% (218) pruritus | 1.2 [0.9–1.4] 0.7 [0.5–0.9]a 0.6 [0.5–0.8]a |
5. | 6.0% (4225) agents acting on the renin-angiotensin system (C09) [19.5% ramipril, 9.5% enalapril, 7.9% valsartan] | 2.2 [2.0–2.4]a | 8.1% (344) angioedema 8.0% (340) dizziness 5.4% (230) nausea | 0.9 [0.6–1.2] 1.1 [0.8–1.4] 1.0 [0.7–1.4] |
6. | 4.7% (3273) psycholanaleptics (N06) [15.0% mirtazapine, 10.6% venlafaxine, 9.9% rivastigmin] | 0.7 [0.7–0.8]a | 8.5% (279) hyponatraemia 6.7% (218) dizziness 6.6% (217) nausea | 6.9 [4.6–10.3]a 1.2 [0.9–1.5] 1.1 [0.9–1.5] |
7. | 4.5% (3138) psycholeptics (N05) [22.8% risperidone, 11.9% quetiapine, 11.4% olanzapine] | 0.4 [0.4–0.5]a | 6.0% (188) drug interaction 5.1% (161) somnolence 4.0% (125) parkinsonism | 1.6 [1.2–2.2]a 2.3 [1.6–3.3]a 1.8 [1.2–2.6]a |
8. | 4.0% (2764) lipid modifying agents (C10) [33.5% simvastatin, 23.9% atorvastatin, 11.9% fluvastatin] | 1.2 [1.1–1.3]a | 22.7% (628) myalgia 13.4% (370) blood creatine phosphokinase increased 12.9% (356) rhabdomyolysis | 0.6 [0.5–0.8]a 0.8 [0.6–1.0] 1.9 [1.4–2.5]a |
9. | 3.9% (2747) antidiabetics (A10) [19.5% metformin, 17.0% insulin human, 8.5% glibenclamid] | 1.5 [1.4–1.7]a | 21.5% (590) hypoglycaemia 7.2% (198) lactic acidosis 5.9% (161) nausea | 2.4 [1.8–3.0]a 2.8 [1.7–4.3]a 0.9 [0.6–1.3] |
10. | 3.7% (2581) analgesics (N02) [25.2% metamizole, 14.8% fentanyl, 9.0% tramadol] | 1.0 [0.9–1.1] | 10.0% (259) nausea 6.9% (177) vomiting 6.2% (161) agranulocytosis | 1.0 [0.7–1.3] 1.3 [0.9–1.8] 1.0 [0.7–1.5] |
rank | younger adults(19–65) % most frequently reported drug classes (number of reports) [(%) three most reported frequently suspected drug substances within the respective drug class] | OR with Bonferroni adjusted CI (older adultsvs.younger adults) | % three most frequently reported ADRs (number of reports) within the respective drug class | OR of reported ADRs with Bonferroni adjusted CI (older adultsvs.younger adults) |
1. | 10.0% (11,126) psycholeptics (N05) [16.8% clozapine, 16.7% risperidone, 15.7% olanzapine] | 0.4 [0.4–0.5]a | 6.0% (670) weight increased 3.8% (426) drug interaction 3.6% (398) leukopenia | 0.1 [0.1–0.3]a 1.6 [1.2–2.2]a 0.8 [0.5–1.2] |
2. | 7.5% (8400) systemic antibiotics (J01) [13.1% moxifloxacin, 11.5% clindamycin, 11.4 ciprofloxacin] | 0.8 [0.8–0.9]a | 8.0% (672) rash 7.9% (667) diarrhoea 7.9% (667) pruritus | 0.6 [0.4–0.8]a 1.2 [0.9–1.4] 0.6 [0.5–0.8]a |
3. | 7.4% (8225) antineoplastic agents (L01) [11.6% paclitaxel, 6.5% docetaxel, 6.5% oxaliplatin] | 1.3 [1.2–1.3]a | 7.3% (601) dyspnea 5.4% (441) pyrexia 5.1% (416) nausea | 1.0 [0.8–1.2] 1.0 [0.8–1.3] 1.2 [0.9–1.5] |
4. | 6.4% (7188) psychoanaleptics (N06) [15.6% venlafaxine, 12.4% mirtazapine, 9.8% duloxetine] | 0.7 [0.7–0.8]a | 5.9% (423) nausea 5.8% (417) dizziness 4.8% (344) drug interaction | 1.1 [0.9–1.5] 1.2 [0.9–1.5] 1.2 [0.9–1.7] |
5. | 5.1% (5689) immunostimulants (L03) [25.0% interferon, 22.4% glatiramer, 21.9% interferon beta-1a] | 0.1 [0.1–0.1]a | 18.0% (1022) multiple sclerosis relapse 4.7% (266) pyrexia 4.6% (260) dyspnoea | 0.1 [0.0–0.3]a 1.8 [1.0–3.4] 0.7 [0.3–1.8] |
6. | 5.1% (5676) antithrombotic agents (B01) [20.6% rivaroxaban, 13.5% phenprocoumon, 9.9% enoxaparin] | 4.6 [4.3–4.9]a | 6.5% (367) thrombocytopenia 6.3% (358) pulmonary embolism 3.7% (211) haemorrhage | 0.7 [0.5–0.8]a 0.4 [0.3–0.5]a 1.3 [1.0–1.7] |
7. | 4.9% (5515) immunosupressivs (L04) [28.7% etanercept, 15.6% fingolimod, 13.1% ciclosporin] | 0.6 [0.5–0.6]a | 4.4% (243) multiple sclerosis relapse 3.4% (189) diarrhoea 3.4% (186) nausea | 0.0 [0.0–0.2]a 0.8 [0.5–1.4] 0.8 [0.5–1.4] |
8. | 4.8% (5323) sex hormones (G03) [12.9% dienogest/ethyinylestradiol, 11.6% drospirenone/ethinylestradiol, 7.5% ethinylestradiol/levonorgestrel] | 0.1 [0.1–0.1]a | 11.1% (590) pulmonary embolism 8.2% (438) deep vein thrombosis 5.2% (279) unintended pregnancy | 0.5 [0.3–1.1] 0.4 [0.2–1.1] - |
9. | 4.7% (5228) antiepileptics (N03) [16.5% carbamazepine, 15.6% levetiracetam, 15.3% pregabalin] | 0.6 [0.5–0.6]a | 7.5% (392) seizure 5.1% (266) dizziness 4.9% (257) hyponatriaemia | 0.6 [0.4–0.9]a 1.7 [1.2–2.4]a 1.3 [0.9–1.8] |
10. | 4.3% (4740) antiphlogistics and antirheumatics (M01) [22.6% rofecoxib, 19.2% diclofenac, 18.4% ibuprofen] | 1.7 [1.6–1.8]a | 6.5% (306) hypertension 6.1% (287) nausea 5.7% (269) dizziness | 2.9 [2.3–3.6]a 0.7 [0.5–1.0] 0.7 [0.5–0.9]a |