Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Pexid (Sigma Pharmaceuticals)
100 mg tablets
This drug was introduced to Australia in 1978 (see 'New drugs' Aust Prescr 1978;2:108), but has not been generally available for a few years. The product is being reintroduced for patients who have contraindications, or have not responded to, other treatments for angina. As perhexiline has serious adverse effects, its use will be restricted to reducing the frequency of attacks in patients who have intractable angina, but cannot have coronary bypass surgery.
Adverse effects occur in 65% of patients and approximately 8% have to stop treatment. The severe adverse effects are peripheral neuropathy, papilloedema, hypoglycaemia and weight loss. Changes in liver enzymes occur frequently and some patients develop liver damage which can be fatal. All patients should be examined monthly and have regular monitoring of plasma concentrations, glucose and liver function.