Drug Name Confusion Between Kuric and Carac

The Institute for Safe Medication Practices (ISMP) recently reported on the potential for mix-ups between two topical creams: Kuric (ketoconazole) and Carac (fluorouracil). Kuric is used to treat fungal infections and seborrheic dermatitis. Carac is used to treat multiple actinic or solar keratoses of the face and anterior scalp. Sanofi-Aventis, the maker of Carac, recently sent a letter to pharmacists describing how one mix-up occurred. In this case, a verbal prescription for Kuric was mistakenly heard and transcribed as Carac, which was then dispensed. The patient developed severe rash with erythema, irritation, and peeling of the skin and secondary infection at the application site and surrounding areas. The letter gave several ways to help avoid these kinds of errors. For example, clarify oral and written orders with the prescriber by verifying both the brand and generic name, as well as the spelling of the product; match the product's indication to the patient's condition; and create electronic alerts that appear when the pharmacist fills prescriptions for either medication.