Published: 5 March 2015

MARC's Remarks: December 2014 Meeting

Prescriber Update 36(1): 8
March 2015

The Medicines Adverse Reactions Committee (MARC) met on 4 December 2014 to consider a number of medicine-related safety issues.

The MARC reviewed the risk of fatal lactic acidosis associated with metformin use, in particular in patients with impaired renal function. The MARC was satisfied that metformin can induce lactic acidosis and this reaction is clinically important. An article on this topic will be published in a future edition of Prescriber Update.

The MARC reviewed the available information on the benefits and risks of cough and cold medicines that contain either bromhexine or codeine for use in children. The MARC recommended that the use of these medicines for cough and cold be restricted to adults and children over six years of age for medicines that contain bromhexine and to adults and children over 12 years of age for medicines that contain codeine.

The MARC reviewed the utility of the trans-Tasman early warning system (EWS). The MARC advised on further methods that may be useful for this type of investigation and recommended that additional communications via the EWS are needed before the system can be fully reviewed.

Further information on these issues can be found on the Medsafe website (