Published: 4 December 2025

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Gathering knowledge from adverse reaction reports: December 2025

Published: 4 December 2025
Prescriber Update 46(4): 67–68
December 2025

Adverse drug reaction (ADR) reporting is an important component of medicine safety monitoring. Case reports can highlight significant safety issues with medicines and how they are used.

The table below presents a selection of recent informative cases reported to the New Zealand Pharmacovigilance Database.

Case detailsa,b	Reaction description and data sheet informationb,c
Report ID: 163131 Age: 85 years Gender: Male Medicine(s): Goserelin  Reaction(s): Cardiac failure	Approximately three weeks after receiving the goserelin injection, the patient developed cardiac failure. Symptoms included leg oedema and shortness of breath. Finasteride (an anti-androgen) was reported as a concomitant medicine.
	The Zoladex 10.8mg data sheet lists cardiac failure as a common ADR in males. The risk is increased when used in combination with anti-androgens.
Report ID: 163317 Age: 68 years Gender: Male Medicine(s): Fusidic acid, atorvastatin Reaction(s): Drug interaction, rhabdomyolysis	A patient taking atorvastatin was started on fusidic acid and developed rhabdomyolysis.
	As stated in the Lorstat and Fucidin data sheets, concomitant treatment with statins and systemic fusidic acid is contraindicated. There have been reports of rhabdomyolysis (including some fatalities) in patients receiving this combination. Discontinue treatment with statins throughout the duration of treatment with systemic fusidic acid. Statins may be reintroduced 7 days after the last dose of fusidic acid.
Report ID: 163403 Age: 40 years Gender: Female Medicine(s): Botulinum toxin type A Reaction(s): Tinnitus, hyperacusis, facial paralysis, neurosensory deafness, dermatochalasis, myalgia, pyrexia, headache	Just over a week after the Botox injection into the forehead, the patient developed tinnitus, increased sensitivity to sound, frontal muscle paralysis, sudden hearing loss, hooding of both eyes, muscle aches, fever and headache.
	The Botox data sheet lists tinnitus, facial palsy, facial paresis, eyelid oedema, blepharoptosis (drooping of upper eyelid that can affect one or both eyes), myalgia, pyrexia and headache as possible ADRs.
Report ID: 163473 Age: Not reported Gender: Female Medicine(s): Semaglutide Reaction(s): Small intestinal obstruction	During semaglutide treatment, the patient developed a small bowel obstruction.
	Intestinal obstruction, including ileus and small intestinal obstruction, are listed in the Wegovy data sheet.
Report ID: 163573 Age: 49 years Gender: Female Medicine(s): Terbinafine, fluoxetine Reaction(s): Delusions of grandeur, suicidal ideation, withdrawal syndrome, drug interaction, euphoric mood	A patient taking fluoxetine started treatment with terbinafine and experienced elevated mood and grandiose feelings. After stopping terbinafine, her mood suddenly dropped, and she reported having suicidal thoughts.
	The Deolate data sheet states that terbinafine may increase the effect or plasma concentrations of medicines that are metabolised by CYP2D6, including selective serotonin reuptake inhibitors (SSRIs).

Notes:

1. Only the medicines suspected to have caused the reaction are listed in the table.
2. The reactions listed in the ‘Case details’ column are coded according to the Medical Dictionary for Regulatory Activities (MedDRA), an internationally used set of standardised terms relating to medical conditions, medicines and medical devices. The reactions listed in the ‘Reaction description’ column are based on what was reported, and do not always match the MedDRA term exactly.
3. If the suspect medicine’s brand name is not described in the ADR report, only the data sheet for the funded medicine is included in the table.

Information about reported suspected adverse reactions is available on the Medsafe website using the Suspected Medicines Adverse Reaction Search (SMARS).

By selecting the ingredient of a medicine or vaccine, you can find out:

• the number of reports and suspected adverse reactions for that ingredient. The suspected reactions are grouped by body system or organs (Summary report)
• single case reports, listing the medicines and/or vaccines involved that contain the ingredient and the suspected adverse reactions (Detail report).