Published: 4 June 2026

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Gathering knowledge from adverse reaction reports: June 2026

Published: 4 June 2026
Prescriber Update 47(2): 32–33
June 2026

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: 165060 Age: 85 years Gender: Female Medicine(s): Cefepime Reaction(s): Myoclonic jerks, dysphagia, Glasgow coma scale (GCS) abnormal, toxic metabolic encephalopathy, acute kidney injury	A patient taking cefepime developed myoclonic jerks/non-convulsive epileptic activity, dysphagia, reduced GCS and acute kidney injury. Toxic metabolic encephalopathy was suspected.
	The Cefepime AFT data sheet states that there have been reports of neurotoxicity. Symptoms of neurotoxicity include encephalopathy, seizures and/or myoclonus. Risk factors for developing neurotoxicity with cephalosporin treatment include being elderly, renal impairment, and central nervous system disorders. See also the Risk of neurotoxicity with cephalosporins article in the March 2023 edition of Prescriber Update.
Report ID: 165857 Age: 73 years Gender: Female Medicine(s): Sodium polystyrene sulfonate Reaction(s): Bowel necrosis, small bowel obstruction, bowel perforation, peritonitis	A patient intermittently using sodium polystyrene sulfonate experienced a small bowel obstruction followed by bowel necrosis and perforation.
	The Resonium A data sheet states that gastrointestinal ischemia, ischemic colitis, gastrointestinal tract ulceration or necrosis which could lead to intestinal perforation have been reported.
Report ID: 166489 Age: 52 years Gender: Female Medicine(s): Triamcinolone Reaction(s): Acid reflux (oesophageal), diarrhoea, vomiting, fever, postmenopausal bleeding	After intra-articular administration of triamcinolone, the patient experienced reflux, diarrhoea, vomiting, menstrual bleeding and a fever.
	The Kenacort-A 10 data sheet warns that menstrual irregularities may occur, and this possibility should be mentioned to female patients past menarche. Gastrointestinal adverse effects can occur with corticosteroids.
Report ID: 166501 Age: 37 years Gender: Male Medicine(s): Cabergoline Reaction(s): Impulse control disorder	A few months after starting cabergoline, the patient developed severe impulse control issues.
	The Dostinex data sheet recommends regularly monitoring patients for the development of impulse control disorders. Advise patients and carers of symptoms including pathological gambling, increased libido, hypersexuality, compulsive spending or buying, binge eating and compulsive eating.
Report ID: 166927 Age: 25 years Gender: Female Medicine(s): Topiramate Reaction(s): Renal tubular acidosis, kidney stones	A patient on long-term topiramate experienced renal tubular acidosis and kidney stones.
	Renal tubular acidosis is listed as a very rare ADR in the Topamax data sheet. There is a warning for nephrolithiasis (kidney stones).

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).

For help with searching, see the How to Search SMARS page.