Lytos and Lithos: alert on the risk of confusion between a drug and a food supplement

A new case of confusion between the drug Lytos (sodium clodronate tetrahydrate) and the food supplement Lithos (potassium and magnesium citrate) was reported to the ANSM during their dispensation in pharmacies. The Riemser Pharma laboratory will change its secondary labeling in 2023. In the meantime, to avoid any confusion, the agency recalls the recommendations drawn up in 2017 for the attention of patients, healthcare professionals and wholesale distributors.

Two health products with similar names but very different indications

Since the pronunciation of these two products is the same and their spellings are very similar, ANSM and ANSES warn of the risk of confusion and medication errors.

This is why, in a press release, they recall the indications for each molecule:

• Lithos is a food supplement marketed by Biohealth Italia. It is prescribed in case of heavy loss of liquids (excessive sweating, diarrhoea, diuresis etc.).
• Lytos is a medicine from the Riemser Pharma GmbH laboratory indicated for certain serious cases of hypercalcemia (increased calcium level in the blood) after the injectable form and in certain destruction of bone tissue with or without hypercalcemia.

Recommendations for healthcare professionals and patients

To avoid any confusion, the ANSM recommends that doctors systematically prescribe the drug Lytos “in international nonproprietary name (INN) in addition to its trade name”.

As for the Lithos food supplement, and in general for all food supplements, the Agency asks prescribers “to add the status of the product (food supplement), to separate them from the drugs and to add if possible the mention ‘as advice’ on the prescriptions“.

Pharmacists are advised to check with the prescriber if in doubt about the information given on the prescription because of hard-to-read handwriting. They must be sure of the active substance of the product and its indication. If it is an oral or electronic order of the product from the wholesaler-distributor, the same thing, the pharmacist must check the active substance of the prescribed product.

Prudence and vigilance also concern wholesale distributors. The ANSM asks them to always check whether it is a food supplement or a medicine when placing orders orally or in writing by pharmacies.

Finally, if a patient has the slightest doubt, he should ask his pharmacist or doctor.