Prescribing Patterns and Safety of Mezclitas for Respiratory Illnesses

Juan Quevedo, Wallace Marsh, Jessica Yulfo, Olga Álvarez, Marcos Felici, Maria E. Rojas


Objective: To evaluate the prescribing patterns of compound mixtures of cough and cold liquid medications, known as mezclitas, which are prescribed to patients with respiratory illnesses in Puerto Rico. Secondary objectives include assessing the potential safety of these mixtures and patients’ perception of them. Methods: Using a cross sectional study approach, a convenience sample was obtained from five pharmacies in Puerto Rico, from October 2008 to October 2009. Patients were asked to complete a 9-item questionnaire about demographic information, in addition to their mezclita prescription data. Results: The mean age of patients was 43 years with a range of less than 12 months to 101 years. For children < four years of age, 71% were prescribed cough and cold medications. Sixty-four percent of the prescriptions were given to females. The most prevalent ingredient employed was guaifenesin, which appeared in about 77% of the mezclitas. ‘Common cold’ was the principal diagnosis for 62% of the prescriptions, of which 75% of these prescriptions contained a corticosteroid and 17% contained a beta2 agonist bronchodilator. The top medical prescribing specialty was general medicine (51%). Thirty-eight percent of hypertensive patients were prescribed a decongestant. The majority of diabetic patients (60%) were dispensed a corticosteroid. Most (74%) patients reported that they had a rapid and good response to their mezclita. Conclusion: Mezclitas were most commonly prescribed for acute symptoms of upper respiratory illness by general physicians despite possible side effects. This study suggests that the prescription patterns of mezclitas do not always consider evidence-based medicine treatment guidelines.


mezclitas, over-the-counter, adverse drug reactions, cough and cold medications Food and Drug Administration, treatment guidelines, Puerto Rico

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