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MMWR – Morbidity and Mortality Weekly Report

1. Thrombotic Thrombocytopenic Purpura (TTP) and TTP-Like Illness Associated with Intravenous Opana ER Abuse — Tennessee, 2012

The Tennessee Department of Health
Public Information Officer
Beth Rader

The Tennessee Department of Health, Centers for Disease Control and Prevention, and Food and Drug Administration  have been investigating reports of a serious blood disorder (thrombotic thrombocytopenic purpura or TTP) related to intravenous abuse of Opana ER, an opioid pain medication.  Opana ER is a recently reformulated version of oxymorphone and is intended for oral use only.  Injection of any pain medication made for oral use presents a risk of fatal overdose and infections, but injection of Opana ER appears to present an additional increased risk of developing this serious blood disorder. 

2. Delayed Hemolytic Anemia After Treatment with Artesunate for Severe Malaria — Worldwide, 2010–2012

Division of News & Electronic Media

Artesunate is considered a safe drug. However, clinicians treating patients for severe malaria with artesunate should monitor patients for hemolytic anemia and report cases to the CDC. Outside the United States, 19 cases of hemolytic anemia were reported in patients with severe malaria after being treated with artesunate, one of the most effective drug treatments for the disease. As a safety measure, CDC malaria specialists reviewed each of the reports and looked for evidence about potential causes. All of these cases occurred outside of the U.S. where a different form of artesunate is used. It is currently unclear if hemolytic anemia is simply a late effect of these patients’ severe malaria, as the literature suggests, or if artesunate contributes to the risk of this occurring. CDC recommends that clinicians treating patients for severe malaria with artesunate monitor the patient for four weeks after treatment for indications of a drop in their blood count and report any occurrences to CDC.  Each year approximately 150 people in the U.S. are diagnosed with severe malaria, a parasitic disease endemic in the United States until the 1950s.


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