Unreadable pharmaceutical product labeling is dangerous

The type fonts on these products are almost impossible to read. At 4.5 points, it’s no wonder.

By Dorothy Dobbie

With an aging population and the eyesight degeneration that goes with this for most people, the size of type on non-prescription pharmaceuticals should be a matter of concern to Canadian and provincial regulators. Unless you have the 20-20 vision of a 15-year-old with perfect sight, labels can be extremely difficult if not impossible to read.

The type size can be as small as 4.5 points on some bottles, almost invisible without the aid of a magnifying glass, plus eyeglasses. To make it worse, some labels are printed in reverse type, with white on a darker colour or printed black on red, for example, making them virtually illegible, even for those with good eyes.

Industry objects
Health Canada has recently recommended a minimum type size of 9.0 points, but manufacturers complain that container sizes will not accommodate larger type.  There are many ways to deal with this – put the medication in a larger container, increase the label size (a small bottle of Tylenol has plenty of room to accommodate 9.0 point type, but the label has been designed to cover only a portion of the container, the label is too small itself to accommodate a larger font); or reduce the size of the product advertising to make more room for critical information. The onus should be on the packager.

The non-prescription drug industry holds a lot of sway in Ottawa though. Minutes from a March, 2011, meeting of the Consumer Health Products Canada Committee, a joint industry-Health Canada consultative group, stated in dealing with a recommendation for using at least 9.0 point type on containers: “Most manufacturers have indicated that this is impossible or very difficult to do with small containers and that smaller font sizes can be considered legible and these concerns have to be recognized, too.”

The minutes go on to say, “It may be possible to revise this section to indicate that Health Canada still recommends minimum font size 9.0 for package labels, wherever possible, to check complaints (author’s emphasis) but clearly indicate that smaller font sizes might be legible, under some conditions. This then becomes the responsibility of the manufacturer. TPD wants to encourage manufacturers to move in this direction, where it can be done, while recognizing that the Regulations (C.01.016) simply state that drug information must be ‘clearly and prominently displayed’.”

Safety paramount
Avoiding complaints from consumers should not be the chief motivator for change here, rather one would think the emphasis should be on the safety of the consumer; the information on these labels is critical to their safe usage, especially the list of ingredients, the dosages and any contraindications.

If you can’t read the dosage or the ingredients, you can be in serious trouble. Case in point: Steven, a 45 year-old-local manager, was recently suffering from muscle pain after a too-vigorous workout. He gobbled down two Aleve and four hours later, he took two more. He then suffered excruciating stomach pain – he thought he had eaten some contaminated food.

Turns out, it was the Aleve, an over-the-counter medication which should only be taken one tablet at a time, once every eight to12 hours. How would he know, though? The instructions on the bottle are printed in 4.0 or 5.0 point type. The drug also has serious cautions about allergies. To be fair, there is a lot of information on the package, including how to read all the information which is cleverly available on a fold-out panel on the back of the bottle. Problem is, you have to be able to read the instructions about how and where to find it. I needed both a magnifying glass and my glasses.

If you have a moment, why not give a shout out on this issue to the Minister of Health Canada, Leona Agklukaak. Send to: The Hon. Leona Aglukkaq, MP, Health Canada, Brooke Claxton Building, Tunney’s Pasture, Postal Locator: 0906C, Ottawa, ON K1A 0K9

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