Prescription Report

Tamiflu and Relenza. Antiviral medications for the treatment of flu, influenza, swine flu, H1N1

2009-05-03T10:47:00.000-07:00

The H1N1 Swine Flu pandemic of 2009 appears to be causing more concern than outbreaks of the flu as a sickness, but many experts suggest there is still potential for problems as they work on an antiviral that will target this strain directly. The Centers for Disease Control "CDC" in the USA is keeping very close watch on the global pandemic and offers excellent guidance at their website below.

In the meantime Tamiflu (generic name: oseltamivir) and Relenza (generic: zanamivir) are being used to treat some with exposure or early signs of Swine Flu. Early diagnosis and treatment are helpful to the medicine's efficacy, but this in turn is creating problems as thousands of "false Swine flu alarms" have crowded labs and hospitals with people who are not at risk.

From the Tamiflu Official Website:

TAMIFLU is only available by prescription from your healthcare provider. If you think you have flu symptoms contact your health care provider . You have 48 hours from the time you first experienced symptoms to take TAMIFLU.

The questions below can help your doctor understand your or your child's symptoms and recommend the right treatment. After you've answered the questions, print the completed worksheet, then bring it to your office visit to help facilitate your doctor discussion.

The following is a list of common symptoms associated with the flu. Check the ones that you are experiencing:

Fever (higher than 100° F)
Headache
Extreme tiredness
Dry cough
Sore throat
Runny nose
Muscle aches
Stomach symptoms, such as nausea, vomiting and diarrhea (more common in children)
Other symptoms: (enter any other symptoms you're experiencing below)

More about symptoms and treatment of the Swine Flu infection from CDC

CDC Swine Flu Updates

CDC Swine Flu Upates via Twitter

Tamiflu official website

Wikipedia on H1N1 Virus and Swine flu

Acne Treatments

2009-05-02T20:51:00.000-07:00

The Mayo Clinic website has a great article on new developments surrounding acne treatments. Here is the Mayo Acne Article

Light therapy appears to be a useful treatment for many, while Mayo also discusses the many over the counter treatments here. Treatments like Proactiv and Nutrogena's acne regimen are promoted heavily on television but don't appear to be detailed in this article. We'll try to flesh out more on this topic later.

Omnaris - a nasal spray for nasal allergies and inflammation

2009-04-19T19:35:00.000-07:00

Omnaris is a spray to treat the discomfort and congestion from nasal allergies.

From the Omnaris official website which is here:

OMNARIS is for the treatment of nasal (nose) symptoms (sneezing, runny nose, itchy nose, and stuffy nose) associated with seasonal nasal allergies in adults, adolescents, and children 6 years of age and older, and for year-round (perennial) nasal allergies in adults and adolescents 12 years of age and older.

After talking to your doctor about other options, if you decide on Omnaris you may want to consider this offer

Revia, Depade, Vivitrol (naltrexone): drugs to combat alcohol or opiate addiction

2009-04-18T19:17:00.000-07:00

Promising new pill therapies are allowing some alcoholics and opiate abusers to regain their normal lives with addiction therapies that are primarily drug based rather than counseling based.

Naltrexone, marketed as Revia or Depade or Vivitrol (an injectable timed release version) is not to be confused with Naloxone, which is almost exclusively used in emergency drug overdoses. Naltrexone can be used in emergency therapy but usually is for long term alcohol addiction treatments:

Wikipedia:
The standard regimen is one 50 mg tablet per day. Initial problems of nausea usually disappear after a few days, and other side effects (e.g. heightened liver enzymes) are rare. Drug interactions are not significant, besides the obvious antagonism of opioid analgesics. Naltrexone has two effects on alcohol consumption.^[7] The first is to reduce craving while naltrexone is being taken. The second, referred to as the Sinclair Method, occurs when naltrexone is taken in conjunction with normal drinking, and this reduces craving over time. The first effect only persists while the naltrexone is being taken, but the second persists as long as the alcoholic does not drink without first taking naltrexone.

CNN reports on ad diction pills

VESIcare for Bladder Control

2009-04-11T23:05:00.001-07:00

Vesicare is a drug for bladder control also commonly called "incontinence" or "Overactive bladder", where patients experience trouble regulating their urination and experience leaks.

The official VESIcare website has more information including this safety recommendation:

Important Safety Information
VESIcare is for urgency, frequency, and leakage (overactive bladder). VESIcare is not for everyone. If you have certain stomach or glaucoma problems, or trouble emptying your bladder, do not take VESIcare. Tell your doctor right away if you have a serious allergic reaction, severe abdominal pain, or become constipated for three or more days. VESIcare may cause blurred vision, so take care while driving or doing unsafe tasks until you know how VESIcare affects you. Common side effects are dry mouth, constipation, and indigestion.

For more information about Overactive Bladder (OAB) and other urology and incontinence disorders check out these websites:

American Urological Association Foundation
www.auafoundation.org/auafhome.asp

American Urogynecologic Society
www.augs.org

American Urological Association
www.auanet.org

National Association for Continence
www.nafc.org

National Kidney and Urologic Diseases Information Clearinghouse
www.kidney.niddk.nih.gov

The Simon Foundation for Continence
www.simonfoundation.org

Urologyhealth.org
www.urologyhealth.org

Oracea for treatment of Rosacea (a skin condition)

2009-03-11T17:48:00.000-07:00

Oracea is an oral prescription medication for the treatment of Rosacea, a skin condition that can include discolorations and skin lesions.

Oracea Website

Rosacea resources and support group

More about Oracea from RXlist website is here

The following Safety information is from the official Oracea website:
Oracea^® is indicated for the treatment of only inflammatory lesions (papules and pustules) of rosacea in adult patients. You may experience intestinal upsets, sore throat or sinus infections/sinusitis when taking Oracea^®. Do not take Oracea^® if you are allergic to tetracyclines, and it may cause harm to a developing fetus; so do not take Oracea^® if you are pregnant or breastfeeding. When taking Oracea^®, stay out of direct or artificial sunlight, and make sure you tell your doctor if you have stomach or GI problems, kidney disease, have a yeast or fungal infection, take blood thinners, take oral contraceptives, or take medicine to treat acne, psoriasis or seizures. Oracea^® does not treat bacterial infections. Use Oracea^® only as prescribed by your doctor. For more information about Oracea^®,

Mirena - a contraceptive device for women

2009-02-10T23:37:00.000-08:00

Official Mirena Website: SimplyMirena.com

Mirena is an IUC or "intra uterine contraceptive".

From the Mirena Corporate Website:

What is the difference between an IUC and IUD?

IUC stands for intrauterine contraceptive and is a delivery method for birth control. There are two forms available, the copper IUD (intrauterine device) and Mirena^®(levonorgestrel releasing intrauterine system).

Also from the Mirena site:

... birth control for up to 5 years (or less, if you choose).¹ Birth control that, once removed, allows you to try to become pregnant right away and adapts to your contraceptive needs throughout the different stages of your life. That's Mirena^®, an estrogen-free intrauterine contraceptive that delivers small amounts of hormone directly to the uterus. Other benefits of Mirena^®:

99.8% effective in preventing pregnancy for up to 5 years (or less, if you choose)¹
Provides lower and steadier hormones than the Pill
Won't cause significant weight gain²
Easily removed with quick return to fertility¹
May also help shorten, lighten or even eliminate periods³

Cytomel for Thyroid

2009-02-05T13:11:00.000-08:00

Cytomel - liothyronine sodium tablets

Cytomel is a hormone pill used to treat Thyroid conditions. Andecdotally, Cytomel was also popular among bodybuilders as a way to increase metabolism and build muscle mass while eating a high calorie diet.

Warning: Cytomel / liothyronine sodium is a very powerful drug even in small dosages and is not to be taken under any circumstances without approval of a doctor and under the strict supervision of your physician.

Following is the extensive FDA approved information from Cytomel manufacturer Monarch Pharmaceuticals. This information is more easily printed from the FDA website here

DESCRIPTION
Thyroid hormone drugs are natural or synthetic preparations containing tetraiodothyronine (T4,
levothyroxine) sodium or triiodothyronine (T3, liothyronine) sodium or both. T4 and T3 are produced in the human thyroid gland by the iodination and coupling of the amino acid tyrosine. T4 contains four iodine atoms and is formed by the coupling of two molecules of diiodotyrosine (DIT). T3 contains three atoms of iodine and is formed by the coupling of one molecule of DIT with one molecule of monoiodotyrosine (MIT). Both hormones are stored in the thyroid colloid as thyroglobulin. Thyroid hormone preparations belong to two categories: (1) natural hormonal preparations derived from animal thyroid, and (2) synthetic preparations. Natural preparations include desiccated thyroid and thyroglobulin. Desiccated thyroid is derived from domesticated animals that are used for food
by man (either beef or hog thyroid), and thyroglobulin is derived from thyroid glands of the hog. The
United States Pharmacopeia (USP) has standardized the total iodine content of natural preparations.
Thyroid USP contains not less than (NLT) 0.17 percent and not more than (NMT) 0.23 percent iodine,
and thyroglobulin contains not less than (NLT) 0.7 percent of organically bound iodine. Iodine content is
only an indirect indicator of true hormonal biologic activity.
Cytomel (liothyronine sodium) Tablets contain liothyronine (L-triiodothyronine or L T3), a
synthetic form of a natural thyroid hormone, and is available as the sodium salt.
The structural and empirical formulas and molecular weight of liothyronine sodium are given
below.
2
Liothyronine Sodium
L-Tyrosine, O-(4-hydroxy-3-iodophenyl)-3,5-diiodo-, monosodium salt
Twenty-five mcg of liothyronine is equivalent to approximately 1 grain of desiccated thyroid or
thyroglobulin and 0.1 mg of L-thyroxine.
Each round, white to off-white Cytomel (liothyronine sodium) tablet contains liothyronine
sodium equivalent to liothyronine as follows: 5 mcg debossed JMI and D14; 25 mcg scored and debossed
JMI and D16; 50 mcg scored and debossed JMI and D17. Inactive ingredients consist of calcium sulfate,
gelatin, starch, stearic acid, sucrose and talc.
CLINICAL PHARMACOLOGY
The mechanisms by which thyroid hormones exert their physiologic action are not well
understood. These hormones enhance oxygen consumption by most tissues of the body, increase the basal
metabolic rate and the metabolism of carbohydrates, lipids and proteins. Thus, they exert a profound
influence on every organ system in the body and are of particular importance in the development of the
central nervous system.
Pharmacokinetics
Since liothyronine sodium (T3) is not firmly bound to serum protein, it is readily available to
body tissues. The onset of activity of liothyronine sodium is rapid, occurring within a few hours.
Maximum pharmacologic response occurs within 2 or 3 days, providing early clinical response. The
biological half-life is about 2-1/2 days.
3
T3 is almost totally absorbed, 95 percent in 4 hours. The hormones contained in the natural
preparations are absorbed in a manner similar to the synthetic hormones.
Liothyronine sodium has a rapid cutoff of activity which permits quick dosage adjustment and
facilitates control of the effects of overdosage, should they occur.
The higher affinity of levothyroxine (T4) for both thyroid-binding globulin and thyroid-binding
prealbumin as compared to triiodothyronine (T3) partially explains the higher serum levels and longer
half-life of the former hormone. Both protein-bound hormones exist in reverse equilibrium with minute
amounts of free hormone, the latter accounting for the metabolic activity.
INDICATIONS AND USAGE
Thyroid hormone drugs are indicated:
1. As replacement or supplemental therapy in patients with hypothyroidism of any etiology, except
transient hypothyroidism during the recovery phase of subacute thyroiditis. This category
includes cretinism, myxedema and ordinary hypothyroidism in patients of any age (pediatric
patients, adults, the elderly), or state (including pregnancy); primary hypothyroidism resulting
from functional deficiency, primary atrophy, partial or total absence of thyroid gland, or the
effects of surgery, radiation, or drugs, with or without the presence of goiter; and secondary
(pituitary) or tertiary (hypothalamic) hypothyroidism (see WARNINGS).
2. As pituitary thyroid-stimulating hormone (TSH) suppressants, in the treatment or prevention of
various types of euthyroid goiters, including thyroid nodules, subacute or chronic lymphocytic
thyroiditis (Hashimoto’s) and multinodular goiter.
3. As diagnostic agents in suppression tests to differentiate suspected mild hyperthyroidism or
thyroid gland autonomy.
Cytomel (liothyronine sodium) Tablets can be used in patients allergic to desiccated thyroid or
thyroid extract derived from pork or beef.
4
CONTRAINDICATIONS
Thyroid hormone preparations are generally contraindicated in patients with diagnosed but as yet
uncorrected adrenal cortical insufficiency, untreated thyrotoxicosis and apparent hypersensitivity to any
of their active or extraneous constituents. There is no well-documented evidence from the literature,
however, of true allergic or idiosyncratic reactions to thyroid hormone.
WARNINGS
Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used
for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal
requirements are ineffective for weight reduction. Larger doses may produce serious or even lifethreatening
manifestations of toxicity, particularly when given in association with sympathomimetic
amines such as those used for their anorectic effects.
The use of thyroid hormones in the therapy of obesity, alone or combined with other drugs, is
unjustified and has been shown to be ineffective. Neither is their use justified for the treatment of male or
female infertility unless this condition is accompanied by hypothyroidism.
Thyroid hormones should be used with great caution in a number of circumstances where the
integrity of the cardiovascular system, particularly the coronary arteries, is suspected. These include
patients with angina pectoris or the elderly, in whom there is a greater likelihood of occult cardiac
disease. In these patients, liothyronine sodium therapy should be initiated with low doses, with due
consideration for its relatively rapid onset of action. Starting dosage of Cytomel (liothyronine sodium)
Tablets is 5 mcg daily, and should be increased by no more than 5 mcg increments at 2-week intervals.
When, in such patients, a euthyroid state can only be reached at the expense of an aggravation of the
cardiovascular disease, thyroid hormone dosage should be reduced.
Morphologic hypogonadism and nephrosis should be ruled out before the drug is administered. If
hypopituitarism is present, the adrenal deficiency must be corrected prior to starting the drug.
5
Myxedematous patients are very sensitive to thyroid; dosage should be started at a very low level
and increased gradually.
Severe and prolonged hypothyroidism can lead to a decreased level of adrenocortical activity
commensurate with the lowered metabolic state. When thyroid-replacement therapy is administered, the
metabolism increases at a greater rate than adrenocortical activity. This can precipitate adrenocortical
insufficiency. Therefore, in severe and prolonged hypothyroidism, supplemental adrenocortical steroids
may be necessary. In rare instances the administration of thyroid hormone may precipitate a hyperthyroid
state or may aggravate existing hyperthyroidism.
PRECAUTIONS
General – Thyroid hormone therapy in patients with concomitant diabetes mellitus or insipidus
or adrenal cortical insufficiency aggravates the intensity of their symptoms. Appropriate adjustments of
the various therapeutic measures directed at these concomitant endocrine diseases are required.
The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
Hypothyroidism decreases and hyperthyroidism increases the sensitivity to oral anticoagulants.
Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants and
dosage of the latter agents adjusted on the basis of frequent prothrombin time determinations. In infants,
excessive doses of thyroid hormone preparations may produce craniosynostosis.
Information for the Patient – Patients on thyroid hormone preparations and parents of pediatric
patients on thyroid therapy should be informed that:
1. Replacement therapy is to be taken essentially for life, with the exception of cases of transient
hypothyroidism, usually associated with thyroiditis, and in those patients receiving a therapeutic
trial of the drug.
2. They should immediately report during the course of therapy any signs or symptoms of thyroid
hormone toxicity, e.g., chest pain, increased pulse rate, palpitations, excessive sweating, heat
intolerance, nervousness, or any other unusual event.
6
3. In case of concomitant diabetes mellitus, the daily dosage of antidiabetic medication may need
readjustment as thyroid hormone replacement is achieved. If thyroid medication is stopped, a
downward readjustment of the dosage of insulin or oral hypoglycemic agent may be necessary to
avoid hypoglycemia. At all times, close monitoring of urinary glucose levels is mandatory in such
patients.
4. In case of concomitant oral anticoagulant therapy, the prothrombin time should be measured
frequently to determine if the dosage of oral anticoagulants is to be readjusted.
5. Partial loss of hair may be experienced by pediatric patients in the first few months of thyroid
therapy, but this is usually a transient phenomenon and later recovery is usually the rule.
Laboratory Tests – Treatment of patients with thyroid hormones requires the periodic
assessment of thyroid status by means of appropriate laboratory tests besides the full clinical evaluation.
The TSH suppression test can be used to test the effectiveness of any thyroid preparation, bearing in mind
the relative insensitivity of the infant pituitary to the negative feedback effect of thyroid hormones. Serum
T4 levels can be used to test the effectiveness of all thyroid medications except products containing
liothyronine sodium. When the total serum T4 is low but TSH is normal, a test specific to assess unbound
(free) T4 levels is warranted. Specific measurements of T4 and T3 by competitive protein binding or
radioimmunoassay are not influenced by blood levels of organic or inorganic iodine and have essentially
replaced older tests of thyroid hormone measurements, i.e., PBI, BEI and T4 by column.
Drug Interactions
OralAnticoagulants – Thyroid hormones appear to increase catabolism of vitamin K-dependent
clotting factors. If oral anticoagulants are also being given, compensatory increases in clotting factor
synthesis are impaired. Patients stabilized on oral anticoagulants who are found to require thyroid
replacement therapy should be watched very closely when thyroid is started. If a patient is truly
hypothyroid, it is likely that a reduction in anticoagulant dosage will be required. No special precautions
7
appear to be necessary when oral anticoagulant therapy is begun in a patient already stabilized on
maintenance thyroid replacement therapy.
Insulin or Oral Hypoglycemics – Initiating thyroid replacement therapy may cause increases in
insulin or oral hypoglycemic requirements. The effects seen are poorly understood and depend upon a
variety of factors such as dose and type of thyroid preparations and endocrine status of the patient.
Patients receiving insulin or oral hypoglycemics should be closely watched during initiation of thyroid
replacement therapy.
Cholestyramine – Cholestyramine binds both T4 and T3 in the intestine, thus impairing absorption
of these thyroid hormones. In vitro studies indicate that the binding is not easily removed. Therefore, 4 to
5 hours should elapse between administration of cholestyramine and thyroid hormones.
Estrogen, Oral Contraceptives – Estrogens tend to increase serum thyroxine-binding globulin
(TBg). In a patient with a nonfunctioning thyroid gland who is receiving thyroid replacement therapy,
free levothyroxine may be decreased when estrogens are started thus increasing thyroid requirements.
However, if the patient’s thyroid gland has sufficient function, the decreased free thyroxine will result in a
compensatory increase in thyroxine output by the thyroid. Therefore, patients without a functioning
thyroid gland who are on thyroid replacement therapy may need to increase their thyroid dose if estrogens
or estrogen-containing oral contraceptives are given.
Tricyclic Antidepressants – Use of thyroid products with imipramine and other tricyclic
antidepressants may increase receptor sensitivity and enhance antidepressant activity; transient cardiac
arrhythmias have been observed. Thyroid hormone activity may also be enhanced.
Digitalis – Thyroid preparations may potentiate the toxic effects of digitalis. Thyroid hormonal
replacement increases metabolic rate, which requires an increase in digitalis dosage.
Ketamine – When administered to patients on a thyroid preparation, this parenteral anesthetic
may cause hypertension and tachycardia. Use with caution and be prepared to treat hypertension, if
necessary.
8
Vasopressors – Thyroxine increases the adrenergic effect of catecholamines such as epinephrine
and norepinephrine. Therefore, injection of these agents into patients receiving thyroid preparations
increases the risk of precipitating coronary insufficiency, especially in patients with coronary artery
disease. Careful observation is required.
Drug/Laboratory Test Interactions – The following drugs or moieties are known to interfere
with laboratory tests performed in patients on thyroid hormone therapy: androgens, corticosteroids,
estrogens, oral contraceptives containing estrogens, iodine-containing preparations and the numerous
preparations containing salicylates.
1. Changes in TBg concentration should be taken into consideration in the interpretation of T4 and
T3 values. In such cases, the unbound (free) hormone should be measured. Pregnancy, estrogens
and estrogen-containing oral contraceptives increase TBg concentrations. TBg may also be
increased during infectious hepatitis. Decreases in TBg concentrations are observed in nephrosis,
acromegaly and after androgen or corticosteroid therapy. Familial hyper- or hypo-thyroxinebinding-
globulinemias have been described. The incidence of TBg deficiency approximates 1 in
9000. The binding of thyroxine by thyroxine-binding prealbumin (TBPA) is inhibited by
salicylates.
2. Medicinal or dietary iodine interferes with all in vivo tests of radioiodine uptake, producing low
uptakes which may not be reflective of a true decrease in hormone synthesis.
3. The persistence of clinical and laboratory evidence of hypothyroidism in spite of adequate dosage
replacement indicates either poor patient compliance, poor absorption, excessive fecal loss, or
inactivity of the preparation. Intracellular resistance to thyroid hormone is quite rare.
Carcinogenesis, Mutagenesis and Impairment of Fertility – A reportedly apparent association
between prolonged thyroid therapy and breast cancer has not been confirmed and patients on thyroid for
established indications should not discontinue therapy. No confirmatory long-term studies in animals
have been performed to evaluate carcinogenic potential, mutagenicity, or impairment of fertility in either
males or females.
9
Pregnancy – Category A. Thyroid hormones do not readily cross the placental barrier. The
clinical experience to date does not indicate any adverse effect on fetuses when thyroid hormones are
administered to pregnant women. On the basis of current knowledge, thyroid replacement therapy to
hypothyroid women should not be discontinued during pregnancy.
Nursing Mothers – Minimal amounts of thyroid hormones are excreted in human milk. Thyroid
is not associated with serious adverse reactions and does not have a known tumorigenic potential.
However, caution should be exercised when thyroid is administered to a nursing woman.
Geriatric Use – Clinical studies of liothyronine sodium did not include sufficient numbers of
subjects aged 65 and over to determine whether they respond differently from younger subjects. Other
reported clinical experience has not identified differences in responses between the elderly and younger
patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low
end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function,
and of concomitant disease or other drug therapy. This drug is known to be substantially excreted by the
kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function.
Because elderly patients are more likely to have decreased renal function, care should be taken in dose
selection, and it may be useful to monitor renal function.
Pediatric Use – Pregnant mothers provide little or no thyroid hormone to the fetus. The incidence
of congenital hypothyroidism is relatively high (1:4000) and the hypothyroid fetus would not derive any
benefit from the small amounts of hormone crossing the placental barrier. Routine determinations of
serum T4 and/or TSH is strongly advised in neonates in view of the deleterious effects of thyroid
deficiency on growth and development.
Treatment should be initiated immediately upon diagnosis and maintained for life, unless
transient hypothyroidism is suspected, in which case, therapy may be interrupted for 2 to 8 weeks after
the age of 3 years to reassess the condition. Cessation of therapy is justified in patients who have
maintained a normal TSH during those 2 to 8 weeks.
10
ADVERSE REACTIONS
Adverse reactions, other than those indicative of hyperthyroidism because of therapeutic
overdosage, either initially or during the maintenance period are rare (see OVERDOSAGE).
In rare instances, allergic skin reactions have been reported with Cytomel (liothyronine sodium)
Tablets.
OVERDOSAGE
Signs and Symptoms – Headache, irritability, nervousness, sweating, arrhythmia (including
tachycardia), increased bowel motility and menstrual irregularities. Angina pectoris or congestive heart
failure may be induced or aggravated. Shock may also develop. Massive overdosage may result in
symptoms resembling thyroid storm. Chronic excessive dosage will produce the signs and symptoms of
hyperthyroidism.
Treatment Of Overdosage – Dosage should be reduced or therapy temporarily discontinued if
signs and symptoms of overdosage appear. Treatment may be reinstituted at a lower dosage. In normal
individuals, normal hypothalamic-pituitary-thyroid axis function is restored in 6 to 8 weeks after thyroid
suppression.
Treatment of acute massive thyroid hormone overdosage is aimed at reducing gastrointestinal
absorption of the drugs and counteracting central and peripheral effects, mainly those of increased
sympathetic activity. Vomiting may be induced initially if further gastrointestinal absorption can
reasonably be prevented and barring contraindications such as coma, convulsions, or loss of the gagging
reflex. Treatment is symptomatic and supportive. Oxygen may be administered and ventilation
maintained. Cardiac glycosides may be indicated if congestive heart failure develops. Measures to control
fever, hypoglycemia, or fluid loss should be instituted if needed. Antiadrenergic agents, particularly
propranolol, have been used advantageously in the treatment of increased sympathetic activity.
Propranolol may be administered intravenously at a dosage of 1 to 3 mg over a 10-minute period or
orally, 80 to 160 mg/day, especially when no contraindications exist for its use.
11
DOSAGE AND ADMINISTRATION
The dosage of thyroid hormones is determined by the indication and must in every case be
individualized according to patient response and laboratory findings.
Cytomel (liothyronine sodium) Tablets are intended for oral administration; once-a-day dosage is
recommended. Although liothyronine sodium has a rapid cutoff, its metabolic effects persist for a few
days following discontinuance.
Mild Hypothyroidism: Recommended starting dosage is 25 mcg daily. Daily dosage then may
be increased by up to 25 mcg every 1 or 2 weeks. Usual maintenance dose is 25 to75mcg daily.
The rapid onset and dissipation of action of liothyronine sodium (T3), as compared with
levothyroxine sodium (T4), has led some clinicians to prefer its use in patients who might be more
susceptible to the untoward effects of thyroid medication. However, the wide swings in serum T3 levels
that follow its administration and the possibility of more pronounced cardiovascular side effects tend to
counterbalance the stated advantages.
Cytomel (liothyronine sodium) Tablets may be used in preference to levothyroxine (T4) during
radioisotope scanning procedures, since induction of hypothyroidism in those cases is more abrupt and
can be of shorter duration. It may also be preferred when impairment of peripheral conversion of T4 to T3
is suspected.
Myxedema: Recommended starting dosage is 5 mcg daily. This may be increased by 5 to 10 mcg
daily every 1 or 2 weeks. When 25 mcg daily is reached, dosage may be increased by 5 to 25 mcg every 1
or 2 weeks until a satisfactory therapeutic response is attained. Usual maintenance dose is 50 to 100 mcg
daily.
Myxedema Coma: Myxedema coma is usually precipitated in the hypothyroid patient of long
standing by intercurrent illness or drugs such as sedatives and anesthetics and should be considered a
medical emergency.
12
An intravenous preparation of liothyronine sodium is marketed by Jones Pharma Incorporated,
under the trade name Triostat® for use in myxedema coma/precoma.
Congenital Hypothyroidism: Recommended starting dosage is 5 mcg daily, with a 5 mcg
increment every 3 to 4 days until the desired response is achieved. Infants a few months old may require
only 20 mcg daily for maintenance. At 1 year, 50 mcg daily may be required. Above 3 years, full adult
dosage may be necessary (see PRECAUTIONS, Pediatric Use).
Simple (non-toxic) Goiter: Recommended starting dosage is 5 mcg daily. This dosage may be
increased by 5 to 10 mcg daily every 1 or 2 weeks. When 25 mcg daily is reached, dosage may be
increased every week or two by 12.5 or 25 mcg. Usual maintenance dosage is 75 mcg daily.
In the elderly or in pediatric patients, therapy should be started with 5 mcg daily and increased
only by 5 mcg increments at the recommended intervals.
When switching a patient to Cytomel (liothyronine sodium) Tablets from thyroid, Lthyroxine
or thyroglobulin, discontinue the other medication, initiate Cytomel at a low dosage, and
increase gradually according to the patient's response. When selecting a starting dosage, bear in mind that
this drug has a rapid onset of action, and that residual effects of the other thyroid preparation may persist
for the first several weeks of therapy.
Thyroid Suppression Therapy: Administration of thyroid hormone in doses higher than those
produced physiologically by the gland results in suppression of the production of endogenous hormone.
This is the basis for the thyroid suppression test and is used as an aid in the diagnosis of patients with
signs of mild hyperthyroidism in whom baseline laboratory tests appear normal or to demonstrate thyroid
gland autonomy in patients with Graves’ ophthalmopathy. 131I uptake is determined before and after the
administration of the exogenous hormone. A 50% or greater suppression of uptake indicates a normal
thyroid-pituitary axis and thus rules out thyroid gland autonomy.
Cytomel (liothyronine sodium) Tablets are given in doses of 75 to 100 mcg/day for 7 days, and
radioactive iodine uptake is determined before and after administration of the hormone. If thyroid
function is under normal control, the radioiodine uptake will drop significantly after treatment. Cytomel
13
(liothyronine sodium) Tablets should be administered cautiously to patients in whom there is a strong
suspicion of thyroid gland autonomy, in view of the fact that the exogenous hormone effects will be
additive to the endogenous source.
HOW SUPPLIED
Cytomel (liothyronine sodium) Tablets: 5 mcg in bottles of 100;
25 mcg in bottles of 100; and 50 mcg in bottles of 100.
5 mcg 100’s: NDC 52604-3414-1
25 mcg 100’s: NDC 52604-3416-1
50 mcg 100’s: NDC 52604-3417-1
Store between 15° and 30°C (59° and 86°F).
DATE OF ISSUANCE November 2001
Manufactured by:
Schering Canada, Inc., 3535 Trans-Canada Highway, Pointe Claire, Quebec H9R 1B4 Canada
Distributed by:
Monarch Pharmaceuticals, Inc., Bristol, TN 37620
83-481648 Rev. 11/01

Reclast for postmenopausal osteoporosis

2009-02-03T22:42:00.000-08:00

Reclast, generic name zoledronic acid, is a once-per-year treatment for postmenopausal osteoporosis, a condition that threatens bone strength in women.

Here is the Reclast Corporate Website

Reclast is taken as a single annual intravenous dose, along with daily calcium and vitamin D. Reclast is designed to help strengthen your bones and protect them from fracture until the next yearly treatment.

From Novartis, the maker of Reclast, here is the FDA approved patient labelling text which is copyright Novartis:

17.2 FDA-Approved Patient Labeling

Reclast® (pronounced RE-klast)

(zoledronic acid)

Injection

IMPORTANT: You should not receive Reclast if you are already receiving Zometa. Reclast and Zometa are the same medicine. They both contain
zoledronic acid.

Read the Patient information carefully before your first infusion of Reclast and before each infusion. There may be new information. This leaflet does not replace talking with your doctor.

What is the most important information I should know about Reclast?

Patients with severe kidney problems should not receive Reclast Injection.

Low blood calcium should be corrected prior to receiving Reclast. If you are being treated for Paget’s disease of the bone it is important to take 1500 mg of calcium and 800 IU of vitamin D daily, especially during the first 2 weeks after getting Reclast. You should take calcium and vitamin D daily as recommended by your healthcare professional.

What is Reclast?

Reclast is a medicine used to treat:

Osteoporosis in women after menopause, and in patients after a recent hip fracture
Men and women with Paget’s disease of the bone

Reclast strengthens your bones by increasing bone mass and lowers the chance of breaking bones (fractures).

Who should not get Reclast?

You should not get Reclast if:

Your blood calcium level is too low

You are allergic to anything in Reclast. See section ‘What are the ingredients in Reclast’ for a complete list of ingredients.

What should I tell my doctor before getting Reclast?

Reclast may not be right for you. Tell your doctor about all your medical conditions, including if you:

have kidney problems
have a history of low blood calcium
are not able to take daily calcium and vitamin D supplements
had parathyroid or thyroid surgery (these glands are located in your neck)
have a malabsorption syndrome
had sections of your intestine removed
have asthma (wheezing) from taking aspirin
have a planned dental surgery such as tooth extraction
are pregnant or plan to become pregnant; Reclast may harm your unborn baby
are breast-feeding or planning to breast-feed. It is not known if Reclast passes into breast milk.

Tell your doctor about all the medicines you take, including prescription and nonprescription drugs, herbal supplements, and vitamins. Some medicines may increase your chance for low blood calcium levels or kidney problems when used with Reclast. Especially tell your doctor if you are taking:

Zometa
A diuretic or “water pill”
An antibiotic. Certain antibiotics called aminoglycosides may increase the effect of Reclast in lowering your blood calcium for a long period of time.

Know the medicines you take. Keep a list of your medicines and show it to your doctor and pharmacist each time you get a new medicine.

How will I receive Reclast?

Reclast is given by infusion into a vein (IV) that takes at least 15 minutes time. Reclast is always infused by your doctor or nurse.
Drink at least 2 glasses of fluid (such as water), within a few hours before receiving Reclast, as directed by your doctor. You may eat normally before your infusion.

For Osteoporosis:

Reclast is given once a year
In patients with osteoporosis, the current recommended daily intake of calcium is 1200 mg and vitamin D 800 IU to 1000 IU daily. If you have osteoporosis you should take calcium and vitamin D daily as recommended by your doctor.
During treatment with Reclast, your doctor may order a bone mineral density test to check your osteoporosis.

For Paget’s Disease:

Is given as a single treatment or your doctor may choose to give you more Reclast infusions based on signs or symptoms of your disease.
To prevent low blood calcium, it is important to take calcium and vitamin D supplements. If you have Paget’s disease you should take 1500 mg of calcium a day in divided doses (for example, 750 mg two times a day, or 500 mg three times a day) and 800 IU vitamin D a day. It is especially important to take the calcium and vitamin D supplements during the first 2 weeks after getting Reclast.
During treatment with Reclast, your doctor may order a blood test to check your Paget’s disease.

What are the possible side effects of Reclast?

Possible serious side effects include:

Low blood calcium (hypocalcemia). Symptoms may include numbness or tingling feeling (especially in the area around the mouth) or muscle spasms. Call your doctor right away if you notice any of these symptoms after receiving Reclast.
Kidney problems. Your doctor may do a blood test to check your kidney function before each dose of Reclast. It is important for you to drink at least 2 glasses of fluid (such as water), within a few hours before receiving Reclast, as directed by your doctor.
Jaw-bone problems (Osteonecrosis of the jaw). Jaw-bone problems may occur in some people and include: infection, delayed healing after teeth are pulled.
Severe muscle, bone and joint pain. Tell your doctor if you have severe muscle, bone, or joint pain after receiving Reclast.

The most common side effects of Reclast include: flu-like illness, fever, pain in your muscles or joints, and headache that can happen in the days after you get Reclast. A mild pain reliever such as ibuprofen or acetaminophen may reduce these symptoms. The chance of getting these side effects goes down with repeat dosing of Reclast.

Tell your doctor about any side effect that bothers you or does not go away. These are not all the possible side effects of Reclast. If you have questions, talk to your doctor.

General Information about Reclast

Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets.

This leaflet is a summary of the most important information about Reclast. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about Reclast that is written for healthcare professionals. For more information, go to www.Reclast.com or call 1-866-732-5278.

What are the ingredients in Reclast?

Active ingredient: zoledronic acid. Inactive ingredients: mannitol, USP; sodium citrate, USP; and water for injection, USP.

What is Osteoporosis?

Osteoporosis is a disease that is a thinning and weakening of the bones. Weaker bone can break more easily. Throughout life your body keeps your bones strong and healthy by replacing old bone with new bone. In osteoporosis, however, the body removes bone faster than it is formed. This causes loss of bone mass and weakening of bones. Weak bones are more likely to break. Osteoporosis is common in women after menopause and with increasing age. People who have an increased risk of osteoporosis: 1) are white (Caucasian) or oriental (Asian); 2) are thin; 3) have a family member with osteoporosis; 4) do not get enough calcium or vitamin D; 5) do not exercise; 6) smoke or drink alcohol often or 7) take medicines that cause bone loss (like prednisone) over a long period of time.

At first, osteoporosis usually has no symptoms, but people with osteoporosis are more likely to break (fracture) their bones. Fractures most often occur at the hip, back (spine), or wrist bones. Fractures of the spine may not be painful, but over time they can make you shorter. Over time fractures can lead to pain, severe disability, or loss of ability to move around. Reclast strengthens your bones and therefore makes them less likely to break.

What is Paget’s disease of bone?

Normally bone breaks down and is replaced by new bone. In Paget’s disease, bone breaks down too much and the new bone made is not normal. Bones affected by Paget’s disease like the skull, spine, and legs, become deformed and weaker than normal. This can cause problems like bone pain and the bones can bend or break.

T2008-51

Manufactured by:

Novartis Pharma Stein AG

Stein, Switzerland

Distributed by:

Novartis Pharmaceuticals Corporation

East Hanover, New Jersey 07936

Use an Inhaler? Check this Mayo Clinic Inhaler and Asthma Drug Chart

2009-01-30T13:21:00.000-08:00

If you suffer from COPD or other asthma-like symptoms you may already be using an inhaler. Albuterol - usualy via a metered inhaler - is the most commonly prescribed treatment for Asthma although many people respond well to non-prescription Primatene which is much cheaper. Neither of these medications should be used daily. If your problems with breathing are frequent your doctor is likely to prescribe different medications.

This excellent summary of options from Mayo is a good starting point if you think you may need breathing medications. Inhaler Chart

Consumer Reports: Dangerous Drugs for Seniors

2009-01-30T13:13:00.000-08:00

Consumer Reports has a good health blog and also reports on prescription drugs and complications that can arise from the use of Prescriptions.

In this free online report CR lists some items to review if you are on any of the listed medications, with possible alternative therapies. As always you should learn as much as you can online and then consult with your doctor to determine the best way to move forward with any prescription drug regimen.

Here's the report

Pfizer expected to buy Wyeth for 68 billion dollars

2009-01-25T23:06:00.000-08:00

CNN Reporting that Pfizer Pharmaceutical is about to buy Wyeth Pharmaceutical for $68 Billion in one of the largest corporate mergers in this sector of all time. Some analysts seem to think that Pfizer fears losing their edge as Lipitor profits slip away while Wyeth's sales of Prevnar topped 2.1 billion last year and are rising as the use of this children's vaccine increases worldwide. Wyeth also has an excellent R&D effort which is likely to offer Pfizer the ability to improve and streamline their own R&D efforts.

More from CNN

Abilify - an Antidepressant prescription medication.

2008-12-21T18:19:00.000-08:00

Abilify is made by Bristol Myers Squibb and the official website is here

From the medication guide by the manufacturer we learn the following:

MEDICATION GUIDE ABILIFY®
Generic name: aripiprazole

Antidepressant Medicines, Depression and
other Serious Mental Illnesses, and
Suicidal Thoughts or Actions

Read the Medication Guide that comes with your or your
family member’s antidepressant medicine. This Medication
Guide is only about the risk of suicidal thoughts and actions
with antidepressant medicines.

Talk to your, or your family
member’s, healthcare provider about:
• all risks and benefits of treatment with antidepressant
medicines
• all treatment choices for depression or other serious
mental illness
What is the most important information I should know
about antidepressant medicines, depression and other
serious mental illnesses, and suicidal thoughts or
actions?

1. Antidepressant medicines may increase suicidal
thoughts or actions in some children, teenagers, and
young adults within the first few months of treatment.

2. Depression and other serious mental illnesses are the
most important causes of suicidal thoughts and actions.
Some people may have a particularly high risk of having
suicidal thoughts or actions. These include people who
have (or have a family history of) bipolar illness (also called
manic-depressive illness) or suicidal thoughts or actions.

3. How can I watch for and try to prevent suicidal
thoughts and actions in myself or a family member?
• Pay close attention to any changes, especially sudden
changes, in mood, behaviors, thoughts, or feelings. This
is very important when an antidepressant medicine is
started or when the dose is changed.
• Call the healthcare provider right away to report new or
sudden changes in mood, behavior, thoughts, or
feelings.
• Keep all follow-up visits with the healthcare provider as
scheduled. Call the healthcare provider between visits
as needed, especially if you have concerns about
symptoms.
Call a healthcare provider right away if you or your family
member has any of the following symptoms, especially if
they are new, worse, or worry you:
• thoughts about suicide or dying
• attempts to commit suicide
• new or worse depression
• new or worse anxiety
• feeling very agitated or restless
• panic attacks
• trouble sleeping (insomnia)
• new or worse irritability
• acting aggressive, being angry, or violent
• acting on dangerous impulses
• an extreme increase in activity and talking
(mania)
• other unusual changes in behavior or mood
What else do I need to know about antidepressant
medicines?
• Never stop an antidepressant medicine without first
talking to a healthcare provider. Stopping an antidepressant
medicine suddenly can cause other symptoms.
• Antidepressants are medicines used to treat
depression and other illnesses. It is important to
discuss all the risks of treating depression and also the
risks of not treating it.
Patients and their families or other caregivers should
discuss all treatment choices with the healthcare
provider, not just the use of antidepressants.
• Antidepressant medicines have other side effects.
Talk to the healthcare provider about the side effects of
the medicine prescribed for you or your family member.
• Antidepressant medicines can interact with other
medicines. Know all of the medicines that you or your
family member takes. Keep a list of all medicines to show
the healthcare provider. Do not start new medicines
without first checking with your healthcare provider.
• Not all antidepressant medicines prescribed for
children are FDA approved for use in children. Talk to
your child’s healthcare provider for more information.

This Medication Guide has been approved by the U.S. Food
and Drug Administration for all antidepressants.
It should be noted that ABILIFY (aripiprazole) is approved to be
added to an antidepressant when the response from the
antidepressant alone is not adequate. ABILIFY is not approved
for pediatric patients with depression.
Call your doctor for medical advice about side effects. You may
report side effects to FDA at 1-800-FDA-1088.

ABILIFY is a trademark of Otsuka Pharmaceutical Company.

Orencia - an alternative to conventional treatments of rheumatoid arthritis

2008-12-14T12:22:00.000-08:00

Official Orencia website is here.

The following information is excerpted from the USA FDA's drug fact sheet about Orencia:

Orencia is a medicine that is used to treat adults with moderate to severe rheumatoid arthritis (RA) who have not been helped by other medicines for RA. RA is a disease that causes pain and joint inflammation (tenderness and swelling). RA can also cause joint damage.

You should not take this drug if you have ever had an allergic reactions to it.

Some but not all of the risks and side effects of Orencia:

Serious infections.
- Patients taking Orencia are at increased risk for developing infections including pneumonia, and other infections caused by viruses, bacteria, or fungi. Call your healthcare professional immediately if you feel sick or get any infection during treatment with Orencia.
Allergic reactions.
- These reactions are usually mild or moderate and include hives, swollen face, eyelids, lips, tongue, throat, or trouble breathing.
Malignancies.
- There have been rare cases of certain kinds of cancer in patients receiving Orencia. The role of Orencia in the development of cancer is not known.
Some common side effects that may occur with Orencia include:
- headache
- upper respiratory tract infection
- sore throat
- nausea

Tell your doctors if any of these apply to you:

Are you taking a TNF blocker to treat Rheumatoid Arthritis? You may have a higher chance of getting a serious infection if you take Orencia with other biologic medications for RA.

Do you have any kind of infection including an infection that is in only one place in your body (such as an open cut or sore), or an infection that is in your whole body (such as the flu). Having an infection could put you at risk for serious side effects from Orencia.

Do you have an infection that won’t go away or a history of infections that keep coming back?

Also talk to your doctor if you:

have had tuberculosis (TB), a positive skin test for TB, or if you recently have been in close contact with someone who has had TB. If you develop any of the symptoms of TB (a dry cough that doesn’t go away, weight loss, fever, night sweats) call your healthcare professional right away. Before you start Orencia, your healthcare professional may examine you for TB or perform a skin test.
are scheduled to have surgery.
recently received a vaccination or are scheduled for any vaccination.
are trying to become pregnant or are already pregnant. It is not known if Orencia can harm your unborn baby.
are breastfeeding. Orencia can pass into breast milk. You will need to decide to either breastfeed or receive treatment with Orencia, but not both.

Orencia and certain other medicines may interact with each other. Tell your healthcare professional about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Know the medicines you take. Keep a list of them with you to show your healthcare professional.

Taking Orencia with TNF blocker medications (Enbrel, Humira, Remicade) is not recommended.

Taking Orencia:

Orencia will be given to you by a healthcare professional using an IV. This means the medicine will be given to you through a needle placed in a vein in your arm. It will take about 30 minutes to give you the full dose of medicine.
You will receive your first dose of Orencia followed by additional doses at 2 and 4 weeks after the first dose. You will then receive a dose every 4 weeks.

China shuts down several websites for bogus drug claims.

2008-12-11T14:46:00.000-08:00

The Chinese government has closed several allegedly fraudulent websites - mostly targeting Chinese consumers - that make claims for mostly herbal remedies and alternative medicine treatments.

More from Reuters

Lyrica - for treatment of nerve pain or "fibromyalgia"

2008-12-10T19:22:00.000-08:00

Lyrica is a drug prescribed to treat various manifestations of "nerve pain" also called fibromyalgia.

Here are detailed treatments of various topics from the official Lyrica website:

Treating Painful DPN

Treating PHN

Managing Fibromyalgia

Add-On Treatment For Seizures in Adults

Glossary

COPD = chronic obstructive pulmonary disease

2008-12-07T09:27:00.000-08:00

COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a disease that worsens over time and makes it hard for you to breathe.

In the USA the term "COPD" includes two main conditions—emphysema and chronic obstructive bronchitis,

COPD can cause coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms.

Cigarette smoking is the leading cause of COPD. Most victims of COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to the disease.

Overview

To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes, or airways.

The airways are shaped like an upside-down tree with many branches. At the end of the branches are tiny air sacs called alveoli (al-VEE-uhl-eye).

The airways and air sacs are elastic. When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sac deflates and the air goes out.

In COPD, less air flows in and out of the airways because of one or more of the following:

The airways and air sacs lose their elastic quality.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed (swollen).
The airways make more mucus than usual, which tends to clog the airways.

Healthy Alveoli and Damaged Alveoli

The illustration shows the respiratory system and images of healthy alveoli and alveoli damaged by COPD.

In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones.

In chronic obstructive bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.

Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term "COPD" is more accurate.

Outlook

COPD is a major cause of disability, and it's the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. An additional 12 million likely have the disease and don't even know it.

COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.

Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn't passed from person to person—you can't catch it from someone else.

COPD has no cure yet, and doctors don't know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.

Citation from NIH Website: http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html

AARP on NY Prescription Drug Reform Bill

2008-12-03T14:25:00.000-08:00

This May 15 Statement is old but helps give some insight into how AARP will lobby
for Prescription Drug reform and transparency in the future. Under an Obama administration
we can expect more Government involvement in the drug industry and probably a stance
on transparency that is likely to be closer to AARP's vision than has been the case
in the Bush Administration.

AARP Statement on New York Bill for Prescription Drug Marketing Reform and Transparency

AARP commends Governor Paterson's leadership in proposing prescription drug
marketing reform and transparency

ALBANY, N.Y., May 15 /PRNewswire-USNewswire/ -- AARP strongly believes New
York has a paramount interest in passing the Governor's prescription marketing
reform proposals which address the undue influence that pharmaceutical
companies have over prescribing decisions that affect not only consumers'
pocket books but the treatment they receive.

The reforms include banning gifts of over $50 (excluding free samples) to
doctors and requiring speakers at continuing medical education programs for
health professionals to disclose any financial relationships they might have
with a drug company.

AARP strongly supports provisions in the proposed legislation to make the
business transactions of pharmaceutical benefit managers (PBMs) more
transparent in order to drive down the cost of prescription drugs.

We strongly encourage the New York State Legislature to pass this legislation
that would help so many New Yorkers before the end of the legislative session.
The pharmaceutical industry should not dictate prescription drug policy in
our State. The Legislature must reject the opposition from the drug industry
and do the right thing for their constituents.

The Governor's bill will increase a New Yorker's ability to access affordable
prescription drugs and improve the quality of their healthcare. In addition,
this legislation would help all taxpayers who fund public prescription drug
programs, such as Medicaid and EPIC.

According to a January 2006 article in the Journal of the American Medical
Association (JAMA), titled "Health Industry Practices That Create Conflicts of
Interest," approximately 90% of the $21 billion pharmaceutical industry
marketing budget continues to be directed at physicians.

When a drug company sales representative walks into a doctor's office armed
with gifts and promotes a drug company's newest, most expensive drugs, New
Yorkers - whether as patients or taxpayers - may not always obtain the most
beneficial and cost-effective drug available.

For several years, AARP has been tracking the price of prescription drugs.
AARP's Rx Watchdog reports have revealed startling trends over the past six
years. Brand name prescription drug costs are steadily rising at close to
double and even triple the rate of inflation.

AARP firmly believes that evidence-based research should be the guide to
prescribing the most effective prescription drugs, not gifts from
manufacturers to physicians. Drugs should be prescribed based on their
effectiveness in treating a medical condition - not because they are new and
in many cases more expensive.

AARP New York Contact: Kristin Legere, 518-447-6723

Detrol LA for Overactive Bladder

2008-11-20T00:06:00.000-08:00

Detrol LA is a prescription medication used to treat problems relating to frequent urination also known as "overactive bladder".

From the official Detrol LA website here are their categories of issues relating to the drug:

Spireva - an inhalant for COPD Respiratory Disease

2008-11-03T17:57:00.000-08:00

Chronic Obstructive Pulmonary Disease or COPD are a type of respiratory disease that is characterized by breathing difficulties. Spireva is an prescription medication that is inhaled to help with COPD.

Official Spireva website: Spireva.com

This COPD information from the NIH:

What Is COPD?

COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time.

COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.

Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.

Overview

To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes, or airways.

The airways are shaped like an upside-down tree with many branches. At the end of the branches are tiny air sacs called alveoli (al-VEE-uhl-eye).

The airways and air sacs are elastic. When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sac deflates and the air goes out.

In COPD, less air flows in and out of the airways because of one or more of the following:

The airways and air sacs lose their elastic quality.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed (swollen).
The airways make more mucus than usual, which tends to clog the airways.

Healthy Alveoli and Damaged Alveoli

The illustration shows the respiratory system and images of healthy alveoli and alveoli damaged by COPD.

In the United States, the term "COPD" includes two main conditions—emphysema (em-fi-SE-ma) and chronic obstructive bronchitis (bron-KI-tis).

Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term "COPD" is more accurate.

Outlook

Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn't passed from person to person—you can't catch it from someone else.

Celebrex

2008-10-18T00:14:00.000-07:00

Pfizer has settled a $900,000,000 lawsuit over problems with Celebrex and another discontinued drug.

Celebrex is still prescribed for many

The official website is here: Celbrex.com

NSAIDs like CELEBREX, help with arthritis pain.

CELEBREX relieves arthritis pain, stiffness, and inflammation. A normal does is 200mg and provides 24-hour pain relief.

Pfizer says that in studies, a lower percentage of patients on CELEBREX reported indigestion, abdominal pain, and nausea versus prescription ibuprofen and naproxen.

Chantix - a drug to help you stop smoking

2008-09-24T17:56:00.000-07:00

Chantix (varenicline) is a drug to help adults stop smoking by reducing the urge to smoke.

Chantix website

This from the Chantix official website:

What should I tell my doctor before starting CHANTIX?

Tell your doctor about all your medical conditions including if you:

have ever had depression or other mental health problems, as these symptoms may worsen while taking CHANTIX.
experienced nicotine withdrawal symptoms with prior quit attempts, with or without CHANTIX. Quitting smoking, with or without CHANTIX, can result in nicotine withdrawal symptoms (such as depressed mood, agitation) or a worsening of existing mental health problems, such as depression.
have kidney problems or get kidney dialysis. Your doctor may prescribe a lower dose of CHANTIX for you.
are pregnant or plan to become pregnant. CHANTIX has not been studied in pregnant women. It is not known if CHANTIX will harm your unborn baby. It is best to stop smoking before you get pregnant.
are breastfeeding. Although it was not studied, CHANTIX may pass into breast milk. You and your doctor should discuss alternative ways to feed your baby if you take CHANTIX.

Tell your doctor about all your other medicines including prescription and nonprescription medicines, vitamins, and herbal supplements. Especially, tell your doctor if you take:

insulin
asthma medicines
blood thinners

When you stop smoking, there may be a change in how these and other medicines work for you.

You should not use CHANTIX while using other treatments to quit smoking. Tell your doctor if you use other treatments to quit smoking.

Symbicort for Asthma

2008-09-09T21:09:00.000-07:00

Symbicort is an inhaled asthma medicine with two key ingredients: budesonide and formoterol.

We learn from Symbicort's official website's information for doctors:

SYMBICORT is indicated for the long-term maintenance treatment of asthma in patients 12 years and older

SYMBICORT is NOT indicated for the relief of acute bronchospasm and should not be initiated in patients during rapidly deteriorating or potentially life-threatening episodes of asthma
SYMBICORT is not indicated in patients whose asthma can be successfully managed by inhaled corticosteroids along with occasional use of inhaled short-acting beta₂-agonists

Symbicort is made by AstraZeneca, a major pharmaceutical company.

More information about Symbicort:

IMPORTANT SAFETY INFORMATION

What is SYMBICORT?

Prescription SYMBICORT^® (budesonide/formoterol fumarate dihydrate) Inhalation Aerosol is a controller medicine for the long-term maintenance treatment of asthma. SYMBICORT is for people 12 years and older whose doctor has decided are not well controlled on another asthma-controller medicine or who need two asthma-controller medicines. SYMBICORT is not for the treatment of sudden
asthma symptoms.

What is the most important safety information I should know about SYMBICORT?

SYMBICORT contains formoterol, a long-acting
beta₂-agonist (LABA). Medicines containing LABAs may increase the chance of asthma-related death. So, SYMBICORT should be used only if your health care professional decides another asthma-controller medicine alone does not control your asthma or you need two controller medicines.

While taking SYMBICORT, never use another medicine containing a LABA.

FDA - Drugs Under Investigation - not necessarily a problem

2008-09-05T22:03:00.000-07:00

This FDA release lists all the drugs currently under investigation by the Food and Drug Administration. It is important to note that this DOES NOT MEAN you should stop taking any of your prescripton meds. If a drug you take is on this list you should talk to your doctor.

As ALWAYS, Prescription Report does NOT provide medical advice. The idea is just to help get you to the information you need....faster.

The following reports list any potential signals of serious risks/new safety information that were identified using the AERS database during the indicated quarter:

Potential Signals of Serious Risks/New Safety Information Identified by the Adverse Event Reporting System (AERS) January - March 2008

Product Name: Active Ingredient (Trade) or Product Class	Potential Signal of Serious Risk/New Safety Information
Arginine Hydrochloride Injection (R-Gene 10)	Pediatric overdose due to labeling / packaging confusion
Desflurane (Suprane)	Cardiac arrest
Duloxetine (Cymbalta)	Urinary retention
Etravirine (Intelence)	Hemarthrosis
Fluorouracil Cream (Carac) and Ketoconazole Cream (Kuric)	Adverse events due to name confusion
Heparin	Anaphylactic-type reactions
Icodextrin (Extraneal)	Hypoglycemia
Insulin U-500 (Humulin R)	Dosing confusion
Ivermectin (Stromectol) and Warfarin	Drug interaction
Lapatinib (Tykerb)	Hepatotoxicity
Lenalidomide (Revlimid)	Stevens Johnson Syndrome
Natalizumab (Tysabri)	Skin melanomas
Nitroglycerin (Nitrostat)	Overdose due to labeling confusion
Octreotide Acetate Depot (Sandostatin LAR)	Ileus
Oxycodone Hydrochloride Controlled-Release (Oxycontin)	Drug misuse, abuse and overdose
Perflutren Lipid Microsphere (Definity)	Cardiopulmonary reactions
Phenytoin Injection (Dilantin)	Purple Glove Syndrome
Quetiapine (Seroquel)	Overdose due to sample pack labeling confusion
Telbivudine (Tyzeka)	Peripheral neuropathy
Tumor Necrosis Factor (TNF) Blockers	Cancers in children and young adults

Singulair for Allergies

2008-08-25T21:21:00.000-07:00

SINGULAIR helps relieve indoor and outdoor allergy symptoms.

Sneezing
Stuffy nose
Runny nose
Itching of the nose

Singulair is taken once per day, does not cause drowsiness, and comes
in a chewable tablet as well as an oral granule to give to children as young as 2 years.

Singulair is an indoor and outdoor allergy medicine that blocks leukotrienes, which are a cause of allergies.

The official Singulair website is here

There are some reports of suicidal thoughts by those taking Singulair although this has not caused enough concern for a recall.

FDA Information about Singulair:
http://www.fda.gov/CDER/consumerinfo/druginfo/singulair.HTM