ScriptSave WellRx diabetes check image

by:
Jeshvi Manhar, 2017 PharmD Candidate/ Sapna S. Patel, PharmD

ScriptSave WellRx - sound alike-look alike medications and diabetes imageSound-Alike/Look-Alike Medications are very important to identify and help reduce medication errors. There is a list of several medications starting with the letter “T” that have become available to treat diabetes. This may lead to confusion among patients and physicians, so it’s important YOU understand how to safely recognize and use your diabetes medication to minimize problems and possible complications.

Tradjenta® decreases the amount of sugar your liver makes and increases the amount of insulin your pancreas makes. This medicine is the easiest to differentiate, since it is an oral tablet taken once daily.

Tanzeum® and Trulicity® are in the same class of medications called GLP-1 Receptor Agonists. These medications are injected under the skin but, they are not the same as insulin! They decrease your blood sugar by releasing more insulin and slowing down your body’s digestion. The easiest way to differentiate these medications from insulin is that Tanzeum® and Trulicity® are injected under the skin once a week without regard to meals.

Now, let’s discuss the three medications that are insulin: Toujeo® U-300, Tresiba® U-100, and Tresiba® U-200. Insulin works by allowing blood sugar to move into the cells and be used as energy. Toujeo® and Tresiba® are considered long acting insulin and are injected under the skin once daily without regard to meals. These medications are not interchangeable! Toujeo® U-300 is the concentrated form of Lantus®. Toujeo® U-300 is 3 times the concentration of Lantus®! It would be easy to inject the wrong dose (especially when switching from one medication or concentration to another). Tresiba® U-200 is twice as concentrated as Tresiba® U-100! Toujeo® U-300, Tresiba® U-100, and Tresiba® U-200 are all packaged in green boxes, making them look alike. Before injecting your medication, take measures to ensure you know what the name and concentration of your medication is, what the box, pen and/or needle looks like, and how your medication should be used correctly. If in doubt, ask your pharmacist about the brand you’re buying and study the label before using the medication.

GENERAL INJECTION TIPS:

  1. Using 29 gauge 5mm pen needles for under the skin injection may cause less pain
  2. Roll the pen between the palm of your hands before use to decrease discomfort or pain
  3. Common injection sites are stomach and thigh
  4. Make sure to rotate injection sites to prevent buildup of fatty tissue and pain
  5. Wipe injection site with alcohol wipe then wait for a few seconds before injecting to reduce stinging
  6. Be sure to safely dispose and use a new needle prior to each injection to prevent infection.

 

Reference:

LexiComp®, 2.20.17, JM PharmD Candidate at OSU College of Pharmacy/SSP PharmD

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ScriptSave WellRx - diabetes glucose monitor check image

by:
Cherokie S. Boyd
Pharmacy Intern P1
SinfoniaRx Florida

What a time to be a person with diabetes! These days there are more medications on the market than ever to help you control your diabetes. But how do you know which medication is right for you?

Of course you should always consult your physician or your local pharmacist for medical advice. However, here is some information about these new medications so that you don’t feel out of the loop.

Some of the current insulin medications that you are used to are Lantus, Humalog, and NovoLog. These medications deliver the hormone insulin to your blood so that insulin can tell your cells to take in more glucose. This keeps your blood sugar down.

Then there are oral medications, like Metformin and Januvia. They both work by making your liver produce glucose less often. Metformin also makes your body more sensitive to the insulin that is already made in your body, while Januvia works to help your body increase insulin production. All of that keeps your blood sugar down.

Now we have the new kids on the block. The GLP’s (glucagon-like peptides), sometimes referred to as Incretin mimics. The GLP’s that are available by brand name are Victoza and Saxenda, Byetta and Bydureon, Tanzeum, and Trulicity. These medications work in three ways.

  • They increase the hormone incretin which triggers your pancreas to make its own insulin
  • They inhibit the hormone glucagon which is responsible for telling your liver to make more blood glucose
  • They make you feel fuller for longer by delaying gastric emptying, which helps you lose weight.

Now that last point is what has caught most people’s attention. It is true that some of these GLP’s can be used for weight loss, too. If you have type 2 diabetes, you know that losing weight is a benefit to help control blood sugar in overweight patients. These medications in particular can also affect your natural insulin production, which means you can get a lower dose of your insulin medications. It’s a win-win! But these medications are not to be used as a first line of defense against your diabetes. These medication’s main claim to fame is that they lower your A1C by 1% in most patients.

Your A1C is a blood test you get at the doctor’s office. It’s a measurement that can detect how well your blood sugar is being controlled over a period of 3 months. Usually you want this result to be somewhere under 7%. This reflects that your blood sugar is being controlled for a longer amount of time. Controlled blood sugar limits your risk for complications such as nerve pain and kidney problems.

Did I mention that these GLP medications can cost you around $700 a month? Not to worry. If these medications sound like something you want to add to your regimen don’t hesitate to talk to your doctor about them. They might be on your health plans insurance formulary, or you might qualify for a prescription discount with the ScriptSave WellRx savings program. Compare it to your insurance copay. It may be cheaper!

Keeping your diabetes in control can be a struggle. Never forget the amazing impact that a diet full of vegetables can have for your body. Keep your body moving. Ample exercise each week is another natural way that you can get your prescribed insulin dose lowered.


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ScritpSave WellRx image of a healthy diet

by Benita M. Daniel
University of Arizona, College of Pharmacy
PharmD Candidate, Class of 2017

The beginning of the New Year is often the time to set new goals and resolutions for the upcoming year. It’s an exciting time to start new resolutions that will help you succeed in the coming year. One of the most common New Year’s Resolution is to lose weight, stay healthy, and save money.

Fad diets are typically known for the potential to achieve rapid weight loss, even without the integration of any physical activity. However, it is important to keep in mind that these diets are harmful to the body since it usually restrict one’s nutritional intake. A healthy approach to losing weight is to include a well-balanced diet with physical activity.

Here are some of the examples of fad diets that were popular mainly in the year of 2016:

Military Diet Substitutes – This rigorous diet only allows the consumption of 13 specific food items such as peanut butter, grapefruit, eggs and bananas. It is commonly referred to as a crash diet.

Atkins 40 – This strict diet regimen focuses on a net carbohydrate intake of 40 grams per day. It’s a low carbohydrate diet with very little sugar intake and avoids all types of refined carbohydrates. It’s important to keep in mind that the recommended daily intake of carbohydrates is around 250 grams.

Mono Diet – This diet typically focuses on the consumption of a single food group. For instance, Taco diet, Pizza diet and Chicken Nugget diet.

Ketogenic Diet – This high fat diet calls for at least 70 percent of fat intake per day, in addition to less than 10 percent of carbohydrates and 20 percent of protein. This diet emphasizes on plant based beneficial fats, rather than the saturated animal fats such as cheese, cream and butter.

These diets might promise fast weight loss, however, it is significant to note that the consumption of a single food group or ingredient does not adequately provide all the nutrients that are essential for the body. It is vital to focus on well-proportioned diet that includes all food groups: protein, dairy products, vegetables, fruits, and legumes with a moderate consumption of fats and oils. Additionally, it is important to remember that the long-term effect of fad diets can be dangerous to the body and cause potential complications.

Potential complications that could occur from following a highly restrictive diet are:

  • Vitamin deficiency – Most diets often do not include food groups that are rich in vitamins and essential elements. It is important to ensure that you receive the essential elements and vitamins that are vital for body functions and to prevent any long-term chronic condition. For instance, Calcium is an essential element that plays a key role in bone growth and in preventing chronic conditions such as osteoporosis.
  • Improper long-term weight control – Most people tend to have a tough time following through fad diets due to its strict regimen. Furthermore, it is also noted that most people who achieve the goal through rapid weight loss often quit immediately upon reaching the goal due to the high restrictions associated with it.
  • Increased levels of cholesterol and triglycerides – Certain diets that consists of high-fat diet such as ketogenic diet can sometimes lead to increased levels of cholesterol, which may require treatment with cholesterol medications, like Crestor (rosuvastatin) or Zocor (simvastatin).
  • Ketosis – This can occur when you consume a high-protein and low carbohydrate diet. It is essential to meet the daily-recommended intake for carbohydrates in order to avoid some of the side effects such as headache, constipation, fatigue and dizziness.

Some ways to achieve a healthy lifestyle and to ensure safe and appropriate weight loss include:

  • Create a meal plan that focuses on a balanced diet that incorporates all food groups including fresh fruits and vegetables, lean meat, whole grains, legumes with moderate consumption of beneficial fats derived from fish and plants and minimal consumption of saturated animal fats. It is also key to avoid any consumption of processed foods, like pre-packaged meals or lunch meat. Those foods can be extremely high in sodium.
  • Focus on portion control by limiting the serving size per meal rather than avoiding major food groups
  • A healthy balance to weight loss is incorporating physical activity that is equal to the amount of calories you eat. The Centers for Disease Control (CDC) recommends a healthy routine to lose weight that includes at least 150 minutes of moderate intensity aerobic exercise every week.
  • It’s important to consult your physician or a dietitian before starting any new diet.

References:


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ScriptSave WellRx image - save on diabetic glucagon kits

by Benita M. Daniel
University of Arizona, College of Pharmacy
PharmD Candidate, Class of 2017

Weakness, anxiety or irritability, a general sense of confusion — these are signs of low blood sugar, or hypoglycemia. It often happens when diabetics take too much insulin.

Hypoglycemia happens to many people with diabetes, and it can be serious or even fatal.

Severe hypoglycemic episode, also referred to as insulin shock, can occur when the body has too much insulin that can lead to low blood sugar levels.

The possible causes for insulin shock include:

  • Overdose of insulin
  • Long interval time between each meals
  • Exercising without eating
  • Consumption of alcohol without eating food

If you’re experiencing a hypoglycemic episode, don’t panic. Most incidents of low blood sugar and can be treated at home.

One of the fastest, most effective treatments is with a glucagon injection. Glucagon is a natural hormone that is produced by the pancreas in response to high levels of insulin in the blood. The administration of glucagon injection is indicated for emergency uses only especially in patients who are experiencing severe hypoglycemic symptoms.

Severe hypoglycemia often results when early low blood sugar symptoms are untreated. It is recommended to use Glucagon if you experience:

  • Irritability
  • Tremor
  • Excessive sweating/hunger
  • Seizures
  • Weakness
  • Confusion
  • Unconsciousness

Glucagon pen injections are typically dispensed in Glucagon Emergency kits that contains a vial of glucagon (powder form), syringe with attached needle containing the sterile diluting agent with instructions on how to mix it prior to administration. It is important to ensure that you and your family including close relatives are properly instructed on how to use glucagon injection in the case of an emergency. A detailed instruction for use is provided by the manufacturing company. Since, glucagon products are currently available in market primarily in powder form, it is necessary to make sure that these necessary steps are taken prior to the administration of glucagon injection:

  • Inject the diluting agent contained within the syringe into the glucagon vial/bottle
  • Gently swirl the glucagon vial/bottle until it is a clear liquid. It is important to make sure that glucagon is not administered until it has a clear and water-like consistency
  • Using the same needle as before, draw up all the contents within the glucagon bottle
  • Sterilize the preferred injection sites: buttock, arm or thigh with an alcohol swab. Insert the needle into the injection site immediately after the reconstitution occurs.
  • If the patient does not respond to the first dose of glucagon, call 911 and physician and administer another dose of glucagon
  • After the administration, make sure to discard any remaining unused contents of the injection since the glucagon is typically unusable.

It is critical to treat the early signs and symptoms of hypoglycemia in order to prevent the progression of severe symptoms of hypoglycemia. Here are some helpful tips to help you prevent low blood sugar levels or hypoglycemia:

  • Identify early signs and symptoms of low blood sugar levels
  • Carry glucose tablets or sugary snacks such as candy or regular soft drink
  • Make sure to take insulin doses after each meal
  • Avoid exercising for longer periods of time without eating any sugary snacks
  • Avoid drinking alcohol without eating
  • Test blood sugar levels regularly as recommended by the doctor in order to ensure blood sugar levels are within goal.
  • Ask your doctor for glucagon injection if in case of emergency

There have been recent developments of newer agents such as Glucagon pens (G-pens) that are currently in Phase 3 of Clinical trials. As per the manufacturing company, Xeris Pharmaceuticals, “Glucagon pen is a highly stable, ready-to-inject glucagon solution as an alternative to the existing glucagon emergency kits and to provide various products addressing the broader problems of hypoglycemia in both the diabetic and non-diabetic population.”

Glucagon pens are prefilled auto-injectors that will activate immediately with the contact of the human skin and works in similar methods to that of an Epi-pen.  Additionally, it does not require multiple steps prior to the administration of the medication to ensure the patient receives the active form of glucagon.

The elimination of the reconstitution will help in the fast and efficient administration of glucagon and this can prevent further complications of hypoglycemia including coma. G-pens seems to be a promising area of research and it will be fascinating to see the positive outcomes that would result due to the development of Glucagon pens.

Recheck your blood sugar after 15 or 20 minutes. If it’s still low, take another 15 to 20 grams of a quick-acting sugar, and eat something if you can. If your sugar level stays low after 2 hours or if your symptoms don’t get better, seek medical attention.


References:

http://www.healthline.com/health/diabetes/insulin-shock#Overview1

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?loc=lwd-slabnav

http://pi.lilly.com/us/rglucagon-ppi.pdf

http://www.xerispharma.com/pipeline


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photo ScriptSave WellRx vitamin supplements

by Sandra Leal, PharmD, MPH, CDE, FAPhA

The US supplement industry is a $30 billion dollar business.1 The Council for Responsible Nutrition estimates that almost 70% of US adults use dietary supplements.2 Before I continue, I must state that I do not have any conflicts of interest and rest assured, although I am a pharmacist, I do not support ‘Big Pharma’ when it comes patients unnecessarily being prescribed medication.

Personally, I use caution when it comes to dietary supplements for one simple reason – they are not regulated like prescription medications. The FDA is the administration that regulates the approval and use of prescription medication. What this means is that on a prescription bottle labeled with a specific amount of ingredients, you can be certain that the actual amount in a given tablet, capsule, cream, suppository, solution, etc. is between about 95% and 105% of what the label actually states. As an example, if you are prescribed to take a tablet that is 100mg in strength, then you can be certain that the amount is between 95mg and 105mg of that medication.

On the contrary, dietary supplements are regulated by the Dietary Supplement Health and Education Act of 1994. Since they are not regulated like drugs, companies that manufacture and produce dietary supplements are able to put whatever claims they want on their bottles. It is possible and highly likely that what is stated on the supplement label is not what is in the actual tablet or capsule. In fact, the New York Attorney General and the Federal Trade Commission have recently filed suit against Prevagen for their claims of memory boosting.

Moreover, many weight loss dietary supplements contain botanicals and plant-derived ingredients that can cause and make health problems worse. Sometimes, these supplements can interact with prescription medicines that you are prescribed. St. John’s wort, in particular, can negatively interact with a number of medications, including Statins (Crestor, Simvastatin), Warfarin (Coumadin), and Tricyclic antidepressants, like Elavil or Pamelor.

I believe there are great health benefits and medicinal properties of nutraceuticals, however there is a great need for credible research and evidence before I would be comfortable recommending these products to my patients. Throughout my years of practice, I have found that many patients do not consider dietary supplements, OTC products, and vitamins as medications. I would recommend that the next time you have an appointment with your doctor, inform him/her of everything you take, even those that you purchase in a store or online, just to ensure that they are safe for you and do not interact with your prescription medications.

The next time you think of taking a supplement, remember that right now you have no way of knowing for sure what’s really in your supplement bottle. And despite the promising on the labels, the pills probably won’t make you any healthier (unless you have a medically diagnosed deficiency), and they might even be hurting you.

 

References:

  1. http://www.vox.com/2016/3/10/11179842/dietary-supplements-medical-evidence
  2. http://www.crnusa.org/CRNPR14-CRNCCSurvey103014.html
  3. http://annals.org/article.aspx?articleid=1789253
  4. http://www.iflscience.com/health-and-medicine/23000-people-us-end-er-annually-because-supplements

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photo of statin prescription bottles - scriptsave wellrx

Do you find yourself struggling with statins?

Why do I need a statin? Why are there so many with different names? Why did my doctor prescribe this brand name statin I can’t afford? What are the risks, side effects, and benefits of this medication? Why are they talking about cola-colored urine?

If you’re like most people, you have thought of these questions leaving your doctor’s office or pharmacy and might have forgotten to ask. You’re in the right place.

Here’s the scoop on statins:

Statins are drugs that lower what is known as “cholesterol,” which is found in the blood. A simple way of thinking of cholesterol is “blood fat.” To be healthy, you want your blood to flow through arteries and veins without leaving traces of fat behind. If traces of fat are left behind, it can cause the blood vessel to become blocked or obstructed. This increases the chances of heart attack and stroke because blood can no longer move easily through the vessel and a piece of fat can break free.

There are two types of cholesterol: HDL and LDL. HDL is what is known as “good” cholesterol. You can think of “H” for “high” meaning you want HDL to be high for good health. The bad cholesterol is known as LDL. You can think of “L” for “low” meaning you want LDL to be low for good health.

Your doctor probably put you on a statin because your LDL is too high and your HDL is too low, you have other conditions affecting your heart, you have diabetes, you are a smoker, or you have an increased risk of heart attack due to lifestyle factors. A statin can help reduce bad cholesterol levels in the blood, but works best in combination with a healthy diet and exercise.

There are several statins on the market that come as brand and generic medications. The brands tend to be expensive, but are usually interchangeable with the generics. If you have a question about affording your brand name statin medication, you can always ask your pharmacist or doctor about discount cards or alternatives you may be able to switch to.

Some of the most commonly prescribed statins that are approved for use in the U.S. include:

Lipitor (atorvastatin) and rosuvastatin (Crestor) are known as “moderate-intensity” to “high-intensity” statins. This means they are used when a greater decrease in LDL cholesterol is needed to achieve your cholesterol goal. The “low-intensity” to “moderate-intensity” statins are Zocor (simvastatin), Pravachol (pravastatin), Lescol (fluvastatin), and Livalo (pitavastatin). This means they are used when a smaller decrease in LDL cholesterol is needed to achieve your cholesterol goal.

When taking a statin be sure to watch out for:

  • Muscle pain or weakness – This might be a sign of muscle breakdown, which is extremely rare, but serious. Be sure to notify your provider right away!
  • Dark cola-urine – This is also a sign of muscle wasting that appears in the urine when the kidneys filters out the waste. Again, be sure to notify your provider right away!
  • Memory problems – Sometimes memory difficulties arise with statin use. If this happens, your dose may need to be adjusted. Normal memory function will return once a medication change is made.
  • Alcohol – Since alcohol is processed by the liver and so is the statin, this can overwhelm the liver and cause problems.
  • Grapefruit juice– Grapefruit juice is metabolized in the same way as your statin. This can also overwhelm the liver and is best avoided.

Additional Tips:

  • If you use multiple pharmacies, be sure to let your pharmacist known which other drugs you are taking and we can make sure everything is safe to take together.
  • Be sure to have a follow-up appointment with your provider 3 months after beginning the statin to make sure it is working for you.

References:

  1. http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statins/art-20045772
  2. http://www.straighthealthcare.com/cholesterol-treatment-guidelines.html#statin-chart
  3. http://www.webmd.com/drugs/2/drug-6105/simvastatin-oral/details#interactions

 


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scriptsave wellrx pharmacogenomic medication testing

Nancy recently had a heart attack. Her Caridologist, Dr. Trish, wants to look over her medications to make sure there are no problems since her discharge from the hospital. Nancy knows about the importance of seeing her doctor after a hospital stay, and she wants to live for a long time so she can she can watch her rambunctious grandchildren, Kevin, Keith, and Mark, grow up. Her three grandchildren keep her very busy and active, so she wants to be able to keep up with them. While Nancy is in the waiting room, she finds a brochure about pharmacogenomics. Nancy is curious and reads up a little bit more while she waits for her doctor. So what is pharmacogenomics? And how does it involve medications?ScriptSave WellRx - Pharmacogenomics Image

What is Pharmacogenomics?

Pharmacogenomics is a form of personalized medicine where “one size does not fit all.” By using your personal genetic makeup, it may be possible to see how well you respond to a medication and then make adjustments to your medication regimen as needed. Utilizing this method takes out the guess work where prescribers may try multiple medications before finding one that works best for the patient. While this personalized approach to medicine may shape the way physicians prescribe meds, it can also help determine if any medications a person is currently taking could be switched to something more effective. Now physicians can take into consideration the clinical factor of genetics when selecting a medication.

And the best part? The process is quick! A swab of saliva or prick of blood is sent off to a lab where the sample is sequenced and the results are sent to your physician or other health care provider. Your provider interprets these results and determines what medicine might be the best fit for you. The FDA has compiled a list of medications for which there are pharmacogenomic markers. Some medications that are tested include: cancer drugs, HIV medications, heart disease, depression, chronic pain, and many more. A full list of medications can be viewed here: http://www.fda.gov/Drugs/ScienceResearch/ResearchAreas/Pharmacogenetics/ucm083378.htm.

Nancy also struggles with chronic pain, and she wonders if pharmacogenomic testing can help her doctor determine if the medication she uses is right for her. She brings this brochure in to Dr. Trish to further discuss the possibility of getting tested. It could be possible that Nancy may need to change her medication. Codeine undergoes metabolism by the enzyme CYP2D6 and is converted to morphine in the body. Morphine is the substance that relieves the pain a patient experiences. Nancy may have a mutation in her CYP2D6 enzyme that converts codeine rapidly, slowly, or not at all. The use of Phatesting may help in tailor Nancy’s medications so she can get the optimal dose from her pain medication.

The world of pharmacogenomics is a rapidly growing field of medicine today. Genetic testing has become more accessible and less expensive over time which has allowed for more and more patients to get tested. In the coming years, more discoveries will be made with genetic variants which will allow us to see how many more medications may play a role in metabolism.


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ScriptSave WellRx azithromycin zpak photo

Common cold got you down? Are you sneezing and blowing your nose day and night? Are your coworkers and family sick, and now it seems like it’s finally your turn? You might be thinking of going to the clinic for azithromycin (Z-Pak) to cure your ills, but that might not be such a good idea.

Z-Pak Antibiotics – Not for the Common Cold

Azithromycin is an antibiotic, which means it is used to treat bacterial infections only, not viral infections. The majority of colds and coughs are caused by viruses, so taking a Z Pak for cold symptoms won’t work. You could suspect a bacterial infection if a fever recurs after the first few days, in which case a Z-Pak would likely help with resistance to the virus. Cat got your tongue and sore throat is the problem? A clinical throat culture will need to be done to assess the pathogen, which usually presents itself as a viral infection. In this case, rest, warm tea, and/or gargling with warm salt water (which reduces inflammation) can help these symptoms. Also, over-the-counter products can help with the sneezing, runny nose, and cough. Be sure to ask for a recommendation from your pharmacist since certain conditions such as high blood pressure may be affected by over-the-counter medications and cause unwanted interactions.

Compare Your Azithromycin Z-Pak Copay with WellRxIf your cold persists for longer than usual and you end up with green discharge from the nose or severe persistent cough after the cold is gone, then it may be time to see your healthcare provider for further treatment of your condition.

Got that bacterial infection after all and have a Z-Pak in hand? Here are some helpful tips:

  • Z-Paks come as six 250 mg tablets in a package. Take 2 tablets by mouth on the first day and 1 tablet by mouth for each of the following 4 days. Do your best to evenly space the doses every 24 hours for the greatest benefits.
  • As with any antibiotic, common side effects include diarrhea, nausea, stomach pain and vomiting.
  • Tell your doctor or pharmacist if you have a history of liver problems are allergic to any medications, have poor kidney function, or are pregnant or breast feeding.
  • In some cases, this drug may cause a fast or irregular heartbeat. If this happens, contact your healthcare provider immediately.
  • As with any medication, if you forget or lose a dose, take it as soon as you remember and never double up!

References:

  1. https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=2089
  2. http://www.healthline.com/drugs/azithromycin/oral-tablet#Highlights1
  3. http://www.healthline.com/drugs/azithromycin/oral-tablet#Highlights1

It’s cough and flu season.

Need to save money on your
Tussionex or Azithromycin (Z-Pak)
prescription?

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Photo of taking medications correctly

Taking your medications as prescribed on long-term basis requires commitment and organization. Taking your medications as indicated by your doctor is extremely important for your continued health. Medications are given to you in the strength that is best suited to treat your medical condition. Here are some general medication facts to help you take your medications safely and effectively.

Medications are not created equalCompare Your Copay - Taking Your Medications the Right Way

Because medications are processed in our bodies differently, pharmaceutical companies sometimes either coat the pills or distribute active ingredients unequally within each pill. Some medications are available in extended-release formulation to be taking less frequently per day compared to those available in immediate-release formulation. Pill splitting may cause certain medications to not be effective by changing the dose, potency, and/or duration of action. Pill splitting is not right for every medication.

Medication or food interactions

Taking your medications with certain vitamins, minerals, dairy products, and/or antacids can also alter how medication absorbed in our bodies. For instance, eating grapefruit can cause cholesterol medications, like Rosuvastatin Calcium (Crestor), to build up in our body. Some herbal products may affect how medication metabolized in our bodies, resulting in higher or lower concentration than prescribed by our doctor. Taking medications as scheduled and as prescribed will improve your overall outcome. Pharmacists can be used for advice on how to take medications, what side effects are normal and possible how to limit some side effects.

Follow the schedule

Not taking medications as scheduled can affect your health outcome and cause side effects. Stopping medications without speaking to your doctor may cause issues as well. Some medications are associated with harmful consequences if suddenly stopped after long-term continuous use. For example, prednisone mimics a natural hormone in our bodies and need to be tapered down to give our bodies enough time to reproduce our natural hormone at the right level. If you take an anti-depressant, like Duloxetine Hcl (Cymbalta), not taking it as scheduled can cause a prickly or tingling sensation on the skin.

Your doctor has a history of what he/ she has put you on, and they need to know if you have stopped anything. Keep follow-up appointments and bring all your medications bottles to all your appointments. If you see more than one doctor, each one needs to know any medication changes to current list to avoid drug duplication and/ or drug-drug interaction. If you have questions, be sure to talk to your doctor or pharmacist.


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A healthy diet can help you have a healthy heart

Heart disease is one of the leading causes of death in men and women in the United States. Heart disease can affect anyone, no matter your age, race or ethnicity. There are many risk factors that contribute to heart disease. Some of these factors include high blood pressure, high LDL (or “bad”) cholesterol, low HDL (“good”) cholesterol, lack of physical activity, being overweight or obese and smoking. You can make changes to improve your heart health.

There are many things a person can do to improve heart health and to decrease heart disease. Some of these include following a heart healthy diet, exercise, maintaining a healthy weight, avoiding excessive alcohol use and not smoking. Knowing your family health history and discussing blood pressure goals regularly with your doctor can help avoid risks for heart disease as well.

Heart Healthy Diet

Compare Your Heart Medication Copay and Improve Your Heart HealthFollowing a heart healthy diet can help decrease your risk for heart disease. Always follow the type of diet and calorie intake your doctor recommends. Heart healthy diets usually include fat-free or low fat dairy products, fruits, vegetables, legumes and whole grains. It is also recommended to eat fish high in omega-3 fatty acids, such as trout, tuna and salmon at least twice weekly. When following a heart healthy diet, it is recommended to avoid too much red meat, palm and coconut oils and sugary foods and drinks. You should also limit your sodium intake. For more information about heart healthy diets including recipes, please visit The American Heart Association’s (AHA) Healthy Eating page.

Exercise

Exercising can help improve your heart health, and is one of the best ways to lower your cholesterol, too. The AHA recommends at least 30 minutes of moderate-intensity aerobic activity at least five days weekly for a total of 150 hours per week. Aerobic exercise is an exercise that makes you use more oxygen than usual and it will stimulate your heart to beat faster. These exercises can include brisk walking, swimming, cycling or even dancing. Aim for and maintain a healthy weight, not only to help with decreasing your risk for heart disease, but to help with your overall health. Remember to speak with your doctor before starting any diet and/or exercise program. Your doctor can help determine if you may need a statin, a common class of cholesterol lowering medications.

Limit Alcohol Use

To help improve your heart health, it is recommended to limit your alcohol intake. Too much alcohol may lead to high blood pressure and put you at risk for other heart related diseases. An alcoholic drink is defined as one 12 ounce beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits. Recommendations for alcohol use include no more than 1 drink per day for women and no more than 2 drinks per day for men.

Stop Smoking

Quitting smoking today and avoiding second hand smoke is important to improve your heart health. Smoking can raise your heart disease risk considerably and smoking can lead to heart attacks as well as strokes. Smoking not only affects your heart, but it also affects other organs in your body including your lungs, bladder, digestive organs and even your bones. If a person who smokes already has existing heart disease, that person is at a much higher risk for heart related health problems. It is important to quit smoking and to stay quit! Staying quit will also help improve overall health. For more information about smoking cessation programs, visit smokefree.gov or you can call the National Quit Smoking Hotline at 1-800-QUIT-NOW (1-800-784-8669). Speak to your doctor about smoking cessation programs and/or products, like nicotine patches, that can help you stop smoking.

Reference:
http://www.cdc.gov/heartdisease/healthy_living.htm
http://www.heart.org/HEARTORG/
http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment#HeartHealthyEating


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