Emergency Preparedness - medications, ScriptSave WellRx

by Leah Samera
University of Arizona College of Pharmacy
PharmD Candidate, Class of 2018

Ready, a public service campaign designed to educate and empower citizens to prepare for emergencies such as natural and man-made disasters, proclaims September to be National Preparedness Month (NPM). In the aftermath of Hurricane Harvey and in anticipation of Hurricane Irma, you may be wondering how to go about preparing for such events. This is especially important to consider if you have a chronic disease or condition.

Illness Follows Disaster

Studies have found that upwards of 70% of the Hurricane Katrina survivors had at least one chronic condition. Additionally, 58% of the visits to emergency treatment facilities in New Orleans after Hurricane Katrina were due to illness, 24% of which were associated with chronic diseases. The research on disasters’ effects on chronically ill patients only serves to reinforce the fact that these emergency situations can lead to both exacerbation and death from chronic illnesses due to direct stress of the disaster, interruption of care, or both.

Emergency Plans and Kits

Organizations like the American Red Cross recommend having an emergency plan and kit prepared for use during a disaster. Some obvious items that should be included in such a kit are water, food, and first aid supplies. However, it is also critical that you have a 7-day supply of your medications on hand as well as any other tools or devices used for your health such as hearing aids with extra batteries, syringes, blood pressure cuffs, et cetera. In order to have at least a 7-day supply of your medications, you must order refills of your prescription medications as soon as you are able rather than before you run out. It is best to keep these items together and in a location that is easy to get to in an emergency.

Planning Ahead

Medications should be stored away from heat, light, and moisture; if possible, keep them in their original bottles and store the bottles in a waterproof bag or container. If you have medications such as insulin that need refrigeration, have a freezer pack and cooler available. It is also important to stay up-to-date on all immunizations, including tetanus, especially if you have diabetes. Additionally, because the stress of these disasters can exacerbate your conditions, it is best to also make appropriate lifestyle changes such as restricting salt intake if you have high blood pressure or learning the carbohydrate counting approach if you have diabetes.

Other Handy Emergency Items

Other items that you should have handy in case of an emergency include any over-the-counter medications you may need like pain relievers, as well as your medication list and insurance card. It is important to keep an up-to-date medication list that not only catalogs the names of your current medications but also their strengths, indications, directions, and prescribers; any bad or allergic reactions you may have had to medications in the past should also be documented. Your prescription benefit card may be needed for approval of an emergency supply if you run out of or lose your medications, or if your medications get damaged or contaminated.

In the event that you end up requiring medications and health resources:

  • RxOpen.org maps open and closed pharmacies, American Red Cross shelters, and infusion centers in areas affected by disasters.
  • The charity Direct Relief provides free prescription drugs and medical supplies to low-income patients at community health centers or clinics.
  • Keep a list of nearby pharmacies and hospitals as well as their phone numbers.

By doing what you can to prepare for disasters, you can lower your risk of exacerbations of your health conditions. As the theme for NPM states: “Disasters Don’t Plan Ahead. You Can.”

References:

  • National Preparedness Month. https://www.ready.gov/september. Accessed September 7, 2017.
  • Kessler RC, Hurricane Katrina Community Advisory Group Hurricane Katrina’s impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007;22(9):1225–1230. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219784. Accessed September 8, 2017.
  • Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2(1):27–32. https://www.ncbi.nlm.nih.gov/pubmed/18388655. Accessed September 8, 2017.
  • Be Prepared for an Emergency. Be Red Cross Ready! http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit. Accessed September 7, 2017.
  • Emergency Preparedness for Prescription Medications. http://www.mayo.edu/pmts/mc6000-mc6099/mc6012-39.pdf. Published 2016. Accessed September 7, 2017.

Are you concerned Hurricane Irma
may impact your prescription refills?
The State Law may be on your side; early refills are permissible.

For medications not covered by insurance,
the ScriptSave® WellRx program is here to help.

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save money on prescriptions

wabc prescription savings storyby Nina Peneda

We price compare for everything from shoes to SUV’s. So why not for medicine? Especially for those uninsured, there are way to save thousands a year. Shrinking your pill bill may start with a few clicks. ScriptSave WellRx compared the generic form of the cholesterol drug, Crestor (rosuvastatin calcium), across the tri-state area.

It could cost you as much as $105.77 for a 10mg month’s supply but according to SciptSave WellRx, using it’s service and savings card, you could price shop that cash, no insurance price down to $16.70. A savings of $89.07.

Be a Smart Healthcare Consumer

“It just pays to be a smart consumer, even in healthcare, you need to be a healthcare consumer, instead of a healthcare patient,” said Shawn Ohri, of ScriptSave WellRx.

Big box stores, groceries and drug stores all offer membership clubs and discount cards to save on the sky-rocketing cost of medicine.

Free memberships in online services like ScriptSave WellRx, websites that provide coupons and negotiate discounts with pharmacies, allow your fingers to do the walking before you do the running around.

“There are many cases where we can actually beat your insurance co-pay, or if you’re in a high deductible health plan there are many cases where our price may be lower,” Ohri said.

For example, according to ScriptSave WellRx, in the low-income areas of the Bronx, the generic version of the popular sleep aid, Lunesta, for someone with no insurance can cost six times more at one store than at a pharmacy less than a mile away.

At Us Pharmacy lab in Northvale, New Jersey, Pharmacist David Yoon feels the comparison services are a good starting point for consumers looking to save.

“It’s not 100-percent accurate, but it gives you a ball park figure who’s cheapest in your neighborhood,” Yoon said.

Ohri suggests always calling the pharmacy to get an updated actual price. And, most importantly, steer clear of expensive name brand medication if it’s okay with your doctor to use the generic form.

“The price difference is astronomical. Sometimes the brand names can cost 50 to 100 times more, especially in the cases where you don’t have insurance,” Yoon said.

Pharmacists also recommend no matter where you are filling your scripts, consider the relationship with the provider and the safety which comes with having all your records on file.

The big takeaway: There are other ways to save. Ask your pharmacy what the cash or retail price of your prescription is it just might beat your insurance price. Price match. If you see a lower price somewhere else, ask your pharmacy to match or beat it. If they want to keep your business they will. And ask your doctor about an assistance program. If you qualify, you could get the prescription for free.

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Zollinger-Ellison syndrome - stomach image

by Derek Matlock, PharmD

What is Zollinger-Ellison Syndrome?

Do you suffer from Zollinger-Ellison syndrome (ZES)? If so, you may be in rare company. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Zollinger-Ellison syndrome is a rare disorder. It occurs in about one in every 1 million people. Normally, when we eat, our body releases a hormone called gastrin, which tells your stomach to make acid to help break down foods and liquids. For patients with ZES, this mechanism is disrupted by tumors or “gastrinomas.” These tumors form in the pancreas or upper small intestine and secrete abnormally large amounts of gastrin from tumors, resulting in peptic ulcers to be formed.

It Might Be Your Genes

Some people with Zollinger-Ellison syndrome may go undiagnosed as the disorder is rare and its cause is not clear. In 75% of cases, ZES is sporadic or random, whereas in 25% it is associated with MEN 1, an inherited condition characterized by pancreatic endocrine tumors, pituitary tumors, and hyperparathyroidism.  Therefore, your doctor may perform a thorough medical and family history to help diagnose ZES. Additional tests may include endoscopy or various imaging and blood tests. They may even measure the amount of acid in your stomach. For patients with sporadic ZES, the most common symptom is abdominal pain. While patients with the inherited form of ZES mostly complain of diarrhea. Other symptoms include, heartburn, nausea, vomiting, stomach bleeding, and weight loss.

Managing Zollinger-Ellison Syndrome

Currently, the goal of managing ZES is to limit complications of the disorder by suppressing acid secretions. Thus, the main medications used in ZES are proton pump inhibitors, or PPIs, like omeprazole (Prilosec®) or pantoprazole (Protonix®), prescribed at high doses. For patients who do not respond to treatment with PPIs, octreotide is used, which stops the secretion of gastrin, the hormone that tells our body to secrete acid for food breakdown. Currently, the only cure for ZES is surgical removal of the tumor or tumors, but this may not be an option in cases where the tumors have spread to other parts of the body. In that case, chemotherapy with medications like streptozotocin, 5-fluorouracil, and doxorubicin are used to shrink tumors.

Zollinger-Ellison syndrome is a rare disorder that may be suspected in patients with multiple or repeat peptic ulcers. Currently, medications like proton pump inhibitors are the main treatment option, while surgery and chemotherapy are options in certain patients. Remember, when taking proton pump inhibitors, they are best taken 30-60 minutes before a meal and may also come with their own unfavorable side effects. Be sure to talk to your doctor or pharmacist about what can be done to best optimize your treatment options for ZES.

Resources:

  1. Medscape: Zollinger-Ellison Syndrome
  2. National Institute of Diabetes and Digestive and Kidney Diseases: Zollinger-Ellison Syndrome
  3. UpToDate: Management and Prognosis of the Zollinger-Ellison Syndrome

For the best prescription savings
on medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

 

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Doctor speaking to patient about medications

TUCSON, AZ–(Marketwired – Aug 9, 2017) – VUCA Health announced today that ScriptSave, a provider of prescription savings solutions and decision support tools helping close the gaps in prescription coverage, will employ its on-demand medication video library to improve medication information and drive better care outcomes for ScriptSave WellRx members.

ScriptSave’s prescription savings program, along with VUCA’s innovative video service, will work together to increase prescription medication adherence by providing patient education in an easy to consume format, thus improving care while enhancing and simplifying the member experience.

Improving Medication Adherence

“It is well documented that two of the key pillars for medication adherence are providing access to affordable medications and the information they need to feel empowered about taking them,” said Shawn Ohri, Vice President, Business Development, ScriptSave. “By implementing VUCA’s on-demand video library, our members can receive accurate health information, in a format that is easy to understand and accessible anytime, anywhere.”

In partnering with VUCA, ScriptSave WellRx members will have access to a robust library of prescription-specific video briefings that deliver information on top-prescribed medications, including proper usage, expected benefits and potential side effects. The videos, available in English and Spanish, are integrated into the ScriptSave WellRx mobile app and website.

“VUCA’s innovative visual education paired with the latest advances in technology is helping individuals across the United States understand how to practice safe administration of their prescription medication,” said VUCA Health CEO David Medvedeff, PharmD, MBA. “By coupling this service with applications like ScriptSave WellRx, members can instantly access their medication information and leverage valuable resources to enhance their overall medication experience.”

About ScriptSave

For more than two decades, ScriptSave has been closing the gaps in healthcare and prescription coverage with innovative savings programs, like ScriptSave WellRx, for the uninsured, under-insured, and insured. Pharmacies, employers, health plans, and other organizations across the nation rely on ScriptSave to deliver prescription savings to their members and customers — yielding $1.3 billion in consumer savings in 2016 alone.

ScriptSave WellRx is recognized and approved by the National Association of Boards of Pharmacy® (NABP®). Our pharmacy recognition lets consumers know that ScriptSave WellRx meets standards set by a global coalition that includes International Pharmaceutical Federation (FIP) and NABP, which has supported the United States boards of pharmacy in their goal of protecting the public health since 1904.

ScriptSave is a member of the MedImpact, Inc. family of companies. For more information, visit www.wellrx.com. Follow us: @SSWellRx (Twitter), Scriptsavewellrx (Facebook).

About VUCA Health

Based in Lake Mary, Fla., VUCA Health (www.vucahealth.com) provides a gateway to patient engagement that serves as an on-demand extension of pharmacists and other healthcare providers. The company’s MedsOnCue solution leverages advanced mobile, web and on-demand video and communication technologies to deliver trusted patient information that enhances the medication use process. It offers a convenient and cost-effective way for clients to provide on-demand patient medication information and strengthen customer connections with video briefings, web messaging, reminders and alerts and a host of other customizable services that extend and enhance the patient relationship.

Contact Information

You can find the original press release here.


For the best prescription savings
on medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

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Behavioral health medications for anxiety or depression - image

Jenny Bingham, PharmD
University of Arizona College of Pharmacy

There are a number of mental conditions that shape mood and behavior. Any condition that affects a person’s thinking, feeling or mood, falls into a medical classification of Behavioral Health.  Such conditions may affect someone’s ability to relate to others, or maintain reasonable function every day. Each person may have different experiences, even if they have the same diagnosis as someone else.

Depression is the most common behavioral health condition in the general population1. Without treatment, depression can lead to decreased quality of life2, increased suicidal thoughts, and overall worsened health outcomes. The most common method of treating depression is to target serotonin and how the body uses it.  Serotonin regulates mood and ultimately is what makes you feel happy. When we have low serotonin levels, you can feel depressed or anxious. Antidepressants each have their own unique mechanism of action that are specific to certain neurotransmitters in the brain.

Anxiety can affect our ability to function due to excessive worry. Without treatment, anxiety can also lead to a worsened quality of life and can even be debilitating for some patients3. Anxiolytics are the medication class used to treat anxiety. The most common method of treating anxiety is to target serotonin and/or norepinephrine.  Norepinephrine is responsible for motor action, cognition, the body’s alert system, and feeling energetic.  When we have low norepinephrine, it is harder to cope with every day stressors and things that are beyond our control.

How do these medications work?  

These medications are often classified as reuptake inhibitors. They target the neurotransmitters serotonin and norepinephrine, to name a few.  Medications prevent the body from recycling these neurotransmitters. By preventing them from being recycled too soon, it allows the body a better chance to use them to improve mood and/or relieve anxiety.

What can you do to make them work better for you?

We know that the body needs certain building blocks to make serotonin and norepinephrine. An important concept to remember is that no matter how many medications are prescribes to treat these conditions, they don’t stand a chance at being effective without the right precursors; an interesting concept in today’s world. The majority with these conditions take more than one medication.

Step 1: What is your protein source?

The greatest building blocks for serotonin are things that you might already have in your kitchen.

Complete proteins are the main precursor for tryptophan, which is later turned into serotonin. You might think that tryptophan only comes from turkey on Thanksgiving, but did you know that you can also get it from eating beef, venison, buffalo, pork, fish, shellfish, cheese, cottage cheese, milk, yogurt, and eggs? 

The building blocks for norepinephrine are also found in your kitchen.

In addition to eating complete proteins, it’s also important to eat incomplete proteins as well. You can find these in nuts, grains, beans, legumes, and soy.

Step 2: What else is included on your meal plan?

When we think about serotonin building blocks, key vitamins play an important role as well.

  • Vitamin B6. Great nutritional sources of this vitamin are found in whole grains, vegetables, and nuts.
  • Vitamin B12. This vitamin is found in meats, fish, liver, and milk.
  • Folic acid and Vitamin D3 are often found in fortified foods.
  • Omega-3 Fatty Acids are found in fish, dairy, and grains.

Step 3: Don’t forget about your supplements and vitamins.

Over-the-counter supplements can help you fulfill your dietary need of the vitamins mentioned above. But, there is a caveat.  Did you know that you can actually take “too much” of a vitamin? When in doubt always review your supplements and medications with your pharmacist for safe use.

As a patient, take comfort knowing that you can control how well your medications work for you. You are the rate limiting factor in the equation. These simple modifications can make a world of difference with managing depression and anxiety. After all, the best investment you’ll ever make is in yourself.

References:

  1. Kessler RC, Ormel J, Petukhova M, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 2011; 68:90.
  2. Daly EJ, Trivedi MH, Wisniewski SR, et al. Health-related quality of life in depression: a STAR*D report. Ann Clin Psychiatry 2010; 22:43. 
  3. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62:617.

For the best Rx price on prescription
depression or anxiety medications,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

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percent opting out of healthcare graph If you’re a ScriptSave® WellRx member, you probably know only too well what it means to face high out-of-pocket costs for prescription medications. We hear this message from members every day and so it didn’t come as a huge surprise when we read details from a Bankrate.com survey.

One quarter of surveyed Americans report that they, or someone in their family, have skipped vital medical care because of the cost. The Bankrate Money Plus Survey also revealed that more than half of those who responded worry about not being able to afford health insurance.

Health Care Anxiety

The survey findings come at a time of rising healthcare costs and huge increases in some health insurance premiums, while increasing insurance deductibles further weigh on the issue. In the survey, 56% say they’re either very or somewhat worried that they might not be able to afford health coverage in the future.

percent concerned about healthcare coverage graph

High-deductible Dilemma – An Expensive Healthcare Punt

High-deductible plans and HSAs (Health Savings Accounts) have been central in the healthcare debate. Such plans hype lower monthly premiums, as compared to traditional insurance. For many, this ends up being little more than an expensive punt (what gets ‘saved’ in premium costs comes back to bite many patients in the form of much higher out-of-pocket expenses when they submit a claim to their insurance provider).

In 2016 the average annual premium for employer-sponsored health insurance was $6,800 for single coverage in a preferred provider organization (PPO), according to data from the Kaiser Family Foundation (KFF).

By comparison, the average annual premium for a high-deductible health plan available through an employer was somewhat more affordable. KFF found that to be $5,762. The trade-off for the lower premium is that the consumer is responsible for saving the necessary amount of money needed to meet a higher deductible in the event of illness or requiring medical attention. In theory, under a high-deductible plan, employees can use a tax-advantaged HSA to cover qualified medical costs so these premium savings can be deferred, tax free, in order to meet future medical expenses. However, for many, this simply does not happen.

Saving Where You Can

No matter how the debate on healthcare reform ends up playing out, here are some things a savvy patient might wish to think about now to make the most of their existing insurance benefits:

  • Get an annual checkup: Finding out if you have early underlying health issues earlier in the year and treating them, brings you closer to meeting your deductible before year-end.
  • Consider low-cost health care alternatives: See if your insurance plan grants access to telehealth services. These online virtual doctor visits can be an inexpensive (and faster!) alternative to many minor medical conditions.
  • Know your network: While your Primary Care Provider may be in-network, many specialty physicians and services may not be. You’ll be paying more for care from out-of-network services, and what you pay may not go toward your annual deductible. 
  • Get a free ScriptSave WellRx prescription savings card (or mobile app): For those facing high out-of-pocket costs for prescription drugs, be it due to a gap in insurance or high insurance copays/deductibles, a free download of the ScriptSave WellRx prescription savings card might help. As a patient, the card (or mobile app) won’t cost a penny to use. If it helps, great—enjoy the benefit of a lower-cost medication. If not, then it didn’t cost anything to try. That said, this savings program did yield an average savings rate is 45% (with savings up to 80%*) in 2016, and the ScriptSave WellRx program is contracted with over 62,000 pharmacies, nationwide. You might be surprised to find out you’re eligible for low-cost prescriptions with your ScriptSave WellRx card.

References:

http://www.cnbc.com/2017/06/07/heres-why-a-quarter-of-american-families-are-skipping-their-doctor-visits.html

http://www.bankrate.com/banking/savings/money-pulse-0617/ 


For the best Rx price on medications,
www.WellRx.com.

Compare prescription drug prices at more than
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transitions of care home health image

“It all started with pain radiating down my left arm. It was hard to breathe and I was short of breath. I knew something was wrong and called 911. I was rushed to the hospital. I remember the sirens, but they slowly faded away. Then I woke up. There was a man in a white coat telling me that I’d had a heart attack. He handed me some medicine bottles and prescriptions. Before you know it, I was discharged and on my way home.”

This was how Nancy described her heart attack. After several days in the hospital,  Nancy was discharged home, and now has to take four new medications every day. That can add up to a lot of out-of-pocket expense.

This scenario happens all too often, and through an unfortunate set of events, Nancy was re-admitted into the hospital just three weeks later.

Moving Through the Healthcare System

Transition of Care (TOC) is the movement of a patient from one setting of care (hospital, ambulatory primary care practice, ambulatory specialty care practice, long-term care, home health, rehabilitation facility) to another.1 This definition by The Centers for Medicare & Medicaid Services (CMS) describes the process of a patient navigating the health care system and the unfortunate, but common reality that gaps in care develop between the hospital and outpatient setting.

A Growing Healthcare Need

This area of healthcare is expanding and becoming more important to help reduce readmission rates and the cost of healthcare. Pharmacists are expanding their roles by providing TOC services to patients newly diagnosed with specific conditions and/or a flare-up of a chronic condition or disease. Quite often will a patient’s medication therapy change upon admittance to a hospital and then at discharge from the hospital. They may be prescribed new medications after a hospital stay. The goal is to ensure the continuity of care for patient and help fill the gap, by:

  • Providing education about a condition
  • Monitoring a condition
  • Helping patients understand their medication.

Why Transition of Care Matters

Helping patients understand their prescription medications allows them to get the most benefit from them, and, to understand why it is important to take their medications as prescribed. Helping patients save on prescription medication costs is what ScriptSave WellRx does.

It is not just pharmacists that are expanding into this role, but other health care professionals like nurses, doctors, and case managers, too. It takes a care team effort and patient-centric approach to ensure that each patient is getting the best, high-quality care available.

 

References:

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/8_Transition_of_Care_Summary.pdf


For the best Rx price on statins and other medications,
visit www.WellRx.com.

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prescription savings pill-splitting - wellrx

by Hayde Blanco, PharmD Candidate
University of Arizona College of Pharmacy

Pill splitting refers to breaking a pill down to obtain a smaller amount of the whole pill. Your doctor can write a prescription that is usually double the dosage of what you should take in one day. You can then cut the pill in half, making the smaller dose that should actually be taken. For instance, a medication might be prescribed for 40 mg, but then the pill is split so you actually end up taking 20 mg.

Why Split Pills?

Pill splitting can be a huge help in cost savings if the same amount of the larger and smaller doses are sold at a similar price. Some of the most common reasons for pill splitting are:

  • Reduce the costs associated with a medication
  • Take a dosage of a drug that is not already available.

These methods can be useful to help some people save on their prescription medications, but are not suitable for everyone or for every type of pill. There are some risk factors that should be taken into consideration before splitting any pills.

Pill Splitting Concerns

When a pill is split, there may be different amounts in each half of the pill. Since the active ingredient in each pill is not usually evenly distributed throughout the pill, this may lead to one half containing more of the active ingredient than the other, giving it more potency. Some pills may be hard to split due to having an unusual shape, being too hard, or crumbling easily. There are also some medications that should never be split.

Pharmaceutical companies create some pills that are scored, meaning that they have a line down the middle to make it easier to split.

pill splitting sertaline
This pill is generic sertraline 100mg (an antidepressant) with a line down the middle. Generic pricing for 30 tablets of 100mg averages about $11.50. Generic pricing for 30 tablets of 50mg averages about $10.00. By cutting the 100mg dose in half, you would save close to half of the cost.

Some of the risk of pill splitting is related to the individual, instead of being related to the pill. A common issue is forgetting to split a pill, which could lead to taking double the amount of the prescribed dose. The directions might also be unclear if the bottle says to take one daily, but your doctor says to take one-half daily. You should always verify with your doctor if you are not sure about the prescription dosage you should be taking.

​Although there are risks involved with pill spitting, it can be an appropriate cost saving technique for some people. If pills are being split, there are some recommendations that should be followed to reduce the risks.

What are the Risks?

Some of the risk can be related to the individual instead of being related to the pill. A common issue is forgetting to split a pill, which could lead to taking twice or more of the needed dose. The directions might also be unclear if the bottle says to take one daily, but your doctor says to take one-half daily. Always verify with your doctor if you are not sure how much you should be taking.

​Although there are risks involved with pill spitting it can be an appropriate cost saving technique for some people. If pills are being split, there are some recommendations that should be followed to reduce the risks.

Splitting Pills Safely

  1. Always discuss your choices with a pharmacist or doctor before deciding to split a pill.
  2. Have a general understanding of which pills are appropriate to split and which are not.
  3. Use an appropriate pill cutter. Using a pill cutter instead of a knife or other object cuts the pill more evenly and leads to better distribution of the active ingredient.
  4. Cut the pills right before taking them instead of cutting them all at the same time. Since the distribution of the active ingredient is often not the same on both sides, taking both halves on consecutive days allows for a more even intake of the active ingredient. Additionally, a medication might not be as effective at treating your symptoms when it is broken down and exposed to air and moisture over time.
  5. Make sure you are can put this into practice safely or have someone help you if you can’t. If you have any problems with memory, trouble using your hands, or do not think you would be able to split the pills on an ongoing basis this will not be an appropriate technique to use.

These medications are usually appropriate to split, but always check with your pharmacist or doctor if it is okay to split your medication:

  • High blood pressure medications
  • High cholesterol medications (statins, like Lipitor, Crestor, or Zocor)
  • Depression medications.

These pills should not be split:

  • Capsules
  • Enteric-coated medications
  • Extended release or long acting medications
  • Combination pills containing more than one drug
  • Prepackaged pills, like birth control
  • Certain classes of medications, such as chemotherapy drugs
  • Pills with a small therapeutic index (these pills need to be taken at a very precise dose because they can lead to side effects more easily if more than the prescribed dose is taken or they might not be as effective if too little is taken).

Always remember to talk to your healthcare provider to be sure it’s appropriate for you to split a certain pill before using this cost saving technique. When done correctly, pill splitting can be a safe and effective method to reduce prescription medication costs.

 

References:

https://www.linkedin.com/pulse/tablet-splitting-risky-practice-stuart-silverman

http://www.consumerreports.org/drugs/is-it-safe-to-split-pills-in-half/

http://www.consumerreports.org/drugs/get-the-right-pill-splitter-and-save-money-on-your-medication/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827917/


For the best Rx price on statins and other medications,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

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ScriptSave WellRx - Statins and Liver Damage

by: James Ketterer, PharmD Candidate
University of Arizona College of Pharmacy

If your doctor has said you have high cholesterol, it’s likely that you’ve heard or read about about the potential side effects of statin drugs and their impact on liver.

Doctors often prescribe statins for people with high cholesterol levels to lower their total cholesterol and reduce their risk of a heart attack or stroke. While statins are highly effective, they have been linked to muscle pain, digestive problems and mental fuzziness in some people and may rarely cause liver damage.

Cholesterol and triglycerides are lipids (fats) that are stored in the body and serve as a source of energy. Lipids, together with proteins and carbohydrates, are the main components of living cells. When lipid levels in the bloodstream are too high or low, this condition is called dyslipidemia. The most common types of dyslipidemia are:

  • High levels of low-density lipoprotein (LDL or “bad”) cholesterol
  • Low levels of high-density lipoprotein (HDL or “good”) cholesterol
  • High levels of triglycerides

You may have heard stories of people who have experienced devastating liver damage from their use of drugs like atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor). Less than 3% of patients on statins report muscle pain while less than 0.5% report rhabdomyolysis (A breakdown of muscle tissue that releases a damaging protein into the blood).

Recently, the risk of statin-induced liver injury has become a hot topic, since this class of drugs is metabolized by enzymes in the liver. Liver injury has a broad definition, but generally includes, at minimum, highly elevated liver enzymes which are directly correlated with liver function and often a precursor to various liver diseases.

Statin Studies

While studies on the safety of these drugs have included thousands of patients, it’s difficult to determine if something like liver injury is one of the side effects of statin drugs, or happening for some other reason. Drug-induced side effects are more commonly identified after a drug hits the market and patients and physicians begin reporting problem cases to the drug manufacturers.

There have been a few studies around the world that have looked at drug-induced liver injury. A study in Iceland identified 96 patients with drug-induced liver injury. Three of those 96 were due to statins (1 with simvastatin and 2 with atorvastatin). During the trial, over 27,000 people were treated with simvastatin and over 7,000 with atorvastatin. That means that 1 out of 27,000 people on simvastatin and 1 out of 3,500 people on atorvastatin had drug-induced liver injury in Iceland over that 2 year period. Of all statins, simvastatin and atorvastatin are responsible for most reported incidents of liver damage, but this is likely just due to the fact that they are prescribed the most.

The Spanish Hepatotoxicity Registry identified 858 cases of drug-induce liver injury. Of those cases they attributed 47 (5.5%) of them to statin use. The total number of patients on statins was not available.

One of the latest studies from the USA ran from 2004 to 2014, examining drug-induced liver injury identified 1188 cases. They determined that about 2% could be contributed to statin use.

A Swedish study compared the reported statin-induced liver injuries to the total number of statin users (based on sales) and found that 1.2 people experience liver injury due to statins per 100,000 users of statins.

A Rare Occurrence

Outside of these large studies, there have been case reports of patients experiencing liver injury following an increase in dosage of their statins. These are few and far between, and are corrected by decreasing or discontinuing the medication. Some of these patients have been restarted on statins and experienced the same liver problems, confirming the drug as the cause. People that experience statin induced liver injury have a generally positive prognosis. These injuries are usually short-term and reversible. One study of interest that looked at 298 patients whom had experienced drug-induced liver injury and found that only 7 of them had any signs of liver problems one year later.

While there’s a lot of information on the safety of statins in the media, the truth is that side effects of statin drugs, including livery injury, are very rare. That’s not to say that they don’t occur, but rather that the benefits in patients with cardiovascular risk, even those with underlying liver problems, substantially outweigh the potential risks.

 

References

Björnsson, Einar S. “Hepatotoxicity Of Statins And Other Lipid-Lowering Agents”. Medscape. N.p., 2017. Web. 9 Mar. 2017.

Simvastatin.  Micromedex Solutions.  Truven Health Analytics, Inc. Ann Arbor, MI.  Available at: http://www.micromedexsolutions.com.  Accessed March 2, 2017.

 

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generic aspirin tablets

by: Rick Lasica, BS
University of Arizona College of Pharmacy PharmD Candidate, Class of 2017

Many people take aspirin occasionally to provide relief from various conditions (e.g. pain, inflammation, fever, headaches), but what about taking a low-dose aspirin every day for prevention reasons? As with all medications, aspirin poses various benefits and risks that need to be taken into consideration before you start taking it. Studies have shown that certain individuals would benefit the most from taking a low-dose aspirin and others shouldn’t take it at all.

Why Take Low Dose Aspirin?

Our bodies make cells called platelets, which help stop us from bleeding uncontrollably. In order to stop this unnecessary bleeding, a blood clot is formed. In this case, the blood clot is beneficial, but sometimes blood clots are formed when they aren’t needed, which have the potential to lead to a heart attack or stroke. Aspirin is a non-steroidal anti-inflammatory drug (NSAID) commonly referred to as a “blood thinner” because it stops platelets from working together to form a blood clot.

Even though aspirin has many potential benefits, it also has many side effects, some serious, that might occur. Most importantly, it can increase your risk of bleeding, both inside and outside of your body. This might be noticed through your gums bleeding while brushing your teeth, any unexplained bruising on your body, or black/tarry stools. Other side effects that might occur are ringing in the ears, nausea/vomiting, dizziness, or yellowing of the eyes/skin.

The United States Preventive Services Task Force (USPSTF) recommends that people aged 50-59 years with an increased risk of heart problems who have never had a heart attack or stroke in the past would likely benefit from taking a daily low-dose aspirin in order to help reduce the chance of one from happening. Also, people who have had a heart attack or stroke are at an increased risk of having another one, and would likely benefit from it as well.

However, you should never start taking aspirin, or any medication, before talking with your physician or pharmacist about it. They will make an assessment of your condition and weigh the benefits and risks of you taking it and make the ultimate decision of whether or not you should take it as part of your daily regimen. Certain people should not take aspirin if they have had any serious bleeding events, are on certain medications, have a high fall risk, or have specific medical conditions. So, next time you interact with your doctor or pharmacist, ask them if they think it is appropriate for you to take a daily low-dose aspirin.

References:

  1. United States Preventive Services Task Force Recommendations on Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer
  2. WebMD: Aspirin
  3. FDA: Safe Daily Use of Aspirin

 

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who can help with non-emergency prescription questions
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