Is coronavirus contagious - image

While the number of illnesses and deaths from influenza remains high, there is news that the fast-spreading Wuhan Coronavirus is hitting the U.S. On January 21, 2020, the first U.S.-based case of the coronavirus was reported.

What is a coronavirus?

Both influenza and coronavirus are contagious viral respiratory infections. Coronaviruses are widespread and include both severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), which have had worldwide impacts in past years. In addition to being passed from person-to-person, coronaviruses can also be contracted from infected animals.

What are symptoms of coronavirus?

Currently reported symptoms of coronaviruses include:

  • Mild to severe respiratory illness
  • Fever
  • Cough
  • Difficulty breathing

How can I protect myself from the coronavirus?

There is not currently a vaccine to protect against the coronavirus. As with influenza, there are a number of precautions you can take to reduce your chances of getting sick from the coronavirus.

  • Avoid touching your eyes, nose, and mouth with unwashed hands
  • Wash your hands frequently with soap and water for at least 20 seconds
  • Use alcohol-based hand sanitizers whenever soap and water aren’t handy
  • Avoid close contact with anyone you think may be sick.
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What if I think I have coronavirus?

If you think you might be sick or coming down with an illness:

  • Stay home except to seek medical attention
  • If you have a face mask, wear it
  • Don’t share drinking glasses, dishes, cups, food, or towels with other people in your home
  • Cover your mouth with a tissue if you sneeze or cough, then throw away the tissue
  • Use sanitizers to frequently clean anything you touch
  • If you go to a doctor’s office or emergency room, call ahead to tell them about any recent travel that may have taken you to areas impacted by the virus and your symptoms.

Taking these precautions can help lessen the chances that you’ll pass the illness on to someone else. If you’re not sick, it’s not too late to get a flu vaccine. While it won’t protect against the coronavirus, Dr. William Schaffner, medical director for the National Foundation for Infectious Diseases, states that it looks like a second wave of flu may be spreading across the U.S.

References:

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.cdc.gov/flu/weekly/index.htm

https://www.cdc.gov/coronavirus/

https://abcnews.go.com/Health/1300-people-died-flu-year/story?id=67754182



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Going to the doctor’s office for your medication can be an inconvenience, especially if you just need a prescription for a minor illness or condition. You may be wondering if you can get a prescription without consulting with a doctor. The answer is no – you must see a doctor to get a prescription. However, that doesn’t always mean that you have to make a trip to the doctor’s office.

Obtaining a Prescription Through Telemedicine

You may have heard of an emerging field called telehealth, which uses technology to provide health services. Telemedicine is a subset of telehealth that refers specifically to an online consultation with a doctor, usually done over video chat on a phone or computer. The convenience of telemedicine appeals to many patients. These consultations may take just 10-15 minutes and can be conducted from the comfort of home.

With telemedicine, you can get a prescription without physically traveling to a doctor. You can talk to a physician and receive a diagnosis using technology. If you require medication for your condition, the doctor will send the prescription to the pharmacy of your choice. Then you can pick up the prescription or have it mailed to you. Telemedicine is a convenient way to fill prescriptions without making a trip to the doctor’s office every time.

Filling an Rx from Your Virtual Doctor?

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Things to Keep in Mind When Using Telemedicine

Although telemedicine can be a convenient option for many patients, there are some things to keep in mind before seeking these services.

Laws Governing Telehealth Vary by State

You may not be able to obtain a prescription via telemedicine in every state. Some have strict guidelines for establishing a patient-provider relationship that may require at least one in-person visit. The Center for Connected Health Policy has an online guide where you can check your own state’s laws. Or, you can ask your chosen telehealth platform.

Not All Medications Can be Prescribed via Telemedicine

A federal law known as the Ryan Haight Act regulates prescriptions of controlled substances. Under this law, doctors must see a patient in person before prescribing a controlled substance online, or the patient’s circumstances need to meet one of seven exceptions specified in the law. This makes it very difficult for a doctor to prescribe a controlled substance via online consultation. Some telemedicine platforms even prohibit their doctors from prescribing controlled substances.

Consider the State Where the Doctor Is Located

With telemedicine, you could be seeing a doctor located in a different state than you. It’s important to verify that your doctor is licensed to practice in your state. Telehealth platforms will usually ask you what state you’re located in, and then match you with a doctor able to practice there.

How Much Does a Telemedicine Visit Cost?

The cost for telemedicine services varies by platform, but a consultation is often just as affordable as an in-person visit, if not cheaper. Some platforms even accept insurance. If you’re uninsured, there are options available that will cost you as little as $15-$20 per visit.

Telemedicine is great for routine conditions such as sinus infections, bacterial infections, or allergies. It can also be used to monitor an ongoing or chronic condition. The field of telehealth is offering patients more convenience and, in many cases, more affordable treatment. Still, many patients are uninsured or underinsured and struggle with the cost of medications or doctor visits.

Whether you need a routine prescription or are managing a chronic condition, make sure you have savings in your pocket. Download the ScriptSave WellRx app today and compare pricing between pharmacies.

Download for iPhone     

Download for Android

Download the free ScriptSave WellRx app from the App Store Download the free ScriptSave WellRx app from the Google Play Store

References:

https://blog.evisit.com/how-to-get-a-prescription-without-seeing-a-doctor

https://www.cchpca.org/telehealth-policy/online-prescribing


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If you take prescription medications, you know how important it is to keep up with your refills and take the medicine as directed. There may be times, however, when you’re away from home and realize you need to refill your prescription. If you’re in a different state, can you still get your Rx filled?

The good news is that you can fill a prescription in a different state. Here are several methods you can use.

Transfer Your Prescription to a Nearby Pharmacy

The process of transferring your prescription is relatively simple. Contact a nearby pharmacy and they will handle most of the process for you. Be sure to give them the contact information of your home pharmacy, as well as specify which prescription(s) you need transferred.

This process is usually quick, but it can take up to 3 business days. If you’re in immediate need of your medication, you should ask the pharmacist for an emergency supply of your prescription.

This method will not work for every medication. Schedule II drugs like narcotics and stimulants cannot be transferred between pharmacies, and other controlled substances only have one available transfer. If you’ve used up transfers, or you’re out of refills, call your doctor and ask them to fax a new prescription to the pharmacy of your choice. Keep in mind that your doctor may ask you to come in for a visit before filling the new prescription, especially for schedule II substances.

Use a Pharmacy in the Same Chain if Possible

Filling your Rx at a different location in the same pharmacy chain does not require a transfer. This makes the process simpler. If you’re away from home and you happen to use a chain pharmacy such as Walmart or CVS, try to find a nearby store.

Ask for a Medication Order to Take with You

If you are packing for a trip and realize that you’ll run out of your medication while you’re away, you can plan ahead. Call your doctor and ask if they will write you a medication order (a paper copy of your prescriptions) to take with you on your trip. Then, you’ll be able to take the prescription(s) to any pharmacy and fill your Rx.

Plan Ahead for Trips out of the Country

If you’re taking a trip outside the United States, your prescription won’t be valid. You should take extra care to plan ahead for trips outside the country. Be sure you have enough medication to last the entire trip because if you run out, you won’t be able to get a refill.

Try to Find a Pharmacy in Your Insurance Network

When you fill a prescription in a different state, be sure to look for a pharmacy in your network. Otherwise, you’ll have to pay the cost out-of-pocket. If you don’t have insurance, ScriptSave WellRx can save you money on out-of-pocket drug costs. Even if you do have insurance, you may find our discounted price is better than your co-pay! Get your prescription discount card now and start saving today.

Get a free Rx discount card today

References:

https://healthproadvice.com/medication/FILLING-PRESCRIPTIONS-WHILE-TRAVELING



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6 ways to lower your blood pressure - image

High blood pressure, or hypertension, is when the pressure in your blood vessels is higher than normal. Over time, high blood pressure begins to damage blood vessels and cause other health conditions.

Typically, there are no symptoms of high blood pressure until serious complications occur. For this reason, it’s often referred to as “the silent killer.” According to the CDC, around one third of U.S. adults have high blood pressure. However, only half of them actively take steps to manage it. If left unmanaged, hypertension can lead to heart disease, stroke, and even kidney disease.

Fortunately, there are a number of lifestyle changes you can make to help improve your blood pressure. In some cases, your doctor might recommend medication in addition to lifestyle changes. Below are six ways you can safely lower your blood pressure.

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1. Get Regular Physical Activity

Regular aerobic exercise, like walking, hiking, or cycling helps strengthen your heart. As your heart gets stronger, it pumps with less effort. This helps reduce the amount of pressure in your blood vessels, lowering your blood pressure.

Generally, you should aim for around 30 minutes of physical activity a day, or at least 150 minutes per week. Even if you’re unable to set aside 30 minutes, you can still benefit by breaking activity into 10 or 15 minute chunks throughout the day.

There also are many small ways you can increase your activity throughout the day:

  • Walking instead of driving.
  • Taking the stairs instead of the elevator or escalator.
  • Spending time outdoors, gardening, or doing yard work.
  • If you work in an office, taking time to get up, stretch, and move around.

Regardless of how you decide to do it, physical activity and exercise are among the best ways to improve your overall health.

2. Eat a Healthy Diet that’s Low in Sodium

Eating a heart-healthy diet can have a large impact on your blood pressure. For starters, cut processed foods from your diet. These foods are typically high in sodium, which raises your blood pressure.

Furthermore, cutting back on carbs and refined sugar can also help lower blood pressure. One study found that a low-carb diet was highly effective in lowering blood pressure, even when compared to low-fat diets.

Overall, high levels of sodium, or salt, in your diet can be one factor in elevated blood pressure. Lowering your salt intake can have benefits both for hypertension and your overall health. If you’re taking medication to treat your high blood pressure, your doctor may have additional dietary restrictions.

3. Manage Your Stress

When we’re stressed, our bodies react in a number of ways. One reaction is to release adrenaline and cortisol. Both are stress hormones that trigger the body’s fight or flight response, in turn increasing heart rate and constricting blood vessels.

Occasional stress is a normal response to everyday life. But when we experience stress on a regular basis, it begins to take its toll on our health. There are a number of ways to decrease stress, including yoga, mindfulness meditation, and improving your time management.

4. Cut Back on Caffeine

There is still debate around the long-term effects of caffeine. However, caffeine does briefly increase blood pressure. For people who are sensitive to caffeine, this effect is even greater.

In general, if you’re suffering from high blood pressure or are sensitive to caffeine, try to limit the amount of caffeine you consume. Instead, try decaf coffee or tea.

5. Maintain a Healthy Body Weight

Losing weight can help significantly lower high blood pressure. A higher body weight places additional stress on blood vessels and increases the workload placed on the heart. Even losing as little as 5 or 10 pounds can begin improving blood pressure.

More importantly, the benefits of maintaining a healthy weight are even larger when coupled with regular exercise and a healthy diet. Most lifestyle changes work to reinforce each other. For this reason, your doctor will likely discuss making gradual changes that work together to improve not only your blood pressure, but also your overall health.

6. Take Your Blood Pressure Medication

Your doctor may prescribe one or more medications to help treat your hypertension. If you are prescribed medications, be sure to take them as directed by your doctor.

You may experience side effects and should report these or any changes in your condition to your doctor. They may want to change your dosage or try a different medication. Regardless, do not stop taking your medication without first talking with your doctor.

If you’re having difficulty affording your medications, there are a number of ways you can lower costs. If you’re prescribed a brand name drug, talk with your doctor to see if there is a generic alternative. In addition, the ScriptSave WellRx discount card can help you find savings on your blood pressure medication at thousands of pharmacies across the U.S.

References:


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You try to take your medication on time and manage your health condition, but mistakes happen. You may find yourself out of medication unexpectedly at some point. Whether you’re on vacation and forgot to pack your Rx or you just forgot to call your pharmacy and order the next month’s supply, you may be able to get an emergency supply of your prescription.

Obtaining an Emergency Supply of Your Medication

The best thing to do when you realize you’re going to run out of medication is call your doctor. They may be willing to contact the pharmacy of your choice so you can get a prescription filled there. Even if it’s after-hours, call anyway and leave a message explaining the situation.

If you cannot get in touch with your doctor or you are in immediate need of your medication, go to a nearby pharmacy and tell them you need an emergency supply. You may be required to provide proof of your Rx, so bring your prescription bottle with you. If the pharmacist determines that going without the drug will endanger your health or wellbeing, they are able to dispense an emergency 72-hour (three-day) supply.

Another option is to go to an urgent care clinic. A doctor there may write you a prescription for a one-time dose to hold you over until you can get in touch with your primary care physician.

Medications Eligible for Emergency Supply

Keep in mind that the pharmacist will only dispense an emergency supply if they determine that your health will be harmed by going without the medication. This is usually the case with medications for chronic illnesses and life-threatening conditions like high blood pressure or seizures.

Save on prescriptions for chronic conditions.

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Laws about emergency prescription refills vary by state. Some states only allow emergency prescriptions to be dispensed during a state of emergency and/or natural disaster. Many states also have regulations about dispensing an emergency supply of Schedule II drugs and other substances with a high potential for abuse.

Getting an Emergency Prescription During a Natural Disaster

A natural disaster often leaves people without their normal supply of prescription drugs. Residents may have to evacuate at a moment’s notice. Their current supply of medication may be left behind or destroyed by flood waters or power outages.

Many states allow pharmacists to dispense up to a 30-day supply of medication in the case of a natural disaster or other emergency. If you’re still at home but your medication has been destroyed or has run out, contact your pharmacy for an emergency prescription. For evacuees, the best option may be to transfer prescriptions to another pharmacy until they can return home.

If you are unable to reach a pharmacy due to flooding or other bad road conditions, try to get medication mailed to you, or transfer to a pharmacy that offers mail-order services. You can always transfer back when the emergency passes.

Plan Ahead When Possible

Although many of these situations arise unexpectedly, try to plan ahead to make sure you don’t run out of medication. Make sure you create an emergency preparedness plan. If you know you’re going to need a refill while traveling, you may be able to order it in advance. Some health insurance plans allow for prescription overrides so that you can get a prescription filled early, or obtain more than a 30-day supply.

If your insurance doesn’t allow this, you may be able to get the extra medication you need by paying out of pocket. However, not all prescriptions are able to be filled early, especially for medications that have a high potential for abuse. Talk to your doctor about what you should do if you know you’re going to be traveling but cannot fill a prescription early.

Save on Emergency Prescriptions

You may have to pay for an emergency prescription out of pocket, especially if your Rx requires prior authorization with your insurance company. Make sure you always have savings in your pocket by downloading the ScriptSave WellRx app. You can search for pharmacies near you and compare prices instantly to get the best discount.

Organize your prescriptions with WellRx app

References:

employer prescription savings program - blog image

Healthy employees are imperative to a company’s success and are the best advocates for any employer. With prescription costs skyrocketing, we know it’s difficult to balance the need to provide healthcare coverage and still keep the cost affordable for both the business and your employees.

With an ever-increasing crunch on resources, providing full benefits to help employees stay healthy can be tough. The ScriptSave WellRx Prescription Savings Program makes prescription medications more affordable and easier to manage. Consumers show their savings card and pay the discounted price. It’s that simple!

Small Business Employer Benefit

At ScriptSave, the health of our community is important to us—that’s why we created the ScriptSave WellRx Prescription Savings Program. Our program helps individuals and families obtain discounts on prescription medications, and many times our prices are lower than insurance copays!

Prescription Savings for Employees

The ScriptSave WellRx Prescription Savings Program offers a fast, easy, and free way for employees to save on their family’s prescriptions.

  • Average savings of 60%, with potential savings of 80%* or more
  • Savings for all prescription medications — brand-name and generic
  • Accepted at more than 65,000 participating pharmacies nationwide
  • Save on prescription medications for the entire family, including pets
  • Compare our discount prices to your insurance copay
  • More Features: pill & refill reminders, Ask-A-Pharmacist, set preferred pharmacies, watch & learn videos, pill identifier, manage medication list, receive drug and lifestyle interaction alerts, and more!
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ScriptSave WellRx can help anyone save. There are no enrollment fees and no limits on usage, so it’s good as long as employees need prescription discounts.

Who Can Benefit from ScriptSave WellRx?

  • Those with limited insurance or no prescription coverage can reduce out-of-pocket expenses
  • Those with health insurance, medicare, or high-deductible health plans can reduce the cost of medications not covered by insurance, and many times ScriptSave WellRx prices are lower than insurance copays!
  • Even employees with pets can reduce out-of-pocket costs on human-equivalent pet medications.

Learn more about how the ScriptSave WellRx prescription savings program can work for your business. Contact us today or simply request a package of cards so your employees can start saving on their prescription costs today!



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manufacturer drug coupons

For anyone who has read the ScriptSave WellRx Facebook comment-threads, you’ll know the topic of manufacturer drug coupons (and the Q&A that relates to them) is a popular one. So popular, in fact, we felt it deserved its own article on what drug coupons are and how they work.

What are Manufacturer Drug Coupons?

These coupons often go by a number of different names. Sometimes referred to as copay cards or copay coupons, also commonly called Copay Assistance Programs or just pharma coupons, the end result is often the same. A program, funded by the pharmaceutical manufacturer of a prescription drug, which helps to lower the out-of-pocket cost that the patient pays at the pharmacy.

Because these programs are funded directly by the pharmaceutical company that manufactured the drug, they are usually able to provide the patient with an extremely low cost. Some programs can even drop a patient’s out-of-pocket expense to zero dollars (i.e., FREE prescription medication to the patient).

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How do Copay Assistance Programs work (and are the really FREE)?

So what’s the catch behind the copay card (…and, yes, there is a catch)? To answer this question, let’s look at why these programs were created by pharma manufacturers in the first place.

Just because the patient might end up paying zero dollars, it certainly doesn’t mean the drug manufacturer gave their product away and didn’t make any money. In fact, nothing could be further from the truth.

The clue is really in the name, “Copay Assistance” or “Copay Coupon” – i.e. these programs are designed to help lower a patient’s insurance copay. More about that to follow, a little further down the page.

It’s important to keep in mind that the pharmaceutical manufacturer collects payment for their drug not just from the patient, but also from the patient’s insurance plan. Furthermore, with traditional health plans, the lion’s share of the payment for the drug would generally be coming from the insurance company rather than from the patient. For example, consider a brand drug that might sell for $1,000 and its generic equivalent that’s available for $100. If the patient’s health plan has a flat copay of $20, then the patient would likely opt for the brand. After all, their personal expense would be the same twenty dollars out-of-pocket cost, regardless of which version of the drug they choose … so why not go for the brand-version. In such an example, the patient would pay $20 in the form of their copay, while the brand drug company would collect the remaining $980 from the insurance company.

With this in mind, let’s consider what might happen if patient’s health insurance plan changes its copay structure for the next plan year. If the patient finds themselves having to pay 20 percent of the cost of their medications (a practice commonly referred to as co-insurance), rather than the flat copay of $20, they would then face an out-of-pocket cost of $200 for the same brand drug (i.e. 20% of $1,000) or only $20 for the generic – same as their previous year’s copay (i.e. 20% of $100).

Under these circumstances, the patient’s choice between brand vs. generic has a direct and significant impact on their own out-of-pocket cost, and the potential impact to the brand manufacturer is most certainly a cause for concern. Not only do they lose the patient’s share of the payment for the medication, they also lose the majority share that would have been paid by the insurance provider. And so comes the case for the copay card, copay assistance program or manufacturer drug coupon.

What if the manufacturer pays, reimburses, or assists with the patient’s cost?

Keeping the math the same as the example above, what if the manufacturer creates a program that offers to kick-in $200 against the patient’s copay? The answer is simple. If the patient faces 20% of the cost of a $1000 brand drug vs. 20% of a $100 generic … but then the manufacturer of the brand offers to subsidize $200 back to the patient if the patient picks their drug, then the patient is left facing a choice between a zero-dollar burden for choosing the brand or a $20 burden for the generic.

Obviously, the patient will now tend to choose the brand. However, although the patient is able to use the coupon to escape paying anything whatsoever for the drug, the drug company is now able to collect $800 from the insurance plan, because the pharmacist dispensed the brand as opposed to the generic (thereby triggering a bill to the patient’s insurance for the brand). In other words, by giving a $200 discount or subsidy to the patient, the pharma manufacturer manages to collect $800 from the insurer, rather than collecting nothing if the patient had opted for the generic.

Pharma coupons – only for the insured

At this point, anyone still reading has probably already had their ‘a-ha moment’ in realizing why these programs (that can be so wonderfully generous to patients across the U.S.) are often only available to patients with insurance. Long story short, without the insurance company in the equation to continue footing their full share of the bill, these programs wouldn’t make any money at all for the pharma manufacturer.

To many folks this seems unfair. However, it doesn’t change the fact that, every single day, manufacturer coupons make a HUGE difference to many patients who can’t afford their medications.

For those without access to these programs, the ScriptSave WellRx prescription discount card might be able to help (although, clearly, we’re never going to be able to help as much as the manufacturers’ own programs – for those who qualify).

If you’re struggling to afford your prescription medications, check out the ScriptSave WellRx website or app to see how much you could be saving on the cost of your medications! Furthermore, if you’re still unsure why the WellRx card from ScriptSave is different to the copay assistance cards from the manufacturers, and how our discount program works, there’s a brief write-up to explain that here.



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common food and drug interactions - scriptsave wellrx blog image

by Stephanie Forbes, PharmD

We’ve all gone to the pharmacy to pick up a new medication and been counseled on interactions with other drugs. But, what about foods that might interact with the new medication?

Oral medicines are absorbed into the bloodstream through our gastrointestinal tract (GI tract). For this reason, food or drinks can sometimes interact with the absorption of the medicines we take.  In some cases, food can actually help with absorption, but in other instances it can be a hinderance, and cause less of our medicine to be taken up into the bloodstream.

Some antibiotics, like amoxicillin/clavulanate extended release (Augmentin) and cefuroxime (Ceftin) are better absorbed when we take them with food. Lovastatin is another example of a medicine that has improved absorption when taken with food. In contrast, some medicines (bisphosphonates like alendronate, antibiotics like ampicillin) are absorbed less when taken with food, and should be taken on an empty stomach.

Foods That May Interact With Drugs

Below are some foods and environmental aspects that can interact with the frequently prescribed medications .

Calcium Rich Foods

When we think of calcium, we tend to think of dairy products. In addition to milk, cheese, and yogurt, calcium supplements and some antacids containing calcium can interact with some medicines. Most commonly interacting with calcium are antibiotics, like ciprofloxacin, tetracycline, and doxycycline. The calcium may bind to the antibiotics creating a substance that prevents them from being absorbed.

Grapefruit

Grapefruit and grapefruit juice an affect the metabolism of drugs through a pathway called CYP450, a metabolism pathway through the liver. The impact of grapefruit (and juice) on this can increase the effects of some drugs to a dangerous level.  Furanocoumarin chemicals, compounds found in grapefruit, can interact with enzymes in the liver and small intestine. Some examples of medicines that interact with grapefruit are simvastatin, felodipine, and ticagrelor.

Vitamin K Rich Foods

Patients who are prescribed the blood thinner warfarin are likely familiar with this drug-food interaction. Anticoagulants like warfarin inhibit vitamin K, which an essential component in the process that makes clotting factors, which help prevent bleeding. A frequent misconception with this interaction is that vitamin K rich foods should be avoided; however, that is not the case. Most important is to keep a consistent intake of vitamin K in your diet, and avoid adding in new foods like kale, spinach, or other leafy greens.

Key Takeaways

Keep in mind, this is not a comprehensive list and other foods and beverages may interact with medications (alcoholic beverages, pickled, cured, and fermented foods, etc.). Always check with your pharmacist or doctor for any dietary considerations when starting a new medication. For additional help between doctor & pharmacy visits, it may be possible to turn to technology. For example, by searching for a given prescription drug on the ScriptSave WellRx website (or mobile app), a patient can click through to the “Lifestyle Interactions” tab, where upon they will see details of known dietary interactions for that drug (the example linked to here is for Atorvastatin/Lipitor, and shows details of the aforementioned MAJOR interaction with grapefruit juice).

Technology tools like ScriptSave WellRx are not just able to flag dietary/lifestyle interactions. They can also highlight potential interactions between the different medications in a patient’s personal prescription regimen. Patients are able to create a free account either on the ScriptSave WellRx website or through the mobile app and, by unlocking the free virtual Medicine Chest, they are able to load details of their own medication to a secure account. The medicine chest is then able to flag not just the known food/dietary interactions with the patient’s own specific drug list, but also potential interactions between the different prescription medications themselves.

References:

  1. Gilchrist, Allison. 5 Dangerous Food-Drug Interactions. Pharmacy Times. September 17, 2015. https://www.pharmacytimes.com/news/5-dangerous-food-drug-interactions. Accessed November 25, 2019.
  2. Technician Tutorial, Drug Interactions 101. Pharmacist’s Letter/Pharmacy Technician’s Letter. October 2016.
  3. Avoid Food-Drug Interactions: A Guide from the National Consumers League and U.S. Food and Drug Administration. April 4, 2017. https://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/GeneralUseofMedicine/UCM229033.pdf. Accessed November 25, 2019.
  4. Bushra, R., Aslam, N., & Khan, A. Y. (2011). Food-drug interactions. Oman medical journal26(2), 77–83. doi:10.5001/omj.2011.21


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dangers of some drugs in older adults - scriptsave wellrx blog image

by Gabriel K. Rallison, PharmD Candidate Class of 2020,
University of Arizona College of Pharmacy

As we age, many of us may struggle to do things that were once so easy. With age, the way your body handles medication can change, too. Side effects may become more noticeable and last longer than they used to.

Potentially Inappropriate Medications for Older Adults

Due to these changes, the American Geriatrics Society published a list of medications that are potentially inappropriate for use by persons over 65 years old, commonly called the Beers Criteria.1

There are several common over-the-counter (OTC) medications on this list that should be avoided.

Antihistamines

The first OTC drug to avoid is diphenhydramine (Benadryl). Diphenhydramine is an antihistamine drug commonly used to treat cold and allergy symptoms and as a sleep aid. However, in older adults, diphenhydramine can cause very unpleasant and sometimes dangerous side effects. Side effects include confusion, dry mouth, difficulty urinating, constipation, and blurred vision.2 Diphenhydramine will often be found alone in products, or in combination with other medications. When buying cold or allergy medicine, make sure to check the active ingredient list to make sure it doesn’t contain diphenhydramine.

A sister drug to diphenhydramine, chlorpheniramine (ChlorTabs), can cause many of the same side effects in older adults and should likewise be avoided.3 As alternatives for treating cold and allergy symptoms, look for products that contain loratadine (Claritin), fexofenadine (Allegra), or cetirizine (Zyrtec).2 These are newer medications of the same type as diphenhydramine, but without the side effects that make diphenhydramine dangerous.

Aside from treating allergy symptoms, drugs from this class are also used to treat motion sickness. These drugs, including dimenhydrinate (Dramamine) and meclizine (Antivert), cause many of the same side effects are diphenhydramine and chlorpheniramine, and should likewise be avoided.1

Non-drug options for prevention of motion sickness should be used instead. To prevent motion sickness, current advice is to keep your eyes closed or looking at the horizon, while avoiding close-up visual tasks like reading when moving.4                      

NSAIDs

NSAIDs, or non-steroidal anti-inflammatory drugs, are a class of medications including ibuprofen (Advil, Motrin) and naproxen (Aleve).2 These drugs are generally used to treat mild to moderate pain, but also have side effects that become more noticeable and dangerous in older adults. NSAIDs can cause stomach ulcers, stomach bleeding, increased blood pressure, kidney damage, and can even make heart failure worse.3 Additionally, these medications can interact with blood thinner medications such as warfarin and increase your risk of bleeding.

While occasional use may not present as great a risk, regular use of either ibuprofen or naproxen should be avoided unless closely followed by your doctor. As an alternative to NSAIDs, you can use acetaminophen (Tylenol). When using acetaminophen, it is important to limit your dose to 1,000 mg or less per dose, and less than 3,000 mg per day to avoid causing liver damage. If you regularly drink alcohol, you should use even less acetaminophen.

Are There Other Medications Older Adults Should Avoid?

The medications mentioned are by no means an exhaustive list, and there may be other medications, OTC or prescription, that should be stopped or adjusted for use in older adults. You should never stop taking a prescription medication without first talking to the doctor who prescribed it, even if it is on the Beers Criteria.

Any questions you have concerning any prescription medication you may be taking should be directed to your doctor or pharmacist. Your pharmacist can recommend OTC medications to help treat what ails you while minimizing undesirable side effects. While we all get older, you can rely on the direction and training of health professionals around you to make the trip as comfortable as possible, helping to minimize the bumps along the way.

References

  1. For Older People, Medications Are Common; Updated AGS Beers Criteria® Aims to Make Sure They’re Appropriate, Too. (n.d.). Retrieved October 10, 2019, from https://www.americangeriatrics.org/media-center/news/older-people-medications-are-common-updated-ags-beers-criteriar-aims-make-sure.
  2. Eng, M. (2008, June 19). Potentially Inappropriate OTC Medications in Older Adults. Retrieved October 11, 2019, from https://www.uspharmacist.com/article/potentially-inappropriate-otc-medications-in-older-adults.
  3. Ten Medications Older Adults Should Avoid or Use with Caution. (n.d.). Retrieved October 11, 2019, from https://www.healthinaging.org/tools-and-tips/ten-medications-older-adults-should-avoid-or-use-caution.
  4. Brainard, A., & Gresham, C. (2014, July 1). Prevention and Treatment of Motion Sickness. Retrieved October 24, 2019, from https://www.aafp.org/afp/2014/0701/p41.html.


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patient doctor communication image - scriptsave wellrx blog

by Gabriel Rallison, PharmD. Candidate, Class of 2020
University of Arizona

Have you ever left your doctor’s office feeling more confused than when you arrived? Maybe even felt like your doctor didn’t understand your concerns? You’re not alone. When over 300 patients were interviewed after being released from the emergency room, only 6 in 10 patients were able to correctly describe their doctor’s directions.1

Good healthcare begins with good communication. If the doctor doesn’t understand your concerns and you don’t understand the doctor’s directions, you may not be getting the best care possible.

There’s a growing awareness in the medical community regarding the need for effective doctor-patient communication. We have several simple recommendations to help you in that process.

Eight Things to Consider on Your Next Doctor Visit:

  1. Write down your concern(s). When thinking about your health concerns, write down when it started, what you think may have caused it, how often it happens, what it feels like, things that make it better, things that make it worse, in as much details as possible.

    Having written notes will help you organize your thoughts during the short time you have with the doctor. Additionally, they will help you better answer the questions your doctor will have. The more information you can give them, the better they will be able to help you.
  2. Consider bringing someone who can support you. A friend or family member can help catch things that might otherwise be missed, ask questions you may have not thought of, and help keep track of the information and instructions shared by the doctor.
  3. Be honest and straightforward about any concerns you have. Your doctor is required to protect your privacy and will only share your information with other healthcare professionals as required for your care. Even if it may be embarrassing, or you feel it may be irrelevant, it is important to share everything. Your doctor should be nonjudgmental and understanding. When you share openly, it will help the doctor see the full picture and catch things that may otherwise be missed.
  4. Don’t be afraid to ask questions! Doctors can sometimes use terms that are overly complex and hard to understand. It’s perfectly okay to ask for clarification in simpler terms or ask them to explain it again. Then, once you think you understand, repeat the information back to your doctor in your own words. This technique, called teach-back, can help you to internalize information and let the doctor know if anything was missed.
  5. Create and maintain a medication list. It can be frustrating for everyone (healthcare team and patients alike) when in response to the question “What do you take?” the answer is, “the little round white pill.” Hospitals can, and do, call pharmacies to find out what patients are taking, but having a list up front can save time and prevent potentially harmful prescribing.

    In not knowing what you are taking, your doctor may mistakenly prescribe medication that could interact with what you are already taking. This could lead to your medications being less effective or additional side effects, so it’s important to create and maintain an up-to-date medication list.

    When making your medication list be sure to include, at a minimum:
    – medication name
    – strength, dose, and frequency of dose
    – reason for taking, and any special instructions that medication may have.

    For example:
    – levothyroxine (name)
    – 125 mcg (strength)
    – One tablet (dose) every morning before breakfast (frequency)
    – For low thyroid hormone (reason for taking), take levothyroxine by itself ½ hour before any other food, medicine or drinks (special instructions).

    When making your list, make sure to include any medicated creams, patches, inhalers, implants, suppositories, or any other less conventional forms of medications, like medical marijuana (MMJ).

    Make sure to include any over the counter medications and supplements you take as well, as many of these may interact with other medications you are taking. 
  6. Consider any language barriers. There can often be language barriers between a doctor and their patient. This can lead to problems in receiving quality medical care.

    In the United States, you have a legal right to oral interpretation and written translation of any medical communication into your preferred language. This may take the form of written instructions or drug labels in your language or having an interpreter in the room or on the phone when you are with your doctor. These resources can help break the language barrier that could otherwise make it hard to get care.
  7. Include other members of your healthcare team. Questions about a medication? Talk with your pharmacist, especially when starting a new medication! Your pharmacist can advise you about side effects to watch out for, possible issues with other medications or supplements you may be taking and give you additional advice about how to improve your medication regimen.
  8. Work together with your doctor for the best outcome. If you have concerns with the treatment plan, ask about them! Work actively with your doctor to decide the plan that will work best for you.

Good medicine is not one size fits all, and as you voice your concerns and strive for better communication, you and your doctor can work as a team to make sure you get the best care possible.

References

  1. Crane, J. A., Patient comprehension of doctor-patient communication on discharge from the emergency department. J Emerg Med. 1997 Jan-Feb;15(1):1-7. https://doi.org/10.1016/S0736-4679(96)00261-2 Accessed Sep 24 2019.
  2. Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: a review. The Ochsner journal, 10(1), 38–43. Accessed Sep 24 2019.
  3. Clancy, C. M. How to Talk to — and Understand — Your Doctor. American Association of Retired Persons. https://www.aarp.org/health/doctors-hospitals/info-09-2010/finding_your_way_how_to_talk_to_8212_and_understand_8212_your_doctor.html Accessed Sep. 25 2019.
  4. Howley, E. How to Make Sure Your Doctor Understands Your Medical Condition. U.S. News. Jan. 16 2018. https://health.usnews.com/health-care/patient-advice/articles/2018-01-16/how-to-make-sure-your-doctor-understands-your-medical-condition Accessed Oct 1 2019.
  5. Don’t Be Shy: 4 Tips for Talking to Your Doctor. Johns Hopkins Medicine. N.d. https://www.hopkinsmedicine.org/health/wellness-and-prevention/dont-be-shy-4-tips-for-talking-to-your-doctor Accessed Sep 24 2019.
  6. Health Literacy | Understanding What Your Doctor Is Saying. American Heart Association. N.d. https://www.heart.org/en/health-topics/consumer-healthcare/doctor-appointments-questions-to-ask-your-doctor/health-literacy–understanding-what-your-doctor-is-saying Accessed Sept 25 2019.
  7. Executive Order 13166. Limited English Proficiency (LEP).gov. https://www.lep.gov/13166/eo13166.html Accessed Oct 2 2019.


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naproxen vs ibuprofen - scriptsave wellrx blog image

Naproxen (brand name Aleve) and ibuprofen (brand name Advil) are two common over-the-counter pain relievers. People often reach for one of these when they have common aches and pains such as headaches, muscle pain, menstrual cramps, and arthritis.

Perhaps you’re wondering which medication is best for your particular pain, or you’re concerned about negative effects. Here is what you should know about Aleve vs. Advil and which pain reliever you should choose.

Are Aleve and Ibuprofen the Same Thing?

Naproxen (Aleve) and ibuprofen (Advil) are both non-steroidal anti-inflammatory drugs (NSAIDs) and they work in the same way – by blocking COX-2 enzymes and COX-1 enzymes. However, they have different onset times and durations. Naproxen (Aleve) is a long-acting drug, meaning it takes longer to start relieving your pain, but it lasts longer too. Ibuprofen (Advil) is short-acting, so it starts working more quickly but needs to be taken more frequently.

Which Is More Effective at Relieving Pain?

Since naproxen and ibuprofen work in the same way, they are generally equally effective for relieving pain. However, the type of pain you’re experiencing may help you decide which to take.

On average, Aleve lasts eight to twelve hours, while Advil lasts just four to six hours. That means that if you have chronic, long-lasting pain, Aleve is probably a more effective option for you. Advil is better for short-term pain, and it’s also considered safer for children.

Prescription Strength vs. Over the Counter

You may have heard about prescription-strength versions of Aleve and Advil. Doctors may prescribe you a higher dose of either of these medications if you have severe pain. There are also a variety of other NSAIDs that are only available by prescription, such as meloxicam, diclofenac, and indomethacin.

Get Discounts on Prescription Pain Relievers.

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What Are the Potential Side Effects of Aleve and Advil?

While COX-2 enzymes are related to pain and inflammation in the body, COX-1 is involved with the lining of your stomach. This means both Aleve and Advil can cause gastrointestinal issues such as ulcers and gastrointestinal bleeding. Aleve poses a slightly greater risk of gastrointestinal issues, so if you are concerned about this side effect, you may want to choose Advil, or a different type of pain reliever such as acetaminophen (Tylenol).

Additionally, these medications can increase the risk of cardiovascular events like heart attack and stroke. If you have a history of cardiovascular issues, talk to your doctor before using an NSAID.

Some other potential side effects include:

  • High blood pressure
  • Kidney or liver problems
  • Headaches
  • Dizziness
  • Leg swelling
  • Ringing in the ears
  • Rash, throat swelling, and other allergic reactions

Do NSAIDs Interact with Anything?

You should watch out for interactions with any drugs you’re taking. There are some substances that interact with NSAIDs. These include blood thinners such as warfarin or aspirin, as well as substances such as tobacco and alcohol. Be sure to tell your doctor and pharmacist about all the drugs you’re taking, including over-the-counter pain relievers like Aleve and Advil.

Can You Take Naproxen and Ibuprofen Together?

NSAIDs also interact with each other. If you are taking Aleve (naproxen), do not take Advil (ibuprofen) at the same time, and vice versa.

How Many Advil or Aleve Should I Take?

The usual dosage for Advil is one tablet every four to six hours. You can increase the dosage to two tablets if one is not effective, but make sure you don’t exceed six tablets in 24 hours. If you’re taking Aleve, the dosage is one tablet every eight to twelve hours. You can take a second Aleve in the first hour if the first pill doesn’t work, but do not exceed three in 24 hours.

Note that you should not take Aleve for longer than ten days if you’re treating pain, and no longer than three days for a fever. Always take the lowest effective dose, and do not exceed the maximum dosage. Serious adverse health effects could result.

Which Is Better – Aleve or Ibuprofen?

If you’re still wondering whether to take Aleve or ibuprofen, remember that Aleve is a long-acting drug, while ibuprofen is short-acting. Aleve will last longer and is more effective for chronic pain, but it also poses a greater risk for gastrointestinal issues. Ibuprofen needs to be taken more frequently but it is generally safer, especially for children.

If you’ve been prescribed either of these medications, save with our drug price lookup tool. Find the lowest price on pain relievers, or search for discounts on any prescriptions you take.

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Do you have GERD - blog image

by Misgana Gebreslassie, PharmD Candidate,
Class of 2020 University of Colorado

Roughly 18 to 26% of Americans have GERD, and the majority are adults between the ages of 30 to 60 years. GERD is a short for gastroesophageal reflux disease, a condition where stomach fluid (acid) backs up into the esophagus (the tube connecting the mouth and the stomach) and causes aggravating symptoms.

Other names that you may have heard for GERD are acid reflux or heartburn. Often acid reflux is caused by muscle weakness of the lower esophageal sphincter, a valve that lets food and drinks into the stomach. [1,2,6]

What are the symptoms of GERD?

Symptoms are typically present after eating and can be different from person to person. The most common ones are: [1,6]

  • Heartburn or burning in the chest
  • Sour taste or burning feeling in the throat
  • Stomach pain
  • Difficulty swallowing food or choking
  • Sore throat or hoarse voice
  • Cough that is not relived by anything
  • Spitting up
  • Frequent burping
  • Asthma

How is GERD treated?

Treatment of acid reflux include lifestyle changes, antacids such as Tums, or stronger stomach acid suppressants like histamine 2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs). [2,3]

Changes to diet or lifestyle can help control symptoms of heartburn and the following changes can be helpful: [2,3,4]

  • Stay away from foods and beverages that can lead to acid reflux or heartburn. Foods and beverages like: coffee, alcohol, chocolate, fatty foods, spicy foods, and citrus fruits/juices
  • Raise the head of your bed 6 to 8 inches
  • Try eating smaller portions and avoid sleeping or lying down within 3 hours of eating a meal
  • Lose weight. Being overweight can contribute to GERD
  • Stop cigarette smoking
  • Wear loose fitting clothes

Do Antacids Treat GERD?

Antacids work by neutralizing or reducing the acidity of the stomach. They are used for milder symptoms and are taken as symptoms occur to relieve heartburn symptoms.  These drugs can affect the absorption of other drugs. Always ask your pharmacist to check for interactions with your current medications as well as how and when to take them.[4]

What Other Drugs Can Treat GERD?

Histamine 2 receptor antagonists (H2RAs) work by suppressing acid secretion in the stomach. They are stronger than antacids in controlling heartburn symptoms. Overall, they are very well tolerated.[3]

Proton pump inhibitors (PPIs) also work by suppressing acid secretion in the stomach. They are used when heartburn symptoms are not well controlled by H2Ras or when symptoms are troublesome affecting quality of life.

PPIs work best when taken on empty stomach half an hour before the first meal of the day. PPIs may alter the way some drugs work. Ask your pharmacist or doctor to check for interactions with your current medications before taking them.[5]

Medicine
Type
Generic
Name
Regulatory
Status
Brand
Name
AntacidsCalcium CarbonateOTCTums
Aluminum hydroxide, magnesium
oxide and simethicone
OTC Maalox
Histamine 2 receptor antagonistsCimetidine OTC Tagamet
Famotidine OTC Pepcid
Nizatidine OTC Axid
Ranitidine OTC Zantac
Proton Pump Inhibitors (PPIs)EsomeprazoleRxNexium
DexlansoprazoleRxDexilant
Lansoprazole15mg – OTC Prevacid
Omeprazole OTC Prilosec
Omeprazole + sodium bicarbonate OTC Zegerid
PantoprazoleRxProtonix
RabeprazoleRxAciphex
OTC = over the counter (without prescription); Rx = prescription only; * Regulatory status obtained from FDA website [7]

All antacids and H2RAs are available over the counter whereas this would only apply to some PPIs. Sometimes these medicines are cheaper without a prescription. If cost is a concern for you ask your pharmacist to help you find ways to reduce your medication cost.[7]

scriptsave wellrx lower prescription price image

References:

  1. Gastroesophageal Reflux Disease (GERD). In DynaMed Plus [database online]. EBSCO Information Services. http://www.dynamed.com.proxy.hsl.ucdenver.edu/topics/dmp~AN~T116914/Gastroesophageal-reflux-disease-GERD. Updated April 26, 2019. Accessed on 8/8/10/2019
  2. Patient education: Acid reflux (Gastroesophageal Reflux Disease) in adults. The Basics. In: UpToDate. [Internet]. Published place unknown: UpToDate; 2019 [cited date unknown). Available from  https://www-uptodate-com. Accessed on 8/10/2019
  3. Kahrilas PJ. Medical management of gastroesophageal reflux disease in adults. In: Talley NJ & Grover S (Editors). UpToDate. [Internet]. Published place unknown: UpToDate; 2019 [cited March 28, 2018]. Available from: https://www-uptodate-com. Accessed on 9/10/2019
  4. Vakil NB. Antiulcer medications: Mechanism of action, pharmacology, and side effects. In: Feldman M & Grover S (Editors). UpToDate. [Internet]. Published place unknown: UpToDate; 2019 [cited March 22, 2018]. Available from: https://www-uptodate-com. Accessed on 9/10/2019
  5. Wolfe MM. Proton pump inhibitors: Overview of use and adverse effects in the treatment of acid related disorders. In: Feldman M & Grover S (Editors). UpToDate. [Internet]. Published place unknown: UpToDate; 2019 [cited Nov 29, 2017]. Available from: https://www-uptodate-com. Accessed on 9/10/2019
  6. Kahrilas PJ, Shaheen NJ, Vaezi MF, et al. American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux Disease. Gastroenterology. 2008 Oct;135(4):1383-1391
  7. Over-The-Counter (OTC) Heartburn Treatment. U.S. Food & Drug Admiration. https://www.fda.gov/drugs/drug-information-consumers/over-counter-otc-heartburn-treatment. Published date unknown. Updated on March 5, 2018. Accessed 8/10/2019


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