Do Proton Pump Inhibitors Increase the Risk of Death - wellrx blog image

By Misgana Gebreslassie, PharmD Candidate 2020,
University of Colorado

Proton pump inhibitors (PPIs) are prescription medications that help with symptoms of acid reflux or heartburn. Appropriate use of PPIs is generally safe. However, some studies have associated certain health risks with long-term use.

How Do Proton Pump Inhibitors Work?

Proton pump inhibitors work by reducing acid secretion in the stomach. The use of PPIs has been increasing since they entered the market in the late 1980s due to their treatment success. Their use has increased from 4% to 8% between 1999 to 2012 in the US adult population. Alarmingly, more than half of this population use them for incorrect medical conditions.[1] It’s important to work with your doctor to make sure you’re taking the right medications for the right conditions.

Common proton pump inhibitors include:

Pay less for your acid reflux medication:

Do Proton Pump Inhibitors Increase the Risk of Death?

A study published in 2017 found a small association between the use of PPIs and increased risk of death. The study compared the rate of death among people who took PPIs, histamine 2 receptor antagonists (H2RAs – another type of stomach acid suppressant) or neither medication. 

There was a higher number of deaths reported among people taking PPIs compared to people taking H2RAs or neither medication. However, this study shows only an association and does not prove taking PPIs directly causes death. Due to the nature of the study, the increased risk of death may be real or may be due to chance.[1,2]

Is It Safe to Take Proton Pump Inhibitors Long-term?

Some studies have associated long-term use of PPIs with a small risk of bone fractures, diarrhea, infection of the gut or lungs, and heart and kidney problems. However, there are no claims that suggest PPIs are the direct cause of these adverse drug outcomes. [1,4]

Another study assessing the overall safety of long-term PPI use was published in May 2019. The study reported no adverse drug outcomes except for increased number of gut infections among participants taking a PPI for 3 years compared to participants taking no PPIs.[3]

Side Effects of Proton Pump Inhibitors

Short-term side effects of proton pump inhibitors are generally mild and may include:

  • Headache
  • Upset Stomach
  • Nausea 
  • Vomiting
  • Diarrhea
  • Constipation
  • Flatulence

Let your doctor know of any side effects you experience while taking a PPI.

Should I Stop Taking a PPI?

If you are taking a PPI, you should continue using it as directed by your doctor. PPIs are generally considered safe when taken as directed by your doctor or pharmacist for short periods of time. 

Sometimes, PPIs are used for gastrointestinal diseases that require a long-term or life-long treatment. In such patients, the benefit of PPI use outweighs the small or modest increased risk of adverse drug outcomes. If you are concerned about your PPI use, talk to your doctor or pharmacist about treatment options. [4]


See available discounts for your PPI prescription:



References

1.     Xie Y, Bowe B, Li T, et al. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. BMJ Open 2017;7:e015735.

2.     Does taking proton pump inhibitors increase the risk of death? Retrieved from: https://www.nps.org.au/professionals/ppis/does-taking-proton-pump-inhibitors-increase-the-risk-of-death. Accessed on 8/12/2019 

3.     Moayyedi P, Eikelboom JW, Bosch Jackie, et al. Safety of proton pump inhibitors based on a large, multi-year, randomized trial of patients receiving rivaroxaban or aspirin. Gastroenterology. 2019 May 29. Pii:S0016-5085(19)40974-8

4.     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



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enjoying natural vitamin d - blog image

By Libby Pellegrini MMS, PA-C

As the long, dark days of winter wear on, thoughts of vitamin D supplementation begin to bubble to the surface of the collective consciousness. You may be wondering whether you should take vitamin D as a supplement, or if it is not necessary because you already receive a sufficient amount through your daily diet and activities.

Read on to learn more about vitamin D, whether or not you should be taking it as a supplement, and why. 

Why Is Vitamin D important?

When it comes to maintaining proper calcium blood levels and bone health, simply eating foods with calcium is not enough. For the body to successfully absorb calcium through the digestive tract, vitamin D must also be present. Vitamin D is also important for body processes not related to bone growth, such as helping with cell growth, ensuring proper nervous system function, and reducing inflammation. 

How Do You Get Vitamin D?

Sources of vitamin D in the diet include fortified foods (check the nutrition label of your milk container or cereal box to see if vitamin D has been added) and fatty fishes, such as salmon or mackerel. Some foods that contain vitamin D are more obscure; check out this list from the U.S. Department of Health and Human Services to discover more vitamin D sources you can add to your diet. 

The good news, if you are not a fan of cod liver oil, is that not all of our vitamin D comes from food. Our bodies can also manufacture vitamin D when our skin cells are exposed to direct sunlight. The recommended amount of sun exposure is 15 to 20 minutes, three times a week. However, in the winter months, especially in northern latitudes where winter can last half the year, it can be difficult for our bodies to manufacture enough vitamin D via direct sunlight. 

How Much Vitamin D Do You Need?

The recommended daily amount of vitamin D for adults who are less than 70 years old is 600 international units (IU) daily; for adults older than 70, the recommended amount increases. Vitamin D supplementation is also routinely recommended for infants, children, and adolescents because individuals in these age groups have actively growing bones, and vitamin D supplementation helps prevents a condition of abnormal bone growth known as rickets. 

How Do You Know If You’re Deficient in Vitamin D?

Many healthcare providers will routinely check vitamin D levels using a blood test. Your healthcare provider may also check your vitamin D level if you have an unusual broken bone (known as a pathologic fracture), or if you are displaying symptoms of a vitamin deficiency, such as tiredness, soreness, or mood changes.

If you are found to be deficient in vitamin D, you may be counseled to first increase your dietary intake and expose yourself to more sunlight to see if your vitamin levels come up without further intervention. However, if you remain deficient, your healthcare provider will likely recommend that you start taking a vitamin D supplement. 

Vitamin D supplements can be prescribed by your healthcare provider, and some are also available over the counter. For any medications that are prescribed, make sure to visit ScriptSave WellRx to save up to 80 percent at the pharmacy. 

Why Does a Vitamin D Deficiency Matter?

Chronic deficiency in vitamin D can manifest as certain undesirable symptoms, such as fatigue, muscle soreness, bone pain, and even depression. Additionally, if you are deficient in vitamin D, your body cannot appropriately use calcium to add to your bone density, so your bones may become too thin. This condition of pathological bone thinning, called osteoporosis, can increase your risk of breaking a bone.

Osteoporosis is a serious medical condition that is typically managed with prescription medications. These medications can be expensive, but you can use ScriptSave WellRx to find the lowest prescription price.

What To Do If You Think You Should Be Taking Vitamin D

If you think you may benefit from vitamin D supplementation, follow up with your healthcare provider. For many people, a vitamin D supplement can improve health. However, people with certain medical conditions should not take vitamin D. In addition, vitamin D can interact with some medications.

It is always best to initiate a new supplement in coordination with your healthcare provider, who can help monitor your progress and suggest course corrections as needed.

Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine, where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University.

References

https://ods.od.nih.gov/factsheets/VitaminD-Consumer/.

https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-12/.

https://my.clevelandclinic.org/health/articles/15050-vitamin-d–vitamin-d-deficiency.https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-20363792



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By Rosanna Sutherby, PharmD

The cold and flu season is in full swing, and hacking, persistent, and annoying coughs are at their peak. If you are suffering from these symptoms, your doctor may prescribe a cough medication, such as benzonatate (Tessalon Perles). Before heading to a pharmacy near you to pick up your medication, here some facts you should know about benzonatate.

What Is Benzonatate?

Benzonatate is a nonopioid (nonnarcotic) antitussive (cough suppressant) that is used to relieve cough if you have a cold or the flu, or if you have a chronic cough that does not respond to opioid cough suppressants. It is not used for chronic cough related to smoking, asthma, or emphysema, or when your cough produces large amounts of phlegm or mucus.

Looking for the best price on benzonatate?

How Does Benzonatate Help with Cough?

Benzonatate is related to a type of drug called ester local anesthetics. It works locally by numbing the stretch receptors in your lungs, throat, and airways. When you breathe, you stimulate these stretch receptors, which causes you to cough. By numbing the stretch receptors, benzonatate inhibits their action and reduces your cough reflex. It begins to work within 15 to 20 minutes of taking the medication and generally lasts for 3 to 8 hours.

What Is the Best Way to Take Benzonatate?

If your healthcare provider prescribes benzonatate, you should follow the instructions on your medicine label. Prescribers may dose this medication differently for different people.

Typically, patients take 100 mg to 200 mg of benzonatate up to three times per day, or every 8 hours. The maximum dose of benzonatate is 600 mg per day. If you take benzonatate capsules, you should swallow them whole. The capsules should not be opened, chewed, broken, dissolved, cut, or crushed. The liquid inside benzonatate capsules can temporarily numb your mouth and throat, suppress your gag reflex, and place you at risk of choking. If you accidentally chew or break a capsule in your mouth, do not eat or drink until the numbing effects have worn off.

Who Can Take Benzonatate?

Benzonatate is indicated for adults and children 10 years and older. It is vital to keep benzonatate capsules in childproof containers and away from children. The Food and Drug Administration (FDA) warns that benzonatate can cause death in children under 10 years of age who accidentally take the medication. In fact, children younger than 2 years of age have overdosed with as few as one or two capsules.

If your child accidentally takes this medication, call the poison control center (1-800-222-1222) and immediately get emergency care.

You should not use benzonatate if:

  • You are allergic to ester local anesthetics, such as benzocaine, procaine, or tetracaine. Lidocaine is not an ester anesthetic.
  • You are allergic to para-aminobenzoic acid (PABA).
  • You have difficulty swallowing.

Can I Take Benzonatate If I Am Pregnant or Nursing?

If you are pregnant, you should talk with your obstetrician-gynecologist (ob-gyn) before taking any medication.

Benzonatate is pregnancy category C, meaning that it should be used if the potential benefits of the medication outweigh the potential risks. A conversation with your ob-gyn will help you decide if benzonatate is safe for you and your baby.

According to the manufacturer, it is not known if benzonatate passes to breast milk. Given the lack of information, you may prefer to use an alternative cough medication if you are nursing.

What Are the Side Effects of Benzonatate?

All medications have side effects, but not everyone experiences them the same way. If you are taking benzonatate, you should be aware of the following potential side effects:

  • Allergic reactions
  • Headache
  • Drowsiness
  • Dizziness
  • Mental confusion
  • Visual hallucinations
  • Constipation
  • Nausea (upset stomach)
  • Itching or rash
  • Chills
  • Nasal congestion
  • Numbing of the chest
  • Hypotension (low blood pressure)
  • Eye irritation

If any of these side effects are severe or bothersome, let your healthcare provider know right away.

How Much Does Benzonatate Cost?

The cost of benzonatate varies depending on where you live, where you shop, and your insurance coverage. The average retail price for thirty 100 mg benzonatate capsules is about $20. If your insurance does not cover cough medications, you can use a free Rx savings card to get the lowest prescription price.

How Do Prescription Discount Cards Work?

Prescription drug cards, or prescription savings cards, help you obtain the lowest prescription price for your medication. Sometimes, you may find that your insurance plan does not cover your medication or that the price with insurance is higher than the cost with a prescription savings card. Using prescription savings cards may save you up to 80% or more off the retail price. Be sure to compare prescription prices before filling your prescription. You can use ScriptSave WellRx discount card for the best discount at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/011210s053lbl.pdf

https://www.mayoclinic.org/drugs-supplements/benzonatate-oral-route/description/drg-20062223

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415124/

https://www.mayoclinic.org/drugs-supplements/benzonatate-oral-route/proper-use/drg-20062223

https://www.pdr.net/fda-drug-safety-communication/tessalon?druglabelid=1327&id=8411https://www.pdr.net/drug-summary/Benzonatate-benzonatate-3512.5759#11



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zoloft and ibuprofen interaction - blog image

By Elizabeth Binsfield BA, RN

Helpful for Many

Many people receive health benefits from taking the selective serotonin reuptake inhibitor (SSRI) Zoloft to manage specific conditions. Zoloft, also known by its generic name sertraline, is prescribed as treatment for conditions such as depression, panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, and a severe form of premenstrual syndrome called premenstrual dysphoric disorder. Having such a medication available to treat the symptoms of these disorders is a tremendous relief to those affected. But it’s very important to be aware of any potential interactions with other medications, both those prescribed and those purchased over the counter.

Get a free ScriptSave WellRx prescription savings card.

Side Effects of Zoloft

As with all medications, Zoloft, or sertraline, has potential side effects that you should be mindful of, especially when taking other medicines. If you take Zoloft, it’s important to check the possible side effects and interactions when preparing to take any other medications. Your doctor and pharmacist are important resources to call on to ensure you aren’t combining medications inappropriately.

Zoloft and other medications like it can make your blood somewhat thinner than it was before you began taking it. It can cause you to have nosebleeds or to bruise more easily. You might even find that scrapes and cuts take a little longer to stop bleeding while you’re on Zoloft. This is why it’s so important to learn more about the side effects of other medications to ensure you don’t make your blood even thinner still.

Side Effects of Ibuprofen

When we have headaches, general aches and pains, or even arthritis pain, we usually reach for what are called anti-inflammatory medications. One of the most commonly known is ibuprofen. Ibuprofen is a very helpful over the counter medication for a variety of ailments, but it also has potential side effects and interactions that are important to consider.

One of the primary concerns with the use of anti-inflammatory medications is their association with stomach upset. They are well known to cause stomach discomfort because they can disrupt the chemistry in our stomachs and cause ulcers with regular use. They also cause the blood to thin, and can lead to excessive bleeding with continuous use.

Dangers of Taking Zoloft and Ibuprofen Together

The health concerns related to thinner blood becomes more likely when you take multiple medications known to cause your blood to thin. The danger of thinner blood is that we are that much more likely to easily bleed. Nosebleeds can be one common occurrence, but of greater concern is the increased risk for bleeding in the brain, which can be extremely dangerous. If you frequently take ibuprofen for pain and you also take Zoloft, you’re at a greater risk for bleeding issues. In addition, if you are elderly, or have kidney or liver disease, your risk for bleeding is even greater.

Safer Pain Relief Options with Zoloft

For over-the-counter pain relief without the risk of thinning the blood, acetaminophen (Tylenol) is a safer choice because it does not have the same side effects. However, you may want to discuss other options with your doctor. There may be topical medications or patches that the doctor determines are safe for you to use in addition to Tylenol. You may also be able to save as much as 80% on your Zoloft prescription and others by using ScriptSave ® WellRx. The WellRx website also offers free helpful tools for managing, tracking, and refilling your medications.

Elizabeth Binsfield, RN is a Richmond, Virginia-based registered nurse and freelance healthcare writer, who has more than 20 years of experience in medical-surgical acute care nursing, wound care, geriatrics, and home and hospice care. She received her nursing degree from Northern Virginia Community College.

References

https://www.drugs.com/sfx/zoloft-side-effects.html

http://www.nbcnews.com/id/22298763/ns/health-health_care/t/common-pill-combos-can-put-you-risk/#.XknErhNKjOQ

https://www.drugs.com/drug-interactions/ibuprofen-with-zoloft-1310-0-2057-1348.html

https://www.webmd.com/pain-management/news/20150714/antidepressant-painkiller-combo-may-raise-risk-of-brain-bleed#1

https://www.health.harvard.edu/newsletter_article/commentary-can-painkillers-cap-antidepressant-effect

https://www.wellrx.com/zoloft/drug-information/

https://www.healthline.com/health/pain-relief/ibuprofen-advil-side-effects#common-side-effects

https://www.webmd.com/digestive-disorders/digestive-diseases-gastritis#1https://www.wellrx.com/



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drug take back programs - blog image

By Joel Yambert, MS, BCMAS, Pharm.D. Candidate, Class of 2020
University of Arizona College of Pharmacy

Have you had a doctor tell you to stop taking a certain medication, or maybe you forgot to continue taking it for it a little bit—maybe the drug is even expired? What are you supposed to do with all these extra pills, patches, inhalers, or other medicines you no longer need? Luckily, there are a couple of different ways to get rid of unwanted or expired medications. These methods help keep the general population safe, and the environment, too.

DEA Drug Take Back Days

The DEA Diversion Control Division posts the next “Drug Take Back” dates on their website to inform people when and where they can dispose of their prescription drugs, while also providing education about potential abuse of medications.The drug take back days generally happen in April and October of each year. The next take back day (at the time of writing this article) is scheduled for April 25th, 2020.

The Legislative Agenda

Many states are creating laws and regulations in hopes that more people will be able to return their medications. In New York, the Drug Take Back Act (DTB) of Chapter 120 Laws of 2018 states that manufacturers establish, fund, and manage a New York state approved drug take back for the safe collection and disposal of unused covered drugs. Certain laws are pushing for it to become easier to return unused drugs for safe and proper collection at any time and not just on certain take back dates.

Drug Return, Recycle, and Reuse

There are other reasons to return your unused drugs, other than just freeing up space in your medicine cabinet. In many states, you can even donate the prescription drugs and return them to be recycled and reused for other patients. As of Fall 2018, there were 38 states that enacted laws for reuse and donation.

For example, Iowa started a program in 2007 and it has since helped 71,000 patients and redistributed $17.7 million in free supplies and medications to people in need. That is a huge help to others who are struggling to afford their prescriptions by simply returning your unused medications.

Are you paying too much for your medications?

What Cannot be Taken Back

Although it is encouraged to return almost all of your unused and expired medications to these take back locations, there are certain items that cannot be returned:

  • Needles, syringes, or other sharps
  • Thermometers
  • Empty containers
  • Bloody or infectious waste
  • Hydrogen peroxide
  • Illicit drugs (marijuana, cocaine, etc.), and more.

Almost every other prescription-medication related can be taken back. But, if the location is not able to take an item back, then they will likely be able to tell you the best place to get rid of it instead.

Safety Above All Else

The main concern for these drug take back programs is the safety of people, animals, and the environment. Drugs can end up in drinking water or being ingested by animals. Even when people use the restroom, there can sometimes still be trace amounts of unmetabolized drug making it back into drinking water after treatment. 

Programs like “National Prescription Drug Take Back Day” are vital in protection and well-being of our water supply and lives. The 2016 National Survey on Drug Use and Health found 6.2 million Americans misused controlled prescription drugs, mostly from family and friends—frequently from the medicine cabinet.

With current events like the opioid crisis occurring, it is not in anyone’s best interest to keep those kinds of drugs around. Additionally, it is not a good idea to throw them in the trash. People seeking drugs often dig through garbage looking for these particular drugs. So the next time you open the cabinet and see your unused or unfinished medications, it may be time to find when and where your next drug take back is taking place.

References:

  1. https://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html
  2. https://www.health.ny.gov/professionals/narcotic/drug_take_back.htm
  3. https://www.ncsl.org/research/health/state-prescription-drug-return-reuse-and-recycling.aspx
  4. http://www.takebackyourmeds.org/what-you-can-do/what-can-you-take-back/
  5. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf


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5 heart problem signs - blog image

By Libby Pellegrini MMS, PA-C

It’s hard to miss the classic presentation of a heart attack—hands clutching the chest in agony, sweating, rapid breathing. Whether in movies, drug commercials, or television shows, popular media have likely drilled the warning signs into your head. Even more nuanced signs of a heart problem, such as neck, arm, or jaw pain, tend to get our attention in a hurry. However, some heart problems make themselves known with signs that are far more subtle. 

Don’t be caught off guard when it comes to protecting your own and your loved ones’ hearts. Read on to learn five signs of a heart problem that are worth worrying about. 

1. Passing Out with No Warning

Fainting can occur for many reasons, including exhaustion, emotional distress, illness, dehydration, rising quickly from a seated position, or a brain condition. Usually, such episodes of fainting, also known as syncope, come with warning signs such as lightheadedness, dizziness, weak legs, or tunnel vision. However, fainting without any preceding clues could be caused by an electrical heart problem.

Typically, electricity drives the normal functioning of the heart. However, when the heart’s chambers receive certain abnormal electrical signals, the chambers can start pumping out of sync, creating a condition called complete heart block. The heart rate slows and blood pressure drops, causing your heart to temporarily stop sending blood to your brain. This can cause you to faint.

The causes of heart block include structural abnormalities in the heart, inflammation, infection, heart attack, surgical procedures, certain genetic abnormalities, or certain medications. If you or a loved one is experiencing episodic fainting, follow up with a healthcare provider immediately.

2. Getting Winded During Normal Activities

If you notice a sudden change in your ability to perform your normal daily activities, such as grocery shopping or walking up a flight of stairs, it could be caused by a problem with your heart.

As a muscle, the heart contracts in a coordinated effort to pump blood throughout the body, pushing blood from chamber to chamber and then out to the body. If one of the valves between the chambers becomes too narrow (due to infection, cumulative damage, or a structural problem), the heart has to work harder to pump blood. This increased pumping effort can cause you to feel more tired than usual during your normal activities. 

One specific valve that can become too narrow is the aortic valve. This valve, which sits on the left side of the heart, is the doorway between the heart and the rest of the blood network. If your healthcare provider suspects you have this heart condition, known as aortic stenosis, he or she will listen to your heart with a stethoscope to check for a murmur and likely order an ultrasound of the heart to better evaluate what is going on. 

3. Fast Weight Gain Without Explanation

Some types of weight gain can be easily explained by a few too many holiday parties, an ice cream marathon, or a bum knee that derails a workout routine. However, rapid weight gain without explanation could be a sign of a heart problem called heart failure.

When the heart is pumping (which is all the time, hopefully!), it relies on a series of mechanisms to keep blood flowing throughout the body. Typically, this is a beautifully orchestrated feedback loop: the heart beats, pushing blood to the kidneys and other organs; the kidneys filter out waste and excess fluid, creating urine; and the blood then is returned to the heart. However, if the heart weakens, it can’t keep up with the cycle, triggering a backup in the plumbing system. Fluid will start to accumulate in the body, outside of the blood vessel network, in places such as the legs, abdomen, or lungs. Retaining excess fluid in this manner can cause sudden weight gain.

Heart failure can come on gradually or suddenly. There are many causes or risk factors, including coronary artery disease, cigarette smoking, obesity, diabetes, high blood pressure, aging, infection, pregnancy, illicit drug use, and heart valve problems. Follow up with your healthcare provider for urgent evaluation if you are experiencing rapid weight gain that has no clear explanation.

4. Shortness of Breath When Lying in Bed

Shortness of breath that increases when you are lying flat can also be a sign of heart failure. When fluid backs up into the lungs, it can cause orthopnea, or feeling airless (short of breath) when lying down. Many people with heart failure will compensate by increasing the number of pillows they use to sleep so they are in a more upright position. 

If you or a loved one are experiencing this sign, follow up with your healthcare provider immediately for a thorough medical evaluation. Many people with heart failure are able to control their condition using medication. If you are prescribed a medicine, visit ScriptSave® WellRx to find the lowest prescription price.

5. Dizziness

Dizziness is a cardinal sign of many heart conditions, particularly problems with the heart’s rhythm. One common heart rhythm problem is atrial fibrillation, or “a-fib.” When the heart switches into a-fib, it beats rapidly in an irregularly erratic pattern, which results in inconsistent delivery of blood to the brain. This sporadic brain perfusion from the variability in blood delivery to the brain can cause the symptom of dizziness.

Atrial fibrillation can be caused by coronary artery disease, high blood pressure, age, infection, or hormonal problems. If you or a loved one is feeling dizzy, especially if you also have a noticeably rapid heartbeat, seek medical attention immediately.

Putting It All Together

Some signs of a heart problem are subtle. If you are experiencing any of the five signs above, follow up with a medical provider immediately. If, after a thorough evaluation, you are diagnosed with a heart condition, you will likely be prescribed a medication. Make sure to check out ScriptSave WellRx at a pharmacy near you to receive the lowest prescription price. 


References:

Cleveland Clinic, Heart Block

Cardio Smart, American College of Cardiology, Aortic Stenosis

Mayo Clinic, Heart Failure

Harvard Health, Atrial Fibrillation

Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine, where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University. 



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While employer health insurance and government programs like Medicare offer prescription coverage for many Americans, there are still a large number of people who fall through the coverage gap. 

Patient assistance programs (PAPs) are offered by many pharmaceutical manufacturers. These programs provide eligible patients with access to brand-name medications at little or no cost.

There are a growing number of PAPs available in the U.S. While most of these programs are funded by drug companies, there is an increasing number offered by states, local governments, and non-profit organizations. Regardless of the organization offering them, PAPs can be a big help to anyone who is unable to afford their medication.

How Patient Assistance Programs Work

Patient assistance programs provide medications for free or at a reduced cost for individuals who are uninsured or underinsured and can’t afford their medication.

Each program differs, however, most will require patients to complete an application form. Some programs may also require financial and medical information from the applicant. In addition, almost every PAP will require some level of information from your doctor. Some programs only request your doctor’s signature while others may require your doctor complete a form. 

Once you have been accepted by the program, your medication may be delivered in several different ways. Some PAPs distribute the medication directly to your doctor’s office, some will send it to a pharmacy, and others may send the medication directly to you. 

Qualifying For Patient Assistance Programs

Eligibility requirements will vary for each patient assistance program. However, there are a number of common requirements that patients must meet to qualify for a program. 

  • Health requirements – Organizations often require patients to provide proof of need for the drug. A written prescription for the medication is often enough, but some programs may require additional documentation, including signed forms from the patient’s doctor.
  • Insurance Requirements – Patients will typically have to provide proof that they are uninsured, under insured, or that their insurance plan does not cover the medication or medical supply.
  • Financial Requirements – Income is another qualifying factor considered by organizations offering PAPs. In order to qualify, patients must demonstrate a financial need. PAPs often use the Federal Poverty Guidelines to establish qualifying income thresholds and some will use tiered eligibility requirements; in other words, a patient in the lowest income tier may receive the medication completely free, while someone in the next eligibility tier will receive the medication at a discount.

Each PAP’s benefits will vary widely and they often have different requirements for patients. If you’re unsure of the program’s requirements, programs will often have a support line you can contact with questions. 

Patient Assistance Programs vs. Prescription Discount Cards

While looking for help to save on prescriptions, you might come across information about both PAPs and prescription discount cards. While both are meant to help individuals lower their prescription costs, they differ in how they work and who is eligible

Unlike PAPs, most prescription discount cards, including the ScriptSave WellRx discount card, are available to anyone, regardless of financial or insurance status. Additionally, you are not required to involve your doctor or meet any medical requirements to use your discount card.

While PAPs are usually sponsored directly by pharmaceutical companies, prescription discount card programs help people save by negotiating discounted cash prices on both generic and brand name medications. Patients can then receive lower cost prescriptions by showing their discount card at participating pharmacies.

Related Article: Rx Discount Cards vs Drug Coupons

Prescription Savings With ScriptSave WellRx

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Medicare Part C, also known as Medicare Advantage, is a health insurance plan offered by private insurance companies that have been approved by Medicare. Advantage plans give you the option to enroll in a single policy that contains the same coverage as Medicare Parts A and B, as well as prescription drug coverage.

With so many parts and plan options, Medicare can be confusing. We’ll explain everything you need to know about Medicare Advantage plans, and whether they’re right for you.

How Is Medicare Part C Different from the Other Parts of Medicare?

A major difference between Medicare Advantage (Part C) plans and Original Medicare plans is the insurance providers. While the U.S. government provides the coverage on Original Medicare plans, Medicare Advantage plans are offered by private insurers who are vetted by the government.

Medicare Advantage plans and Original Medicare also differ in coverage. Original Medicare consists of Part A, B, and D. Part A covers inpatient services like hospitalization or care in a skilled nursing facility. Part B covers outpatient care such as routine doctor visits, lab tests, and preventative care. Part D provides coverage for prescription drugs.

Medicare Advantage plans provide the same coverage as Part A and Part B, as well as prescription drug coverage that varies with each plan. Since private insurers offer Medicare Advantage plans, drug formularies vary.

Find discounts on drugs not covered by your Medicare Part C plan:

Some Part C plans can also provide additional vision and dental benefits that may not be covered by Original Medicare. They may even give you extra wellness benefits like discounted gym memberships.

Is Medicare Advantage Right for Me?

Individual needs vary, so it’s important to compare your health insurance options and choose the coverage that is right for you. Here are some of the benefits of Medicare Advantage plans:

  • Same coverage as Medicare Part A and Part B.
  • Added benefits such as prescription drug coverage, dental, and vision (varies by plan).
  • Care coordination; under certain Part C plans, you can designate a Primary Care Physician (PCP) to help coordinate your care. Certain plans also provide medication therapy management.

Overall, a Part C plan offers more comprehensive coverage in one plan. If you were to enroll in an Original Medicare plan, you would have to elect for Part D prescription drug coverage separately, and dental and vision care would be limited. 

However, there are a few drawbacks to Medicare Advantage plans, including:

  • More limited provider networks
  • Special authorization or referral requirements

While Original Medicare plans allow you to see any provider who accepts Medicare, a Part C plan requires you to see a provider in that plan’s specific network. The Part C provider networks are usually regional, not national like Original Medicare. Additionally, your Part C plan may require you to obtain prior authorization for certain medical procedures or get a referral from your PCP to see a specialist.

Medicare Supplement Insurance

You may have heard about Medicare Supplement Insurance, or Medigap. Like Medicare Advantage plans, Medigap is offered by private health insurance providers. 

However, Medigap requires you to maintain Medicare Part A and Part B coverage. In fact, it is illegal for you to purchase Medicare Supplement Insurance if you have an Advantage Plan. If you currently have Medigap and are thinking of joining an Advantage Plan, you should contact your insurance company to drop your policy.

A Medigap policy is meant to help cover additional healthcare costs that Original Medicare does not, like:

  • Deductibles
  • Coinsurance
  • Copayments

As a supplement to Original Medicare, you must pay a separate monthly premium for your Medigap policy. This payment is made to the private insurer issuing the policy. 

It is important to note, Medigap policies are supplemental and only offer limited coverage. For example, policies may not cover:

  • Prescription drugs
  • Vision or dental care
  • Most long-term care
  • Private-duty nursing

In this regard, Medicare Advantage plans offer the benefit of an all-in-one comprehensive policy. 

Can I Be Turned Down For A Medicare Advantage Plan?

In general, if you are eligible for Medicare Parts A & B, then you will not be denied coverage by Part C. Patients with pre-existing medical conditions are also still eligible for Medicare Advantage plans. The only exception is for End-Stage Renal Disease (ESRD).

Individuals with ESRD may be ineligible for most Medicare Advantage plans. However, certain Special Needs plans may still provide coverage. 

Medicare Advantage Plan Costs

Monthly premiums for Medicare Advantage plans can range from $0 to more than $300. Premiums vary between plans and even by location. However, when comparing plans, it’s important to consider more than just premiums. 

For example, while some plans may have a $0 premium, copays and deductibles for these plans can be much higher than in plans with more expensive premiums. Always compare all the costs of a plan and make sure that it meets your healthcare needs.

Medicare Advantage Plan Prescription Drug Coverage

While many Medicare Advantage plans include prescription drug coverage, drug formularies vary across plans. This means co-pays may differ and not all drugs will be covered by your plan. 

If your medication is not covered by your Medicare Part C policy, or the co-pay is too high, ScriptSave WellRx may be able to help you save. Our drug price comparison tool lets you check prices at multiple pharmacies in your area. You can also get a free prescription discount card to help you save at the pharmacy.

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By Joel Yambert, MS, Pharm.D. Candidate, Class of 2020,
University of Arizona College of Pharmacy

We’ve all seen it happen before. You’re in line at the pharmacy and next thing you hear, “No way. How do you expect anyone to afford that? I’m not paying for that!” Healthcare costs in the United States have continued to skyrocket. A recent poll from the Kaiser Family Foundation shows that nearly one-in-four (25%) people stated they have difficulty affording their medications and three-in-ten (30%) report not taking their medications as prescribed due to drug costs.

So why are all these medications so expensive?

The Main Players in Drug Costs

There are a number of players in the pharmaceutical pipeline who impact the price of medications.

Government/
lawmakers
Pharmaceutical Companies/
Manufacturers
Pharmacy Benefit Manager (PBM)/
”Insurance”
Pharmacy stores/hospitals Patient
Pass laws that affect pricing, taxing, and reimbursement of drug creation and distribution Base pricing on a variety of factors: cost to create the drug, number of people with potential to take the drug, and severity of need for the drug Acts as the middleman between health plans, drug manufacturer, and pharmacy Pharmacies pay a wholesaler to get drugs from the manufacturer and have contracts with PBMs to dispense the drugs There are a variety of places to get your drugs, private or government insurance, and other elements

Government Factors

According to a government survey from the National Health Expenditure Accounts Team, spending on prescription drugs increased 12.2% in 2014. There was a drug recently approved for a rare childhood disorder that costs $2.1 million for treatment. Policymakers and legislature are constantly working on ways to control drug costs to try to find a balance between those creating the drugs, those paying for them, and the companies that act in between them—such as PBMs. Government officials and lawmakers look to other countries’ policies to continuously evaluate the state of drug costs, and healthcare in general, in the United States.

High Costs of Drug Development

As discussed in my article “Antibiotic Overprescribing: Creating the Next Big Superbug?,” the manufacturing and development of new antibiotics has been halted by most drug companies due to the lack of profit from their investment in antibiotics.

Drug development costs for pharmaceutical companies continue to rise as well as the cost to the consumers. The median cost of drug development for a single drug was $648 million, according to a 2017 study. Another study stated the cost to be an average of $2.7 billion.

These costs have put more pressure on pharmaceutical companies to be profitable in their drug development processes. Some diseases, like Alzheimer’s, have had their drug development funding cut in order to tackle more profitable diseases like cancer.

Pharmacy Benefit Managers and Pharmacies

Pharmacy Benefit Managers (PBMs) act as middleman, so they negotiate drugs from the manufacturers at a discounted price for pharmacies. The pharmacy then purchases the drug from a wholesaler and the PBM charges the pharmacy a fee for getting the drug at a discounted cost. By doing this, the PBM retains the rebates on the medications instead of passing them down to pharmacies or consumers. Rebates are also gained by the PBM when they put the drug from the drug manufacturer on their PBM formulary. Due to this, the pharmacy is paying the wholesaler for the discounted cost and paying a fee to the PBM.

For pharmacies to gain money back from paying for the PBM service and for the medication itself, they pass the financial burden downstream to the patient (or buyer). You can see that there are many different processes occurring that result in the way drugs are priced and how much they end up costing the patient.

Advantages of a Free Market

This may seem like finding affordable medication is helpless. What can you do to combat high drug prices? Many pharmaceutical company (or drug) sites will have coupons for their drugs that patients can use. There are also apps available, like ScriptSave WellRx, that provide discount pricing, sometimes less than the amount your insurance is willing to provide, on certain medications. There are many more avenues patients can take in order to combat against the high price of their medications. Talk to your pharmacist or doctor about potential price burdens.

Your health is in your own hands. You have the ability to research these pathways in order to get the best deal you can for your mediation needs. Don’t be afraid to ask questions to your various healthcare providers in order to get the help you need. Sometimes pricier drugs have alternatives that may be more affordable to fit your budget!

References:

  1. https://www.kff.org/health-costs/press-release/poll-nearly-1-in-4-americans-taking-prescription-drugs-say-its-difficult-to-afford-medicines-including-larger-shares-with-low-incomes/
  2. Martin AB, Hartman M, Benson J, Catlin A. National Health Expenditure Accounts Team. National health spending in 2014: faster growth driven by coverage expansion and prescription drug spending. Health Aff. 2016;35(1):150–60.
  3. Prasad, V., & Mailankody, S. (2017). Research and Development Spending to Bring a Single Cancer Drug to Market and Revenues After Approval. JAMA internal medicine177(11), 1569–1575. doi:10.1001/jamainternmed.2017.3601
  4. Ventola C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T: a peer-reviewed journal for formulary management, 40(4), 277–283.
  5. https://www.rheumatology.org/Portals/0/Files/Issue-Brief-Pharmacy-Benefit-Manager-Transparency.pdf


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overprescribing antibiotics

by Joel Yambert, MS, Pharm.D. Candidate, Class of 2020
University of Arizona College of Pharmacy

It’s another intense flu season and it may seem like everyone around you is getting sick. That sick person may even be you! People rush to the doctor to see what medications they can be given to make them feel better and “back to normal” quickly. The truth is, whatever is causing your sickness may not need antibiotics at all.

A recent study from the Centers for Disease Control and Prevention (CDC), states that around one-third of antibiotic prescriptions given to people to take are unnecessary. Illnesses where antibiotics aren’t needed, but taken anyway, may be putting you and others in an even tougher, sicklier situation in the future. This is due to bacteria (or “bugs”) gaining resistance to antibiotics, creating so-called Superbugs.

How Do Bacteria Acquire Resistance?

It’s a commonly believed myth that your body gets used to certain antibiotics and forms its own resistance to them. The fact is, bacteria, like humans, can change and can obtain their own methods of resisting antibiotics. Another way is, bacteria are able to gain deoxyribonucleic acid (DNA) from other bacteria through gene transfer to gain resistance.

Bacteria are very dangerous in this way. One of these superbugs, Methicillin-resistant Staphylococcus aureus (MRSA), is a type of bacteria whose resistance has grown more common in recent years. It accounts for more deaths of Americans every year than homicide, emphysema, HIV/AIDS, and Parkinson’s disease combined.

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Policies and Ideas to Prevent Antibiotic Resistance

There are many procedures and policies suggested to fight against overprescribing of antibiotics that are discussed among healthcare groups:

  • Use of antimicrobial programs – having an antimicrobial expert review and consider correct antibiotic use in hospitals and other healthcare locations.
  • Use of rapid point-of-care tests – strep throat and similar rapid tests can correctly identify bacteria or lack of them.
  • Delayed antibiotic prescribing – having patient not pick up antibiotics right away and only get medication if sickness continues or gets worse.

Some doctors say the need of antibiotics’ prescriptions for breathing infections, the most likely cause of a clinic visit, is thought to be less than 20%. Many factors can cause overprescribing, from a push for increased profits to the lack of time to properly assess patients in healthcare settings. 

Hopefully, further action is taken to prevent the increasing rate of antibiotic-resistant bacteria. This concept of a “superbug” is on a global scale, showing a worldwide overuse of these drugs. Unfortunately, there’s also a lack of progress for newer antibiotics from the drug companies, due to the increased cost of drug creation.

Ways to Fight the “Superbug”

The CDC has a goal to lower inappropriate outpatient antibiotic use by 50% by the end of 2020. There are ways you can personally fight superbugs as well:

  1. Finish your antibiotic prescriptions—even if you are feeling better, continue taking the antibiotics per your doctor’s instructions
  2. Don’t take someone else’s antibiotics to treat your own sickness without getting advice from a medical professional.
  3. Have good hygiene – Thoroughly washing your hands, and food before cooking and maintaining clean living conditions can go a long way to reducing infections.

Trust Your Healthcare Provider

You should continue to trust your healthcare workers (doctors, nurses, pharmacists, etc.) to evaluate your sickness and provide the care and medications you need. A doctor can usually run tests that can identify what bacteria may be causing your sickness.

Steps are being taken through academic programs and other health groups to teach about proper antibiotic use. Trust that your doctor will prescribe the right antibiotics (or not prescribe them at all!) to make the best outcome for your present and future health.

References:

  1. https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html
  2. Infectious Diseases Society of America (IDSA), Spellberg, B., Blaser, M., Guidos, R. J., Boucher, H. W., Bradley, J. S., … Gilbert, D. N. (2011). Combating antimicrobial resistance: policy recommendations to save lives. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America52 Suppl 5(Suppl 5), S397–S428. doi:10.1093/cid/cir153
  3. Llor, C., & Bjerrum, L. (2014). Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic advances in drug safety5(6), 229–241. doi:10.1177/2042098614554919
  4. Ventola C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T: a peer-reviewed journal for formulary management40(4), 277–283.
  5. Uchil, R. R., Kohli, G. S., Katekhaye, V. M., & Swami, O. C. (2014). Strategies to combat antimicrobial resistance. Journal of clinical and diagnostic research: JCDR8(7), ME01–ME4. doi:10.7860/JCDR/2014/8925.4529


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Update: As of the week ending January 25, 2020, the CDC says there have been 10,000 deaths and 19 million illnesses this flu season.

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?

Google has reported an explosion of searches for “beer virus” and “corona beer virus.” Before you throw that six-pack out, the Coronavirus has nothing to do with beer.

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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