measles vaccine image

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

If you follow recent news, you’ve probably heard about measles outbreaks cropping up in California1, Washington2, and New York.3 The Centers for Disease Control and Prevention (CDC) reports, as of September 2019 there have been 1,241 confirmed cases of measles in the United States this year, a number already higher than the previous four years combined.4 With so many cases, this year marks the largest outbreak of measles in the United States in 27 years.5

What is measles?

Measles, also known as rubeola, is a viral disease that can lead to fever, cough, runny nose, and red, watery eyes.4 These symptoms will usually appear about 7 to 14 days after being infected, before which a person may not even know they are sick.

In addition, a few days after these symptoms start to show, a measles rash will appear. This rash normally starts on the face and spreads down the body, starting with small red spots that will merge over time. The rash will usually remain for about five days before fading away.

Why should I be concerned?

The measles virus is spread when an infected person coughs or sneezes, releasing viruses into the surrounding area. Once in the air, the virus can remain there for up to 2 hours, with anyone passing through the area at risk of breathing in the virus and getting sick.3,4

This virus is very contagious, which means that if exposed people are not protected by a vaccine, they have a 9 out of 10 chance of catching the disease!2 While measles is technically considered eliminated in the US, recent cases come from unvaccinated people traveling outside of the country, catching measles abroad, and bringing it home with them.1,2,4

Measles symptoms generally are not very severe, but this disease can have very serious complications including:

  • permanent hearing loss
  • severe lung diseases
  • swelling of the brain
  • pregnancy complications
  • death.4

Before the vaccine for measles was developed, over 3 million people were infected annually, with 48,000 hospitalized and 400 dying from measles and related complications each year.

How can I protect myself?

The best protection for measles is the vaccination.1,2,3,4 The measles vaccination is available as a combination vaccination with mumps and rubella, together called the measles-mumps-rubella or MMR vaccine.4

This vaccine works by teaching your body’s immune cells what to watch out for and helps prepare the body’s defenses for the viral attack. The vaccine is very effective, and when used as recommended is 97% effective at preventing measles.4

For most adults, the CDC recommends getting one dose of the vaccine, with certain conditions requiring a second dose achieve full immunity.9 In small children, the recommendation is to get one dose at 1 year old, and a second dose between 4 to 6 years old.9 The vaccine can and should be given to children under 1 year of age if planning on traveling internationally.3,9

Is the vaccine safe?

Yes, the MMR vaccine has been shown in repeated studies and trials to be safe and effective.2,3,6 While there have been concerns expressed that vaccines may cause autism, dozens of studies over the last 25 years including tens of thousands of patients have found no link between vaccines and autism.7,8

Additionally, the vaccine component purported to cause harm, a preservative called thimerosal, has never been a part of the MMR vaccine.6 The most common side effect of vaccines is redness and soreness at the injection site, and in rare cases a mild fever or rash may arise.4

Where can I get the vaccine?

The MMR vaccine is available at your doctor’s office or your pharmacy and is free of charge with most insurance plans.  If you don’t have a regular doctor or pharmacy, you can use https://vaccinefinder.org/ to find a location near you.10

Pharmacies are especially convenient, with 9 in 10 Americans living within 5 miles of a pharmacy.  At most pharmacies, no appointment is required, and your pharmacist can have you vaccinated and on your way in mere minutes. So then, what are you waiting for?

References

  1. Disneyland, Universal Studios Hollywood Visitors Reportedly Exposed to Measles. TIME. Aug 24, 2019. https://time.com/5660904/new-zealand-teenager-measles-southern-california/ Accessed Sept 20, 2019.
  2. Measles Cases Mount in Pacific Northwest Outbreak. NPR News. Feb 8, 2019. https://www.npr.org/sections/health-shots/2019/02/08/692665531/measles-cases-mount-in-pacific-northwest-outbreak. Accessed Sept 23, 2019.
  3. US in danger of losing measles-free status, a ‘mortifying’ effect of anti-vax movement. USA Today. Sept 13, 2019. https://www.usatoday.com/story/news/nation/2019/09/13/us-could-lose-measles-free-status-if-outbreak-continues-new-york/2300281001/ Accessed Sept 19, 2019.
  4. Measles (Rubeola). Centers for Disease Control and Prevention. N.d. https://www.cdc.gov/measles/index.html Accessed Sept 19, 2019.
  5. U.S. measles cases reach highest level in 27 years. NBC News. May 31, 2019. https://www.nbcnews.com/health/kids-health/u-s-measles-cases-reach-highest-level-27-years-n1012401 Accessed Sept 23, 2019.
  6. Vaccine Safety. Centers for Disease Control and Prevention. N.d. https://www.cdc.gov/vaccinesafety/index.html Accessed Sept 20, 2019.
  7. Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism. Journal of the American Medical Association. April 21, 2015. https://jamanetwork.com/journals/jama/fullarticle/2275444 Accessed Sept 23, 2019.
  8. MMR Vaccine Does Not Cause Autism: Examine the evidence! Immunization Action Coalition. N.d. http://www.immunize.org/catg.d/p4026.pdf Accessed Sept 23, 2019.
  9. Immunization Schedules. Centers for Disease Control and Prevention. N.d. https://www.cdc.gov/vaccines/schedules/index.html Accessed Sept 19, 2019.
  10. Vaccine Finder. HealthMap.  N.d.  https://vaccinefinder.org/


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dangers of vaping and e-cigarettes - blog image

by Marcos Puente, PharmD Candidate Class of 2020
University of Arizona

If you have transitioned from regular cigarettes to electronic cigarettes (e-cigarettes) or vaping products for a safer and healthier alternative, you may want to reevaluate your decision. Until recently, many people believed that e-cigarettes and vaping were considered a “better” option compared to cigarettes because they do not release tar as well as other toxic gases found in cigarette smoke.5

Although many individuals have found that transitioning to e-cigarettes or vaping has helped with reducing their use of traditional cigarettes, and in some cases have helped cigarette smokers quit overall, recent cases of lung illnesses have raised the question: are e-cigarettes and/or vaping truly a better, safer alternative to traditional cigarettes?

An Epidemic of Lung Ailments

Vomiting, coughing, shortness of breath, and fatigue have been the most common signs and symptoms most individuals have complained about after vaping/using e-cigarettes within the last 90 days4. As of September 7, 2019, there have been at least 450 cases of an unknown lung disease possibly related to vaping, which has already claimed the life of three people across the nation. The Food and Drug Administration (FDA) and Center for Disease Control and Prevention (CDC) are investigating extensively to pinpoint the exact cause of these lung disease outbreaks and if they are in anyway related to vaping and/or using e-cigarettes3.

What We Now Know

  • CDC and FDA are warning consumers about the vaping-linked lung disease
  • CDC is recommending avoiding e-cigarettes while the FDA is suggesting avoiding products that contain THC (marijuana compound that produces a high)3
  • It is still too early to pinpoint an exact cause or culprit for the outbreak of these lung illness cases3

Potential Cause of these Lung Illness Cases

Although an exact explanation has not been recognized as to what is causing these recent lung disease outbreaks, health investigators have linked vaping to the underlying cause of these lung ailment cases. A clinical psychologist from San Francisco, Dr. Danielle Ramo, suggests that certain additives in the vapor being released from these vaping products contain oils that can be highly dangerous and toxic if heated and inhaled.1 One of the oils being identified in many of these recent outbreak cases is vitamin E, which is commonly used as a supplement and topical moisturizer/cream. Although Vitamin E is safe when applied topically and consumed as a supplement, it can cause damaging effects when inhaled as smoke.3 Although not all vaping products and e-cigarettes contain these additives, it is sill highly recommended to avoid these products until further research and studies have been completed.1

What this Means to You

If you are currently using e-cigarettes or vaping as an alternative to traditional cigarettes, it is highly recommended to quit until a definitive cause is identified for the growing number of lung disease cases across the nation.4 It is too early to determine if a certain brand is responsible for these outbreaks or if the lung illness cases are related to a specific ingredient found in some products offered on the shelves, or possibly even a black-market product being sold which can potentially contain an unsafe chemical. Whatever the cause may be, quitting e-cigarettes and vaping overall can potentially decrease your risk of developing future lung disease (e.g. COPD, lung cancer).

Need Help Quitting?

There are services and support to help assist you in quitting vaping and/or using e-cigarettes. To get free, personalized support from an expert you can call 1.800-QUIT-NOW or 1.800.44U-QUIT to talk with a tobacco cessation counselor. There is also becomeanex.org, a website designed to help support and give you resources to help you quit smoking or vaping.2

Sources:

  1. Graff, Amy. “57 Cases of Lung Illness Linked to Vaping Reported in California, 1 Death.” SFGate, San Francisco Chronicle, 9 Sept. 2019, www.sfgate.com/bayarea/article/vaping-California-acute-lung-disease-death-14424730.php
  2. “Imagine Your Life without Tobacco. Looks Great, Right?” Become An EX Smoker, Learn to Quit Smoking, Stop Smoking Cigarettes, www.becomeanex.org/.
  3. Lavito, Angelica. “What Should People Avoid Inhaling during Mysterious Lung Disease Outbreak? Health Officials Disagree.” CNBC, CNBC, 7 Sept. 2019, www.cnbc.com/2019/09/07/cdc-fda-clash-on-warning-consumers-during-lung-disease-outbreak.html.
  4. Richtel, Matt, and Denise Grady. “What You Need to Know About Vaping-Related Lung Illness.” The New York Times, The New York Times, 7 Sept. 2019, www.nytimes.com/2019/09/07/health/vaping-lung-illness.html
  5. Ross, John. “E-Cigarettes: Good News, Bad News.” Harvard Health Blog, 5 Aug. 2019, www.health.harvard.edu/blog/electronic-cigarettes-good-news-bad-news-2016072510010


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photographs for memories images for alzheimer's

by Cherokie Dyer, PharmD candidate class of 2020,
University of Florida

Alzheimer’s is an irreversible brain disease best known for the hallmark sign of dementia. It is believed that Alzheimer’s is caused by plaques that form in the brain and damage your memory, thinking skills, and ability to do simple tasks. Usually the disease shows up around 60 years of age, with rare exceptions.

Treatment for Alzheimer’s

Currently, there are a few treatments to help with the symptoms of Alzheimer’s disease including agitation, loss of appetite, mood, and paranoia but there is no cure for the disease itself. In the past, Alzheimer’s disease seemed to be a random occurrence in old age.  The good news is that we now have research to suggest that it can be prevented or delayed.

Five ways to Prevent Alzheimer’s

There is not one specific behavior that you can start to prevent or delay Alzheimer’s. Rather, the Rush study lends evidence to suggest that it is a combination of four or more of these lifestyle behaviors that can lower your chances of getting Alzheimer’s. These findings even apply to people with an increased risk of Alzheimer’s due to genetic factors and family history.

  • Not Smoking
  • Exercising for at least 150 minutes a week at a moderate or vigorous level
  • Eating a brain supporting diet
  • Very light to moderate alcohol consumption
  • Engaging in late-life cognitive activities

The Alzheimer’s study indicates that practicing two or three of these behaviors can reduce your risk by about 37%. Practicing four or five of these behaviors can reduce your risk by 60%.

What is a Brain Food?

While most of these Alzheimer’s preventing behaviors are self-explanatory, two may need further explanation: ‘Eating a brain supporting diet’ and ‘light to moderate alcohol consumption’.

The MIND diet was developed by the same researchers as the Rush Study and incorporates recommendations from two popular heart healthy diets. It stands for Mediterranean-DASH Intervention for Neurodegenerative Delay and it was adjusted based on foods that would be accessible for Americans to readily include in their diet.

The MIND diet emphasizes ten foods you should eat daily and five foods you should avoid.

Start Eating: Green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and one cup of red wine

Avoid Eating: Red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food.

Key Take Aways

  • Alzheimer’s is a progressive disease that can manifest as severe dementia.
  • There currently is no cure, but there is hope to prevent or delay it as you age.
  • Embracing at least four out of five lifestyle adjustments found in the Rush Study can lower your risk of developing Alzheimer’s disease by 60%.

References:

https://www.nia.nih.gov/health/what-alzheimers-disease

https://www.nbcnews.com/health/aging/can-alzheimer-s-be-stopped-five-lifestyle-behaviors-are-key-n1029441

http://www.nbcnews.com/id/57163245/ns/technology_and_science-science/t/mind-your-diet-protect-against-alzheimers/#.XS5OzehKiUl

Mind Diet – https://www.ncbi.nlm.nih.gov/pubmed/25681666

Findings from the Rush Memory and Aging project – https://www.ncbi.nlm.nih.gov/pubmed/22471867



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stress hurts your health image

by Cherokie Dyer, PharmD Candidate,
Class of 2020, University of Florida

When was the last time you felt stressed?

Stress is so common that there is an organization called, “The American Institute of Stress.” According to this group, there are 50 common signs and symptoms of stress. Many of the signs we think about when it comes to stress are difficulty making decisions, excessive anxiety, worry, guilt, and nervousness. Other common signs include increased frustration, irritability, and edginess. We can determine these signs based on our interactions with people. But… did you ever think about what stress is doing to your body on the inside?

How does Stress affect the body?

Stress can be a good thing in an emergency. It turns on your ‘fight or flight’ response. This gives you that ‘adrenaline rush’ feeling, which is the release of cortisol and epinephrine. Stress raises your blood pressure, makes your heart beat faster, and boosts sugar levels in your blood. It can also slow down your digestive tract, make your muscles tense up, and make your breathing become more rapid. All these bodily reactions are great to help you act during a crisis.

However, it’s not good when our bodies are constantly flooded with stress for a long period of time.

  • Heart racing and blood rushing may cause inflammation in arteries and lead to heart attacks or strokes.
  • Constant boosts in blood sugar can affect insulin and lead to pre-diabetes.
  • An impaired digestive tract can keep the body from getting valuable nutrients and lead to hard or loose stools.
  • Constantly tensed muscles can cause tension headaches and migraines.
  • Rapid breathing can cause hyperventilation and lead to panic attacks.
  • Increased cortisol may cause the body to hold on to belly fat.
  • These reactions can start to make the menstrual cycle irregular or lower sperm counts.
  • Stress can also affect eating patterns making us want to eat more or less than usual.

Believe it or not, constant stress can wreak havoc on our body in a multitude of other ways. Especially if you already have medical conditions like heart disease, diabetes, irritable bowel syndrome, or obesity. Your constant stress could very well be the thing that’s preventing your medications from helping you get better.

Two Key Strategies to Manage Stress

Try to prevent it and cope with it when it comes. Figure out the things that trigger your stress. Do your best to avoid them or work around them. For instance, if leaving on time for work stresses you out, invest in a new alarm or get up even earlier to give yourself more time.

There are other ways to prevent stress besides just avoiding your triggers.

  • Carve out some more alone time for yourself
  • Do more of the things that you bring you joy
  • Make the effort to get near 8 hours of sleep
  • Eat more fresh foods and whole foods
  • Avoid stimulants like caffeine.

If you are already feeling stressed out, then there are a ton of options that you can try:

  • Calming activities like prayer, yoga, massages, and/or deep breathing
  • Active movements like going for walks, jogs, lifting weights, or taking group classes like kickboxing
  • More of your favorite hobby, listen to music you like, play with your pet more often, or participate in volunteer work.

The options are endless and there is no correct answer!

Bottom Line

Stress can be negative for both our sanity and our bodies. There are a variety of ways to deal with stress. Identify when you feel the most stressed out. Do your best to avoid that trigger and/or cope with those feelings, and your body will thank you in return.

References

https://www.stress.org/stress-effects
https://www.stress.org/military/combat-stress/management
https://www.stress.org/daily-life



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by Emily Ross, PharmD Candidate,
Class of 2020

You can add it to your morning coffee or smoothie. It is available in drops, creams, gummy bears, face masks and so much more. Some say it can help with anxiety, depression, insomnia, arthritis pain and a variety of other issues. You have likely seen it in your local market, pharmacy or shop on the corner. That’s right, we are talking about the latest health trend – CBD.

With all these new products to hit the market it has people wondering: Is CBD safe? Does CBD work? Should I use CBD? We are going to discuss these concerns and more to see if CBD is worth all the hype.

What is CBD?

Let’s start off with basics – CBD stands for cannabidiol. This is a chemical component of the plant Cannabis sativa which has two primary species – hemp and marijuana. The hemp variety contains a higher percentage of CBD. The other major component in the cannabis plant is THC – which is the psychoactive agent responsible for producing the effects most people associate with marijuana. For the purposes of this article, we will be focusing on CBD.

What is CBD Used For?

From relieving pain to helping with insomnia, people are using CBD for a variety of reasons. Many of the problems CBD has the potential to relieve is based on its action in what is called the endocannabinoid  system (ECS.)

This is a special system in the human body that is involved in many life functions including sleep, appetite, pain and immune system. By acting on receptors in the ECS, it may help treat issues listed with the above systems. In addition, it may also have anti-inflammatory effects that would help with chronic conditions such as arthritis.

Another indication for using CBD for many people is to relieve anxiety and depression symptoms. There are studies that show CBD to have an antidepressant effect due to its interaction with serotonin. Serotonin is a molecule in the body that regulates mood and behavior.

In addition, there are unsupported claims that CBD can help to reduce cancer-related symptoms, decrease acne, benefit heart health and may even prevent diabetes. I have just listed a few of the many different reasons people are using this new product.

Does CBD Work?

CBD makes a lot of great promises; however, this only goes so far if there are not proven benefits and results. There have been many studies done in animals and humans with CBD on the possible benefits. CBD has show efficacy in small clinical trials in reducing stress and anxiety, but more research is needed.

The research as to whether it is effective for pain relief is very early and the results are uncertain. As of now, there may be benefits due to the anti-inflammatory properties. CBD works in a different way than traditional prescription pain relievers, such as opioids, so there may be use for combination therapy when recommended by your doctor.

Is CBD Safe?

As of now, there has not been serious or major adverse effects reported in these studies. Though, CBD has been reported to have some side effects and can interact with other medications. Common side effects include:

  • Fatigue
  • Irritability
  • GI upset (nausea, diarrhea)
  • Dry mouth
  • Changes in appetite

Another big consideration is that CBD products are like herbals and other dietary supplements: there is no standardization on products. Different companies have different additives, and those may contain trace amounts of THC.

As of now, there are no regulations (FDA) in place that guarantee the safety of all the ingredients in the product. The FDA has issued a warning statement that there are many unanswered questions about the science, safety and quality of products that contain CBD.

Should You Try CBD? The Bottom Line

CBD comes in many forms and is being used to treat a variety of issues. While there are many convincing reasons to try it, more studies need to be done in order to make a conclusion and treatment decision regarding CBD. Everyone is different and what works for one person may or may not work for another.

The most important thing to remember is to talk to your doctor or pharmacist before starting any new supplement or product to make sure that it is safe for you.

References:

Bemben, Nina M. “CBD Oil and Medical Marijuana: Pharmacists Need to Know the High Points.” Wolters Kluwer, 21 May 2019, www.wolterskluwercdi.com/blog/cbd-oil-and-medical-marijuana-pharmacists-need-know-high-points/.

FDA Office of the Commissioner. “What to Know About Products Containing Cannabis and CBD.” U.S. Food and Drug Administration, FDA, 17 July 2019, www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis.

Grinspoon, Peter. “Cannabidiol (CBD) – What We Know and What We Don’t.” Harvard Health Blog, 5 June 2019, www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476.

Kubala, Jillian. “7 Benefits and Uses of CBD Oil (Plus Side Effects).” Healthline, Healthline Media, 26 Feb. 2018, www.healthline.com/nutrition/cbd-oil-benefits#section7.

Volkow, Nora D. “The Biology and Potential Therapeutic Effects of Cannabidiol.” NIDA, 24 June 2015, www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/biology-potential-therapeutic-effects-cannabidiol.

Williams, Reagan A. “CBD Oil: Leading Patients to Safe Use.” Pharmacy Today, Nov. 2018, www.pharmacytoday.org/article/S1042-0991(18)31505-6/fulltext.



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what is this med for image - wellrx

by Emily Ross, PharmD Candidate,
Class of 2020

Improving Medication Adherence and Management

Managing several different medications can be overwhelming, confusing and time-consuming. Without effective medication management, errors and missed doses may happen easily. This can lead to ineffective drug therapy and not getting results from taking medications. One key to proper medication management is organization. There are simple ways to create organizational systems into your daily routine to get the most benefit from your drug therapy.

Medication Management Tools

  • Pill Box: One of the simplest ways to keep medications organized is to use a daily or weekly pill box. There are a variety of sizes and colors to fit your needs. These range from simple ones that have a compartment for each day to more complex ones that have dividers for each dosage time (ex: morning, afternoon, evening).
  • Medication List: Keeping and maintaining a current list of all the medications you take is very useful to keep up to date on your treatment. It is important to include all over the counter drugs, supplements, and herbals that you may take as well. Taking this to your doctor appointments and the pharmacy ensures all your providers are aware of your medications and can help prevent duplicate drug therapies and potentially harmful drug interactions.
  • Medication App: There is an app for about anything – including managing your medications! There are several apps available to download to your phone or mobile device. Read about the different features of each one and then choose one that best meets your needs. These are available for both android and apple devices. Some examples are:
    • MyMeds: Connects patients, caregivers, and providers to help have better understanding of current medications
    • MyMedSchedule Plus: Simple and easy to use, offers reminders, pictures of medications and tracks how often the medication is taken
    • The ScriptSave WellRx App: In addition to providing prescription price transparency, the ScriptSave WellRx app allows patients to set Take Your Pill reminders, as well as when it’s time to refill prescriptions.

      The WellRx platform also provides free access to some potentially life-saving functionality:
      • Drug Interaction Warnings: Patients can receive and share warnings with their caregivers when drugs in their personal in-app Medicine Chest might interact with each other.
      • Lifestyle Interaction Warnings: This includes warnings about potential drug interactions with certain foods patients eat, or activities they might engage in.
      • Expanded Drug Information: Patients can view detailed information, images, and videos for drugs within the Medicine Chest. Much of this information is available in English and Spanish.

Tips for Managing Your Medications

Now that you have all your medications organized, the next step is remembering to take them! It is easy to forget or miss a dose of your medication but with a few helpful tips – you can minimize the amount of times this happens and improve adherence.  

  • Reminders: This can be as simple as programming a daily reminder or alarm into your phone that alerts you when it is time to take your medication. You could go the more classic route and have a note that is posted in a spot that you see it every day such as the bedside table, bathroom mirror or fridge. You can also set reminders in the ScriptSave WellRx mobile app.
  • Timers: If a device separate from your phone is more your style, there are several options that can provide an alarm or noise to help remind you that it is time to take medication. Likely, there are many items you already own, such as an alarm clock or kitchen timer, that can be set to the time you need to take medication. E-pill® offers several medication alarms and even has devices that combine pill boxes with reminder alerts.
  • Routine: Include taking medications into a daily routine. First, think of a task you do every day, such as brushing your teeth. Make a point to take your medication at the same time you brush your teeth. By joining the tasks together, taking your medications will become part of your daily routine and decrease the chance of missing a dose.
  • Medication Synchronization: Many pharmacies offer medication synchronization programs that allow you to pick up all your medications at one time. This not only cuts down on trips to the pharmacy but also lessens the chance of allowing a prescription to run out before returning to the pharmacy for more refills.
  • 90-Day Supply: If allowed by your insurance, obtaining a 90-day supply of medication is a good way to have adequate stock and minimize pharmacy trips. Similar to the idea of syncing your medications, there is less of a chance of running out of medication and missing doses.

With all these organization and adherence tips, you’ll be a pro at knowing your medication and taking them on time! There are many benefits that come from organization, such as reducing the stress of managing and taking multiple medications. Additionally, it may decrease health care cost by saving the need for more doctor appointment or medications due to gaps in drug therapy.

These are easy steps that can be done to increase how well your medicines work for you. By using the tools for a good organization system and following the adherence tips, you can improve your overall health and well-being.

References:

Fayed, L. (2019, June 24). How to Manage and Organize Medication for Your Safety. Retrieved from https://www.verywellhealth.com/ways-to-manage-your-medication-514511

MyMeds: Redefining the Medication Experience. (n.d.). Retrieved from https://my-meds.com

MyMedSchedule: Free medication schedules, reminders, and health tracker. (n.d.). Retrieved from https://secure.medactionplan.com/mymedschedule/

Pill Timers. (n.d.). Retrieved from https://www.epill.com/alarms.html

ScriptSave WellRx App Makes Medication Management Easier: https://news.wellrx.com/2019/01/23/scriptsave-wellrx-app-makes-medication-management-easier/



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suicide prevention hotline image scriptsave wellrx blog

Treatment for Depression and Anxiety: The Fight to End Suicide

by Cherokie Dyer, PharmD candidate class of 2020,
University of Florida

Alarming Suicide Statistics

Over the past 17 years, rates for death by suicide has dramatically risen here in the United States. From 1999 to 2016, 25 states had over a 30% increase in their suicide rates. There’s rarely any one reason for someone to commit suicide. However, most suicides are attributed to life stressors, loss of a relationship, and a recent or approaching crisis. Another huge contributor is the presence of a mental health disorder such as depression or anxiety.

In the year of 2017, the CDC states that there were:

  • 44,965 suicide deaths
  • 13.9 suicide deaths per every 100,000 people
  • 39% of adults 18 and older had serious psychological distress in the past 30 days
  • 56.8 million physician visits resulted in mental, behavioral, and neurodevelopmental disorders as a diagnosis
  • 5.5 million emergency room visits were due to mental health disorders

The Good News

The amount of people being treated for depression and anxiety disorders is also rising. In 2012, the World Health Organization stated that 350 million people across the globe were affected by depressive disorder. This is followed with an increase in diagnosis and treatment of these disorders.

Common Anti-Depressant and Antianxiety medications include:

Brand Name Generic Name Drug Class
Zoloft Sertraline Selective Serotonin Reuptake Inhibitor
Lexapro Escitalopram Selective Serotonin Reuptake Inhibitor
Prozac Fluoxetine Selective Serotonin Reuptake Inhibitor
Wellbutrin Bupropion Dopamine/Norepinephrine Reuptake Inhibitor
Cymbalta Duloxetine Serotonin/Norepinephrine Reuptake Inhibitor
Effexor Venlafaxine Serotonin/Norepinephrine Reuptake Inhibitor
Pristiq Desvenlafaxine Serotonin/Norepinephrine Reuptake Inhibitor
Remeron Mirtazapine Alpha-2 Antagonist
  Amitriptyline Tricyclic Antidepressant

It’s great that more people are getting help for their mental health conditions. The increase in people getting treatment will help to decrease the number of people wanting to harm themselves. If you have sought treatment for anxiety or depression or know someone who sought treatment, I am so happy! Everyone’s life is valuable. If you or someone you know suffers from anxiety or depression and hasn’t yet felt comfortable seeking treatment, don’t hesitate. The awareness of these conditions and options for treatment are expanding; set up an appointment to talk about what you are experiencing.

Things to Remember about your Antidepressants or Antianxiety Meds

These medications take time to work. In many cases, you won’t see an effect until after about 1 month. Taking your medications as prescribed can help strengthen their effectiveness and prevent side effects like dizziness, fatigue and nausea. If significant time passes and you still don’t feel any better, ask your doctor to try you on another medicine. Never quit these medicines abruptly as this can result in bothersome, and sometimes serious withdrawal symptoms. Be sure to follow your doctor’s instruction to taper these medications if it’s determined that they need to be stopped.

Outside of Medicine

Outside of prescription medication, these are 3 valuable ways to improve mental health. Incorporating these changes along with your medication can also increase their effectiveness.

Nutrition: Your body makes all your brain chemicals from the food you eat daily. That’s your protein, complex carbohydrates (fruits, veggies, whole grains), and good fats. If you don’t eat this kind of balanced diet, you may consider taking a daily multivitamin.

Sleep: Getting close to 8 hours of sleep each day gives your body the time to make more brain chemicals. It’s the best opportunity for your body to fix and replace other cells like the nerves and muscles.

Exercise:  Daily exercise improves your brain activity and increases the release of brain chemicals. A great example would be going for a brisk walk outside. The movement, along with getting at least 10 minutes of sun each day, is another great way to both exercise and get your daily vitamin D allowance. Not to mention exercise is a good way to relieve anxiety and avoid personal stressors! 

Suicide Lifeline

If you or someone you know are thinking about harming themselves in any way, call the National Suicide Prevention Lifeline at 1-800-273-8255. You can also text HOME to 741741 to receive texts from the Crisis Text Line. If you feel there is an emergency, you should always call 911 or go to the nearest hospital.

References:

Suicide Prevention websites:

https://www.crisistextline.org/

https://suicidepreventionlifeline.org/

Statistics:

https://www.grandviewresearch.com/industry-analysis/anxiety-disorders-and-depression-treatment-market

https://www.cdc.gov/nchs/fastats/mental-health.htm

https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w

Medication and Nutrition information:

https://www.fda.gov/consumers/free-publications-women/depression-medicines-help-you

http://www.martiefankhauser.com/


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by Jennifer Bingham, PharmD, BCACP & Stephanie Forbes, PharmD

The Prescription Opioid Addiction Epidemic

Pain is complex and the sensation and intensity can vary among individuals who are suffering, so there are many treatment options — mind-body techniques, acupuncture or physical therapy, and medications, both over the counter and prescription. For many patients with severe pain from injuries or surgery, opioid painkillers are supposed to provide pain relief, but because they have been heavily marketed and inappropriately prescribed, there has been an ever increasing number of deaths throughout the U.S. caused by misuse and addiction.

What is Narcan®?

Narcan® (naloxone hydrochloride) is an opioid antidote.1 It is indicated for patients that has suspected opioid overdose symptoms, such as respiratory and central nervous system depression.1 It is available in two formulations, including injectable and nasal preparations. The nasal spray contains one dose per unit,1 hence it is important to contact 9-1-1 for emergency medical assistance once opioid overdose is suspected to ensure additional assistance is available if needed. 

Who Should Use Narcan Nasal Spray?

Narcan nasal spray is intended for use by people who are experiencing an opioid overdose or are showing signs of opioid overdose.2,3 As mentioned above, it’s use is not a substitute for emergency medical care. Whenever administering Narcan, always call 9-1-1 right away.  Since it is an opioid antagonist, Narcan only works to reverse the effects of opioids, both prescription and non-prescription. Some examples of opioids it reverses are morphine, codeine, opium, hydrocodone, heroin and methadone.4

Who should have Narcan Nasal Spray?

People who receive Narcan are typically taking high doses of opioids for pain management over a long treatment period.2,5 Additionally, those taking extended-release or long-acting opioid medications or receive rotating opioid medication regimens may also have Narcan.   Patients who have a known hypersensitivity to naloxone hydrochloride should not use Narcan.1 Narcan access (needing a prescription) varies across states and the medication should be replaced before the expiration date passes.5

How to Store Narcan Nasal spray?

Narcan nasal spray should be stored in the blister and cartons provided until use.1 A controlled room temperature between 59°F to 77°F with protection from light is recommended for storage, and the product should not be frozen. The nasal spray may be stored at temperatures outside of this range (39°F to 104°F) for brief periods of time only.

Ask your pharmacist if you should talk to your provider about Narcan.

References:

  1. Narcan Nasal Spray (naloxone hydrochloride) [prescribing information]. Radnor, PA: Adapt Pharma Inc; January 2017.
  2. Naloxone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/treatment/naloxone/. Last Updated April 11, 2019; Accessed June 3, 2019. 
  3. Coffin, Phillip MD, MIA. Prevention of lethal opioid overdose in the community. UptoDate®. Last Updated June 25, 2018. Accessed June 3, 2019.
  4. What Are Opioids. Department of Health and Human Services. https://www.hhs.gov/opioids/prevention/index.html. Last Updated May 15, 2018. Accessed June 4, 2019
  5. Opioid Overdose Reversal with Naloxone. National Institute of Drug Abuse. https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio/. Last Updated April 2018, Accessed June 3, 2019.

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by Cindy Cho, PharmD Candidate Class of 2019,
The University of Arizona College of Pharmacy

Are You Doing This Important Step After Using Your Inhaler?

If you use an inhaler for a breathing condition, like asthma, you may have been told by your doctor that you will need to rinse your mouth with water and spit after you use your inhaler. It may seem like a cumbersome additional step, especially since it already takes time out of your day to use your inhaler, so why is it important to spend time to rinse and spit after using your inhaler?

Not All Inhalers Require You to Rinse and Spit

Just to clarify, you don’t need to rinse and spit with every inhaler. There are numerous inhalers on the market with different active ingredients and different purposes (For more on this, refer to this post on the difference between rescue and controller inhalers: (https://news.wellrx.com/2016/08/18/breathing-condition-meet-lifesaver/).

However, a common type of inhaler that does require you to rinse your mouth after each use is called an inhaled corticosteroid (ICS) inhaler. ICS inhalers contain small amounts of steroids to help people breathe easier. Other types of inhalers have different active ingredients (e.g., albuterol, formoterol, tiotropium), so it is not necessary to rinse your mouth after using those.

Common ICS Inhalers

Examples of common ICS inhalers, or combination inhalers that contain a corticosteroid, are:

  • Advair Diskus & Advair HFA (fluticasone/salmeterol)
  • Aerobid (flunisolide)
  • Alvesco, Omnaris, Zetonna (ciclesonide)
  • Arnuity Ellipta (fluticasone furoate)
  • Asmanex (mometasone)
  • Azmacort (triamcinolone)
  • Dulera (mometasone/formoterol)
  • Flovent, Flovent HFA (fluticasone)
  • Pulmicort, Rhinocort (budesonide)
  • Qnasl, Qvar (beclomethasone)
  • Symbicort (budesonide/formoterol)

If you are using one of these inhalers or have been told that your inhaler contains a steroid in it, you will need to rinse your mouth with water and spit after each use.

Why do I Have to Rinse and Spit with ICS Inhalers?

ICS inhalers have a small amount of corticosteroid medication that reduces inflammation in your bronchial tubes and ultimately open your airways to help you breathe easier.1 These medications can be delivered through metered dose inhalers, dry powder inhalers, or through a nebulizer. When you breathe in your steroid inhaler medication, a small amount of steroid can stick to your mouth and throat as it makes its way into your lungs to help you breathe. If this small amount of steroid is not rinsed out from the inside of your mouth or throat, it can cause a fungal infection known as thrush.2

What You Need to Know About Thrush3

Oral thrush in adults generally looks like thick, white or cream-colored spots inside the mouth. The inside lining of your mouth may appear swollen and slightly red and may feel uncomfortable or a burning sensation. The good thing is that thrush is a treatable infection. Your doctor will prescribe an antifungal medicine in the form of a tablet, gel, lozenge, or mouthwash to help treat it. The better news is that this condition is preventable with proper rinsing and spitting.  

What You Can Do

Make sure to rinse your mouth with water and spit after using your ICS inhaler to prevent thrush. Another way to make it easier for you to incorporate rinsing your mouth after using your ICS inhaler is to brush your teeth after using your inhaler. As a friendly reminder, your ICS inhaler should be used on a routine basis, unless your doctor tells you otherwise, even when your breathing seems better. These inhalers will help maintain your breathing over time to prevent breathing-related complications and keep you out of the hospital.

References:

  1. Barnes PJ. Inhaled Corticosteroids. Pharmaceuticals (Basel). 2010;3(3):514-540. Published 2010 Mar 8. doi:10.3390/ph3030514
  2. Shuto H, Nagata M, Terashi Y, Yamaguchi M, Takizawa T, Shuto C, Watanabe K, Tosaka K, Okano M, Noguchi H. Esophageal candidiasis as complication of inhaled steroid therapy. Arerugi 2003; 52(11)1053–1064
  3. Oral thrush – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/oral-thrush/symptoms-causes/syc-20353533. Published March 8, 2018. Retrieved February 22, 2019.

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by Ryan Lowe, PharmD Candidate,
University of Arizona

The More Medications, The Merrier?

Have you ever heard of the term “polypharmacy” before? When you break that word down you get “poly”, which means multiple, and “pharmacy”, which means medications. Polypharmacy is defined as the use of multiple drugs, or more than are medically necessary.1 Depending on who you’re talking to will determine where their cut off is for ‘multiple drugs’, with some thinking as few as three is considered polypharmacy, while others say you need as many as five.

An example of using more drugs than are medically necessary would be having two blood pressure medications when your blood pressure has been running low. There are a lot of concerns about polypharmacy, especially in the elderly population.

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Polypharmacy in the Elderly

A study published in 2004 wanted to find out how prevalent polypharmacy was in the nursing home setting. With over 13,000 patients in the study, they found that approximately 40% of them were taking 9 or more medications.2 While 9 medications may seem absurd, as this study shows it’s not that unheard of.

As you can well imagine, taking multiple medications can lead to a variety of potential concerns. First off, the more medications you take means the more money it will cost to pay for those medications. Added hospital or clinic visits to manage those medications also contribute to the rise in costs. Another major concern is that of drug side effects, commonly referred to as Adverse Drug Events (ADEs).

Some patients report a side effect to one medication which then gets an entirely new medication to replace it. This can lead to a cycle of adding new medications which leads to polypharmacy. The more medications you must take also makes it harder to remember when to take them. Some patients struggle to take only one or two medications every day, so having upwards of nine becomes a very daunting task. Despite all these risks, there is still one concern that is at the forefront of any pharmacist’s mind: drug interactions.

The Major Risk of Drug Interactions in Polypharmacy

Drug-drug interactions, or DDIs, happen when one medication interferes with the way another medication works in your body. If you are taking nine medications at the same time, there is a much greater risk that at least two of those drugs will interact with one another. These interactions can range from the benign to the severe, sometimes increasing the effect of one drug or preventing it from doing its job.

Here is a list of some (but not all) of the most common drug interactions:

  • Warfarin: If you take warfarin to help thin your blood to prevent a stroke or DVT, you should know that warfarin has numerous DDIs. Ibuprofen or Aleve should be avoided when taking warfarin, and many antibiotics can also affect the level of warfarin in your body.
  • Grapefruit: You may have heard about some drugs interacting with grapefruit (including juice), but what drugs and why? Grapefruit can block an enzyme in your body that many drugs use as their metabolizing agent. When this happens, the amount of drug rises in your body to sometimes dangerous levels. If you’re taking any of these drugs then you should avoid eating grapefruit: some statin medications (like simvastatin and atorvastatin), nifedipine, cyclosporine, buspirone, amiodarone, and fexofenadine (generic Allegra).3
  • Levothyroxine: When you take levothyroxine, you’re supposed to take it one hour before you eat breakfast in the morning. This is because levothyroxine interacts with almost every food you can think of. If you take the drug with breakfast, lunch, or dinner then it will not be able to absorb fully, and it won’t reach its desired effect.

There are several tools available to check for drug interactions. The free ScriptSave WellRx app has a feature that allows you to check the medications you are taking for any harmful interactions. The app also has a lot of other useful features. For example, you can set reminders for taking your medications in case you have a hard time keeping track of them all, or when to refill them. You can also look up information about your medications including what it should like and possible side effects. The app is available for both Apple and Android, and can also be used in Spanish! If you still have questions, you can call the Ask a Pharmacist line at 1-866-268-2611 to speak to a pharmacist directly.

References:

  1. Maher, Robert L, et al. “Clinical Consequences of Polypharmacy in Elderly.” Expert Opinion on Drug Safety, vol. 13, no. 1, 2013, pp. 57–65., doi:10.1517/14740338.2013.827660
  2. Dwyer, Lisa L., et al. “Polypharmacy in Nursing Home Residents in the United States: Results of the 2004 National Nursing Home Survey.” The American Journal of Geriatric Pharmacotherapy, vol. 8, no. 1, 8 Feb. 2010, pp. 63–72., doi:10.1016/j.amjopharm.2010.01.001.
  3. “Consumer Updates – Grapefruit Juice and Some Drugs Don’t Mix.” U S Food and Drug Administration Home Page, Office of the Commissioner, 18 July 2017, www.fda.gov/ForConsumers/ConsumerUpdates/ucm292276.htm.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

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by Ryan Lowe, PharmD Candidate,
The University of Arizona College of Pharmacy

For many patients with diabetes, insulin has become a mainstay of their therapy. Despite the addition of newer drugs on the market (like the exciting GLP-1 agonists such as Victoza (liraglutide), insulin remains a popular choice among physicians for its numerous benefits. The dose of insulin can be easily adjusted; if your blood sugars are running high then simply try taking two more units and reevaluate in a couple of days. Insulin is also a great drug when used in combination with other medications such as metformin; these combinations allow for greater control of a patient’s diabetes. According to a study from the CDC, the percent of patients taking both insulin and an oral medication increased between 1997 and 2011. This suggests the importance of both types of medication in diabetes management. 1

What are the different types of Insulin available?

Insulin can be divided up into two categories: long acting and short acting. Most patients start out with a long acting insulin before a short acting insulin is added. The most common long acting insulin is Insulin Glargine, or Lantus. Another long acting insulin you may see is Insulin Detemir, or Levemir. These insulins are normally dosed once a day, and they work to keep your fasting sugars (your blood sugar when you’re not eating any food) within normal limits.  The most common side effect of long acting insulin is hypoglycemia, or low blood sugar. When you take too much insulin your body eats up too much glucose, resulting in low blood sugar levels. If you are hypoglycemic then you may start shaking, feeling dizzy or faint, and feel confused or anxious. The quickest remedy for this is eating a high sugar snack or drink, such as a glass of orange juice. As noted earlier, one of the main benefits of long acting insulin is being able to adjust the dose more frequently to find the perfect dose for you. With a tablet medication it is harder to find the perfect middle ground; you either take one tablet or you take two. Insulin doesn’t work that way; since insulin is a liquid injection you can easily take a little more or a little less than you were previously to account for your blood sugar levels.

Short acting insulin works much quicker than the long acting insulins, hence the name. There are two common short acting insulins: Insulin Lispro, or Humalog and Insulin Aspart, or Novolog. These insulins are commonly taken after a meal. The idea behind this is that the insulin will counteract a large spike in blood sugar gained by eating a large meal. However, these insulins are rarely taken alone; rather they are normally used in combination with long acting insulin to combat both types of sugars: fasting and post-prandial, or post-eating sugars. Hypoglycemia is still a risk with these short acting insulins, but it isn’t as great a risk as with the long acting insulins. One consideration that has been on many patient’s mind, however, is the rising cost of insulin – and Humalog specifically has been in the news lately.

Why is Humalog making headlines?

Humalog is a short acting insulin manufactured by Eli Lilly, a drug company responsible for numerous popular medications. Eli Lilly released some pricing information about Humalog, and the numbers are raising some eyebrows among patients, healthcare providers, and even politicians. An insured patient will typically pay around $135 a month for Humalog (which is a decrease of 8.1% from 2014). When you don’t factor in the rebates typically covered by an insurance company, the monthly price of Humalog rises to $549.2 These differences have gotten a lot of people talking. Eli Lilly hopes that the information they released will help shed some light on the often-muddled issue of rising drug costs. Politicians on both sides seem to agree that drug costs need to come down in America, but the solution to this issue is not an easy one. Eli Lilly themselves hope to improve the situation by releasing a “half-price” Humalog under the generic name Insulin Lispro. The cost will be $137.35 per vial, which should significantly improve the annual cost for those uninsured patients with diabetes.3

In response to the Eli Lilly price drop for Humalog, Sanofi recently announced a program that they hope will make a difference in the cost of insulin.4 They unveiled a Netflix-like program that takes that model directly to patients, supplying insulin products for a flat monthly rate instead of the usual cost per prescription or refill. The drugmaker will use its Insulin Valyou Savings Program to deliver insulin products for $99 per month. For that monthly fixed price, Sanofi will offer up to 10 boxes of insulin pens and 10 mL vials per month, regardless of a patient’s income. The new $99-per-month price could be as little as one-tenth of the amount patients would have paid previously.

References:

  1. “Age-Adjusted Percentage of Adults with Diabetes Using Diabetes Medication, by Type of Medication, United States, 1997–2011.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 20 Nov. 2012, www.cdc.gov/diabetes/statistics/meduse/fig2.htm.
  2. Lovelace Jr., Berkeley. “Eli Lilly Sheds Light on Confidential Pricing, Discloses Charges for Popular Diabetes Drug Humalog.” CNBC, CNBC, 25 Mar. 2019, cnbc.com/2019/03/25/eli-lilly-discloses-pricing-data-for-its-popular-insulin-humalog.html.
  3. “Lilly to Launch a Half-Price Version of Insulin.” CNBC, CNBC, 4 Mar. 2019, www.cnbc.com/2019/03/04/lilly-to-launch-a-half-price-version-of-insulin.html.
  4. “Sanofi provides unprecedented access to its insulins for one set monthly price” Sanofi, 10 Apr. 2019   http://www.news.sanofi.us/2019-04-10-Sanofi-provides-unprecedented-access-to-its-insulins-for-one-set-monthly-price 

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by Haley Stenquist, PharmD Candidate Class of 2019
The University of Arizona College of Pharmacy

A new group of generic medications are hitting the prescription drug market in 2019. At ScriptSave, we get a lot of questions about generic medications vs. brand name prescription drugs. “A” rated generics meet the same quality standards as brand name prescription drugs and so they provide the same medical benefits. A drug that is “A” rated by the FDA as a generic equivalent contains identical active ingredients as the brand name drug, the same dosage as the brand name drug, and delivers the same concentrations of drug to the bloodstream within the same amount of time. So what are the differences and what’s coming to a pharmacy near you?

Are Generic Drugs the Same as Brand Name?

Yes, generic drugs are “copies” of the brand name medication that was developed by a company other than the one that originally brought the branded medication to market. Generic drugs are available for a fraction of the price of brand name medications, so consumers are naturally eager for the generics to hit the market. Per the FDA guidelines, a generic drug application must first display the following parameters:

  • The generic drug is “pharmaceutically equivalent” to the brand
  • The manufacturer is capable of making the drug correctly
  • The manufacturer is capable of making the drug consistently
  • The “active ingredient” is the same as that of the brand
  • The right amount of the active ingredient gets to the place in the body where it has effect
  • The “inactive” ingredients of the drug are safe
  • The drug does not break down over time
  • The container in which the drug will be shipped and sold is appropriate
  • The label is the same as the brand-name drug’s label
  • Relevant patents or legal exclusivities are expired2

How Long Does It Take for a Drug to Become Generic?

After an application for a patent of a new drug is filed with the United States, it is granted patent exclusivity for 20 years.  The path to generic drugs coming to market was made cheaper, easier, and faster after the introduction of the Drug Price Competition and Patent-Term Restoration Act of 1984 or known as the Hatch-Waxman Act. This allowed companies to submit an abbreviated new drug application (ANDA). About one year before the expiration of the patent drug, companies that are wanting to manufacture the generic drug will submit the ANDA to the FDA. Generally, after that patent has expired and the ANDA is approved, a generic counterpart can be introduced into the market.1

First Generic Drug Approvals for 2019

Currently, the FDA has approved 16 first-time generics in 2019 between different manufacturers (each manufacturer must submit their own ANDA). These include:

  • pyridostigmine bromide syrup—Mestinon Syrup
    • Improves muscle strengths in patients with myasthenia gravis
    • Novitium Pharma LLC—03/08/2019
  • levofloxacin ophthalmic solution, 1.5%—Iquix Ophthalmic Solution
    • Treatment of corneal ulcer caused by certain bacteria
    • Micro Labs Limited, India—02/27/2019
  • deferiprone tablets, 500mg—Ferriprox Tablets
    • Treatment of transfusional iron overload due to thalassemia syndromes
    • Taro Pharmaceuticals Industries Limited—02/08/2019
  • sevelamer hydrochloride tablets, 400mg, 800mg—Renagel Tablets
    • Control of serum phosphorus in patient with chronic kidney disease
    • Glenmark Pharmaceuticals Limited—02/08/2019
  • levomilnacipran extended-release capsules, 20mg, 40mg, 80mg, 120mg—Fetzima
    • Treatment of major depressive disorder (MDD)
    • Amneal Pharmaceuticals Company GmbH—02/04/2019
  • acyclovir cream, 5%—Zovirax Cream
    • Treatment of recurrent cold sores in immunocompetent patients over 12 years of age
    • Perrigo UK FINCO Limited Partnership—02/04/2019
  • Wixela Inhub (fluticasone propionate and salmeterol inhalation powder, USP) 100mcg/50mcg, 250mcg/50mcg, 500mcg/50mcg—Advair Diskus
    • Treatment of asthma in patient over 4 years of age and COPD maintenance (250mcg/50mcg)
    • Mylan Pharmaceuticals Inc.—01/30/2019
  • sirolimus oral solution, 1 mg/mL—Rapamune
    • Prophylaxis of kidney organ rejection in patient over 13 years of age
    • Novitium Pharma LLC—01/28/2019
  • vigabatrin tablets USP, 500mg—Sabril Tablets
    • Treatment of refractory complex partial seizures (CPS) in patients over 10 years of age that have failed multiple alternative treatments
    • Teva Pharmaceuticals USA, Inc.—01/14/2019
  • ingenol mebutate gel, 0.05%, 0.015%—Picato Gel
    • Treatment of topical acne
    • Perrigo UK PINCO Limited Partnership—01/07/2019 (0.015%) and 01/09/2019 (0.05%)
  • lurasidone hydrochloride tablets, 20mg, 40mg, 60mg, 80mg, 120mg—Latuda Tablets
    • Treatment of schizophrenia and depressive episodes associated with bipolar disorder in adults
    • Torrent Pharmaceuticals Limited, Accord Healthcare Inc., Lupin Limited, InvaGen Pharmaceuticals, Inc., Amneal Pharmaceuticals Company GmbH—01/03/20193

Newest Generics of 2019

  • As of 03/12/2019, the FDA approved a new generic of Diovan (valsartan) among the vast recalls from multiple manufacturers, this was granted to Alkem Laboratories Limited.4
  • Lannett announced FDA approval for aspirin and extended-release dipyridamole capsules, 25mg/200mg—Aggrenox Capsules for secondary prevention of stroke and transient ischemic attacks (TIA) on 03/27/2019.5

Forecasted Generics for the Remainder of 2019

The Impact of Generics

It is a long, grueling process for a brand name medication to finally be released to the market as a generic, taking in excess of 20 years. Generic medications are instrumental in helping alleviate the financial burden of prescription medication costs in patients. Each year, the effect continues to grow. In the first quarter 2019, there is already a large impact with new generic medications coming to market. This impact is forecast to continue throughout the year, especially with the possibility of heavy hitters such as Lyrica and Restasis.

References:

  1. “S.1538 – 98th Congress (1983-1984): An Act to Amend the Federal Food, Drug, and Cosmetic Act to Revise the Procedures for New Drug Applications, to Amend Title 35, United States Code, to Authorize the Extension of the Patents for Certain Regulated Products, and for Other Purposes.” gov, 24 Sept. 1984, www.congress.gov/bill/98th-congress/senate-bill/01538.
  2. Center for Drug Evaluation and Research. “Generic Drugs – What Is the Approval Process for Generic Drugs?” U S Food and Drug Administration Home Page, Center for Drug Evaluation and Research, www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/genericdrugs/ucm506040.htm .
  3. Center for Drug Evaluation and Research. “First Generic Drug Approvals.” U S Food and Drug Administration Home Page, Center for Drug Evaluation and Research, fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/DrugandBiologicApprovalReports/
    ANDAGenericDrugApprovals/default.htm
    .
  4. Office of the Commissioner. “Press Announcements – FDA Provides Update on Its Ongoing Investigation into ARB Drug Products; Reports on Finding of a New Nitrosamine Impurity in Certain Lots of Losartan and Product Recall.” U S Food and Drug Administration Home Page, Office of the Commissioner, fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm632425.htm.
  5. “Generic Drug for Stroke Prevention Granted FDA Approval.” Pharmacy Times, pharmacytimes.com/news/genericdrug-granted-fda-approval.
  6. “Pipeline Report Generic Drugs .” Welldynerx. welldynerx.com/content/uploads/2019/02/Generic-Drugs-Feb-2019-2-12-19.pdf.
  7. “Upcoming Generic Drugs.” Corporate Pharmacy Services, corporatepharmacy.com/page/upcoming_generic_drugs.

 

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