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Archive for the ‘Cholesterol’

Michigan Based Retail Pharmacy, Meijer, Offers Generic Cholesterol Reducing Prescription Drug, Lipitor, For Free

September 04, 2012 By: Nadia Category: Cholesterol, Free Prescriptions, HealthCare, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Drugstore News, 9.4.12 – By Alaric Dearment

In what could symbolize the so-called “patent cliff” that an executive from healthcare market research firm IMS Health spoke of at a recent trade show, a regional mass merchandise chain is taking what used to be the world’s top-selling drug and giving it away for free.

Meijer announced Tuesday that it would offer generic versions of Pfizer’s cholesterol drug Lipitor (atorvastatin calcium) for free at all of its 199 pharmacies, saying it would be the first retailer in the Midwest to offer such a program. The program is the fourth free-drug program offered by the retailer over the last six years.

“We’re pleased to announce that our customers will now be able to fill their generic cholesterol-lowering atorvastatin calcium prescriptions for free in all of our pharmacies,” co-chairman Hank Meijer said. “In keeping with our commitment to provide low-cost solutions for the families we serve, the free cholesterol-lowering medication program is another way to help the customers who rely on our pharmacies.”

Before it lost patent protection, in November 2011, Lipitor had sales exceeding $7 billion per year in the United States. Ranbaxy Labs was the first to launch a generic version when the drug’s patents expired, and Ranbaxy’s own market-exclusivity period expired in May of this year. At the National Association of Chain Drug Stores’ Pharmacy and Technology Conference last month, IMS VP industry relations Doug Long said during a presentation that “We’re in the teeth of the patent cliff,” which refers to a period taking place over the next few years when a wave of expirations of several top-selling drugs’ patents will occur, eventually leaving many therapeutic indications such as cholesterol heavily commoditized and dominated by multiple generics.

“This initiative will have a huge impact because the cost of pharmaceuticals is frequently a barrier to getting appropriate treatment,” West Michigan Heart cardiologist and Spectrum Health Meijer Heart Center Cardiac Catheterization Labs director David Wohns said. “The biggest way to reduce the risk of heart disease comes from treating cholesterol. To have that drug available for free has the ability to impact countless lives.”

How Much Money Will Generic Lipitor Save?

January 03, 2012 By: Nadia Category: Cholesterol, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: Wall Street Journal – Katherine Hobson, 12.12.11

We’ve written about some of the most common consumer questions about the newly launched generic version of Pfizer’s cholesterol-lowering Lipitor.

One remaining question is how much money will be saved from the generic iterations of the name-brand blockbuster — the U.S. sales of which were $7.8 billion in the year ended Sept. 30, according to IMS Health.

A group of researchers takes a stab at that issue in a perspective piece published online by the New England Journal of Medicine. Their conclusion: “the overall cost savings from the availability of generic atorvastatin are projected to reach $4.5 billion annually by 2014, equivalent to 23% of total expenditures on statins in that year.” (The aging population could mean another $30 million of cost savings annually by 2014, they note.)

To make their calculations, they looked at what happened after Merck’s Zocor lost patent protection in 2006, and also considered how the aging of the population would drive future demand for statin drugs. They predict that generic atorvastatin will “dominate the statin market as a result of patients’ switching to it from simvastatin [generic Zocor] and from [AstraZeneca’s] Crestor, and it will have an estimated market share of 44% by 3 years after market entry.”

The researchers, from institutions including the Western University of Health Sciences and Yale University, project that the price of generic atorvastatin will be 82% of the pre-generic Lipitor at the time of market entry and 49% of the brand-name after the first six months.

However, these projections come with an asterisk: they “estimate what would happen with the rapid availability and timely uptake of generic atorvastatin.” The researchers say “aggressive business tactics” used by Pfizer to keep people using name-brand Lipitor, including deals with pharmacy-benefit managers and discounts to patients, may prevent switches to the generic.

“In order to capitalize on this opportunity for cost savings from the expiration of Lipitor’s patent, there must be a rapid, concerted effort by many players in the health-care system to facilitate awareness of and access to the generic,” they write.

Lipitor Goes Generic, As Good as Crestor, But Pfizer Markets to Extend Brand Revenues

December 12, 2011 By: Nadia Category: Cholesterol, HealthCare, Medicine Advice, Medtipster, Prescription News, Prescription Savings

www.Medtipster.com Source: USA Today, 11/15/2011

On November 30, 2011, the cholesterol medication Lipitor (atorvastatin) converted to generic status. For the first six months, two companies, Watson Pharmaceuticals, Inc. and Ranbaxy Laboratories, Ltd., will produce the generic. After May 2012, several generic manufacturers are expected to enter the market.

Pfizer Inc., the maker of Lipitor is marketing hard for people to keep buying its brand-name version for the next 6 months. Pfizer is offering

  • patients a discount card to get Lipitor for $4 a month, and
  • rebates to insurance companies that cover Lipitor for the next 6 months.

This action by Pfizer will result in the costs of Lipitor being below generic prices and Pfizer will get 70% of the proceeds from one of the two versions sold now.

USA Today reported, that large doses of Lipitor and Crestor did about equally well according to a study of 1,385 patients presented at the annual meeting of the American Heart Association in Orlando. Crestor, made by AstraZeneca, “will be the last major statin not on patent,” said Cam Patterson, chief of cardiology at the University of North Carolina-Chapel Hill, who was not involved in the study. “The market for Crestor will go close to zero.”

Study findings

At the end of the two-year study,

  • Two-thirds of patients had less plaque in their arteries.
  • Both statins shrunk the size of plaque in the coronary artery by about 1%.
  • Patients on Crestor had a low-density lipoprotein (LDL) level of 63 milligrams per deciliter, while those who took Lipitor had a level of 70.
  • Patients on Crestor had a high-density lipoprotein (HDL) level of 50 milligrams per deciliter, compared to 49 for those who took Lipitor.

Nehal Mehta, a cardiologist with the University of Pennsylvania’s School of Medicine, says there’s no way to know if such a small change actually matters, in terms of preventing heart attacks and saving lives. And relatively few patients would even benefit that much. Only about 20% of patients are taking such high doses — 40 milligrams daily of Crestor or 80 milligrams daily of Lipitor, says Mehta, who wasn’t involved in the study.

Such minor differences in cholesterol levels are unlikely to affect heart disease risk, Patterson says. “The bottom line is that there isn’t a difference” between drugs,” he says. “You should make your decision on other factors, like which one is least expensive.”

About Lipitor and Crestor

Cholesterol medications are the leading class of prescription drugs in the USA, with 255 million prescriptions a year. Lipitor — the country’s best-selling drug, with sales of $7.2 billion last year — will be available as a generic Dec. 1, at a fraction of its current cost. Patterson says there will be no reason for insurance plans to pay for Crestor — the eighth-leading drug in the USA, with $3.8 billion in annual sales. In fact, by next month, nearly all statins will be available generically. Generics now account for 78% of all retail prescriptions sold, according to IMS Health.

Are statins overprescribed for low-risk patients?

January 26, 2011 By: Nadia Category: Cholesterol, HealthCare, Medicine Advice, Medtipster, Prescription News

www.Medtipster.com Source: Boston Globe – 1.24.2011

It’s a common scenario: A 60-year-old woman is told she has high cholesterol but has no other risk factors for heart disease like high blood pressure, diabetes, or a smoking habit. Should she take a statin to lower her cholesterol?

Many doctors say, why not? But a review study by the Cochrane Collaboration, a nonprofit research organization, suggests otherwise. The review, which analyzed 14 trials involving the use of statins to prevent heart disease in low-risk patients, found only “limited evidence” that the drugs provide significant benefits, especially in women, and urged that “caution should be taken when prescribing statins” to prevent heart disease.

The cholesterol-lowering drugs – which include atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor) – have clearly been shown to reduce heart attacks, strokes, and deaths in higher risk patients such as those with diabetes or established heart disease. And they have minimal side effects.

In fact, the American Heart Association recommends that low-risk patients with high cholesterol consider taking a statin if lifestyle changes, such as increased exercise or weight loss, don’t work to bring cholesterol levels down.

But the Cochrane review study – written by British researchers – calls that practice into question, highlighting “shortcomings” in studies that found clear benefits in anyone who took statins to lower high cholesterol levels.

“The potential adverse effects of statins among people at low risk of [cardiovascular disease] CVD are poorly reported and unclear,” the authors wrote.

Other experts, though, disagree. “I think they make grand pronouncements that are wrong,” says Dr. Chris Cannon, a cardiologist at Brigham and Women’s Hospital who participated in another recent review study of statin use in low-risk patients published in the November issue of Lancet. (Cannon has accepted research grants from statin manufacturers and served on an advisory board for Bristol-Myers Squibb, which makes the statin Pravachol.)

The Lancet study found that high-risk and low-risk patients who take statins to lower their cholesterol can reduce their risk of having a heart attack, stroke, or heart procedure by 25 percent.

In absolute risk terms, statin users who don’t have heart disease would lower their yearly risk of having heart complications from 1.8 percent to 1.4 percent. Those who have already been diagnosed with heart disease would lower their yearly risk from 5.6 percent to 4.5 percent – and those with type 2 diabetes from about 5 percent to about 4 percent.

The lower your heart disease risk, the smaller the benefits you’ll receive from statins. That means the risk of side effects will play a greater role in determining whether you should take the drug. The Cochrane report found that statins didn’t increase the risk of cancer and posed a small risk of rhabdomyolysis, a serious condition involving the breakdown of muscles.

The biggest side effect, severe muscle soreness, occurs in about 3 to 5 percent of users, though some research indicates the incidence may be higher in women and for those who take higher doses or more potent statins.

Even the most common medications pose threats

August 12, 2010 By: Nadia Category: Cholesterol, HealthCare, Medicine Advice, Medtipster, Prescription News

www.Medtipster.com Source: LA Times – Author: Karen Ravn

Here’s a look at five of the most-prescribed drugs and their possible risks, side effects and possible interactions.

Some drugs are so common that consumers — at their peril — don’t think twice about them. But each drug, whether prescription or over-the-counter, poses risks. To highlight these risks, we offer up a few details on five of the most-prescribed medications, with additional input from pharmacists interviewed for this package of stories.

Hydrocodone with acetaminophen

Brand names: Vicodin, Lortab

Description: A combination of a narcotic (hydrocodone) with a non-narcotic (acetaminophen) pain reliever, it’s prescribed for moderate to severe pain.

Most serious risks: Abuse and addiction; acetaminophen overdose. Too much acetaminophen can cause severe liver damage, even death, but many patients aren’t aware of this danger — or of how many medications contain acetaminophen. Acetaminophen is the active ingredient in Tylenol, but it’s also found in many other medications.

Possible side effects: Constipation, drowsiness, dizziness, nausea, vomiting, stomachache.

Common interactions: Barbiturate anesthetics (e.g., thiopental); cimetidine (Tagamet); antidepressants, including monoamine oxidase (MAO) inhibitors such as phenelzine (Nardil) and tricyclic antidepressants such as amitriptyline; sodium oxybate (GHB). These may lead to excessive sleepiness or create breathing difficulty.

And our pharmacists say . . . : This is probably one of the most abused drugs on the market. While taking this drug, avoid taking alcohol and other drugs that cause sleepiness. If you drive while taking it, you can be cited — and convicted — for driving under the influence. Check the labels of any other medications you are taking to see if they contain acetaminophen, and only take one source of acetaminophen at a time. Fluids and fiber can help prevent constipation, but you may also need to take laxatives. Taking this drug with food can reduce stomachache. The dizziness or drowsiness that can come with the drug can increase the risk of falls — a serious danger for older people.

Lisinopril

Brand names: Prinivil, Zestril

Description: An ACE (angiotensin-converting enzyme) inhibitor, lisinopril improves blood flow by interfering with the production of angiotensin II, a substance that constricts blood vessels and releases hormones that raise blood pressure. It’s prescribed for high blood pressure and heart failure and to improve survival chances after heart attacks.

Most serious risks: Birth defects if taken while pregnant; hyperkalemia, a condition caused by high levels of potassium that can lead to an irregular heartbeat; nausea; slow, weak or nonexistent pulse; and even heart attacks. It is a particular risk in patients with poor kidney function.

Possible side effects: Nagging dry cough, dizziness. Less common but more severe: swelling of the face and lips, difficulty swallowing or breathing, itchiness.

Common interactions: Diuretics (may increase risk of low blood pressure); diabetes medications (may increase risk of low blood sugar); lithium (may increase lithium concentrations to toxic levels); potassium (may cause retention of potassium, so potassium supplements can lead to hyperkalemia); nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen (these reduce the excretion of ACE inhibitors, so their concentration in the bloodstream increases).

And our pharmacists say . . . : This medication should never be used by pregnant women. ACE inhibitors are generally less potent in African Americans. Also, studies have shown that when taking lisinopril (or other ACE inhibitors), African Americans are at increased risk for angioedema (swelling similar to hives but under the skin and potentially life-threatening). Seniors too are at higher risk for angioedema. Also, if seniors are taking a diuretic and then start taking lisinopril too, their blood pressure may drop too quickly. It’s better to start with lisinopril and add the diuretic later. If you drink alcohol while taking lisinopril, that can also make your blood pressure drop too much. Because lisinopril suppresses your body’s ability to quickly adjust blood pressure, you could faint if you jump out of bed or stand up too fast. Avoid potassium supplements or salt substitutes containing potassium.

Simvastatin

Brand name: Zocor

Description: Like other statins, simvastatin inhibits a particular liver enzyme (HMG Co-A reductase) to reduce the liver’s capacity for making cholesterol. It’s prescribed to reduce LDL cholesterol, often called “bad cholesterol.”

Most serious risks: Birth defects if taken while pregnant; (rarely) rhabdomyolysis, a severe breakdown of skeletal muscle that can lead to acute renal failure and death should myoglobulin (a muscle protein) leak into the blood or urine (making urine dark).

Possible side effects: Constipation or diarrhea, upset stomach, mild muscle or joint pain.

Common interactions: Digoxin (digitalis), warfarin (Coumadin), gemfibrozil, niacin, cyclosporine, danazol, verapamil, amiodarone. Simvastatin may increase the effects of digoxin and warfarin. The other drugs — as well as grapefruit or grapefruit juice — may increase the risk of muscle cramping, myopathy (muscle disease) and rhabdomyolysis.

And our pharmacists say . . . : When taking this drug, stick to your cholesterol-lowering diet — or you’ll defeat the purpose. Take at the same time every day, preferably at night. Do not take while pregnant. Do not drink grapefruit juice or eat large amounts of grapefruit. Avoid alcohol, which can raise triglyceride levels and possibly damage your liver. Muscle-related side effects are more likely in the elderly than in younger patients, and they may be more serious in the elderly, since they’re already declining in muscle strength. In addition, the link between statins and muscle pain is easy to miss in the elderly because they often have pain from other causes.

Levothyroxine

Brand names: Levothroid, Levoxyl, Synthroid, Unithroid

Description: A thyroid hormone, levothyroxine is prescribed for hypothyroidism, a condition in which the thyroid gland doesn’t produce enough thyroid hormone.

Most serious risks: High blood pressure, even a heart attack, if the dose is too high — or if someone with normal thyroid production takes it in an attempt to lose weight. The latter is especially dangerous for someone who’s also using amphetamines.

Possible side effects: Side effects are relatively rare because this is the same chemical the thyroid itself makes. But if the dose is too low, you may continue to have symptoms of hypothyroidism (e.g., fatigue, sluggishness, unexplained weight gain). If the dose is too high, you may develop symptoms of hyperthyroidism (e.g., sudden weight loss, increased appetite, nervousness or anxiety). Tell your physician immediately if you have chest pain or a rapid or irregular heartbeat or pulse.

Common interactions: If you take insulin or other diabetes medications, the correct dosage may change if you start taking levothyroxine. Many other medications can also interact with levothyroxine, including non- prescription drugs, vitamins, minerals and herbal supplements.

And our pharmacists say . . . : Take once a day in the morning on an empty stomach 30 minutes before breakfast or other medications. If you take iron, calcium or antacids (e.g., Mylanta, Maalox), you should take them at least four hours after levothyroxine. Scheduling can be a problem for seniors who take medication for osteoporosis, which also has to be taken by itself before breakfast. Talk to your physician or pharmacist to set up a schedule to make sure you take both. Levothyroxine is usually taken for life, although the dosage may change. (Get an annual blood check to determine if you’re at the right level.) Dosage may need adjustment during pregnancy. If you stop taking levothyroxine without medical supervision, serious complications can result. If you miss a dose accidentally, you can take it later in the day, but do not try to “make up” for it by taking an extra dose the next day. Small changes in your thyroid pill can cause large changes in thyroid levels in the blood. So you should continue to take the same brand that you start on and get stabilized on. Don’t shop around and change brands from month to month. Hypothyroidism can cause cognitive difficulties, and some patients admitted to nursing homes with a diagnosis of dementia can be “cured” by taking levothyroxine.

Azithromycin

Brand names: Zithromax, Zitromax, Sumamed

Description: A macrolide antibiotic, azithromycin works by stopping the growth and reproduction of bacteria (as opposed to killing them directly). It’s in the erythromycin family and can be taken by patients who are allergic to penicillin. It’s prescribed for a wide range of bacterial infections.

Most serious risks: As are all antibiotics, the drug is completely ineffective against viral infections, yet it’s often prescribed without testing to see if an infection is viral or bacterial. This leads to widespread overuse that contributes to the growth of resistant bacteria — i.e., bacteria impervious to available antibiotics.

Possible side effects: Nausea, abdominal discomfort, vomiting, diarrhea.

Common interactions: Azithromycin may interact with a number of medications. Tell your physician or pharmacist about any other medications you take — including vitamins, nutritional supplements, herbal products and non-prescription drugs — in case your doses need to be changed.

And our pharmacists say . . . : Azithromycin is usually taken once a day for one to five days. This is a big plus in comparison to another popular antibiotic, amoxicillin, which is usually taken for seven to 10 days. But as with amoxicillin and all other antibiotics, you can’t stop taking it as soon as you start feeling better. You have to finish your prescription. Stopping early increases the risk that the infection could come back. If you take antacids (e.g., Maalox, Mylanta), take them at least two hours before, or four hours after, taking azithromycin. If you miss a dose, don’t double up. Take the next dose on time and continue on schedule until the prescription is gone. When patients with viral infections take an antibiotic, they may feel better four or five days later and assume it has worked — but really the infection has just run its course.

If You Don’t Lower Cholesterol Through Diet Now, You’ll Hate Yourself Later

May 07, 2010 By: admin Category: Cholesterol, Diet and Excercise, HealthCare, Medicine Advice, Medtipster, Prescription News

Medtipster is pleased to publish an article from it’s first guest author. Thank you Deborah!

www.Medtipster.com Source: Deborah H. Land, www.cholesterolloweringdiets.net

a. The Myth of Good and Bad Cholesterol   

For some people, cholesterol is bad because they do not know there are two types of it. These two types are LDL and HDL – the bad cholesterol is called LDL, while the good one is called HDL. Plaques can form on one’s arteries if you have a lot of LDL in the bloodstream. Eventually, your arteries will get narrow as a result of being clogged up and it will block off blood flow. The truth is, your high cholesterol is not caused by dietary cholesterol but by other things. This is caused by excessive amounts of Tran’s fat and saturated fat. Exercise and eating a lot of fiber and unsaturated fats will do a lot to keep cholesterol down.

 b. What Numbers Mean in Cholesterol

 Every adult should have their cholesterol checked at least every 5 years. When you get a cholesterol test, you’ll usually get back four different results. Here are the 4 categories and the healthy range you want to be in.

Total Cholesterol – less than 200 mg/dL (5.2 mmol/L)

LDL Cholesterol – less than 100 mg/dL (2.6 mmol/L)

HDL Cholesterol – greater than 40 mg/dL (1.0 mmol/L)

Triglycerides – less than 150 mg/dL (1.7 mmol/L)

If you are over or under the desired level on any category, it is usually indicative that a diet or exercise change is needed.

c. Vitamin E and How it Can Protect the Heart

 Vitamin E is an important vitamin found in leafy vegetables, nuts, and vegetable oils. It was previously believed that a Vitamin E supplement could reduce the risk of heart disease, but several studies in the last few years have shown that this supplement does little to prevent heart attacks or strokes.

 d. Five Fabulous Foods to Decrease Cholesterol Levels

 1. Oatmeal and Oat Bran: These contain a high amount of soluble fiber, which can lower LDL.

2. Fish: Fish is a great source of omega 3 fatty acids, which lowers LDL and raises HDL.

3. Nuts: Not only are nuts high in fiber, but they contain the healthy fats you need to keep LDL in check.

4. Plant Sterols: This is found in foods like margarine, salad dressing, orange juice, and functional cookies. 2 grams per day will lower your LDL by 10-15%.

5. Soy: This popular meat replacement can lower LDL by up to 3%.

e. Health Benefits of Plant Sterols 

Plant sterols can be found in foods such as Benecol Spread, granola bars, VitaTops Muffin Tops and fat free milk. To help your heart, you should eat a lot of plant sterols-packed food and stop eating foods with saturated fat. You should know that this does not balance out a diet rich in saturated fats. To be in control of your cholesterol, you should still eat healthy and exercise often.

About the Author – Deborah H. Land writes for the cholesterol diet tips  blog (www.cholesterolloweringdiets.net), her personal hobby website she uses to help people eat healthy to lower bad cholesterol levels.

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