Medications certainly aren’t the only thing that will cause hair loss, but they are often overlooked. If you feel like you are losing your hair, one of your first steps is to look at your medication list. You will also pay attention to other well known causes including poor diet (caloric or protein restriction), major illness or surgeries, major psychological stress, significant weight loss, chronic iron deficiency, thyroid disorders, and childbirth.
Don’t have any of those? Well then lets look at which medications are common culprits of hair loss caused by drugs:
- The cholesterol lowering drugs, aka “the Statins”. Only atorvastatin (Lipitor) and simvastatin (Zocor) have reported hair loss as an adverse effect, not the newer statin Crestor (rosuvastatin).
- The anticoagulants (warfarin or Coumadin) are commonly used blood thinners and have been reported to cause hair loss.
- The ACE Inhibitor blood pressure medications captopril and lisinopril are the two in this category that have reported hair loss in > 1% of folks taking them.
- Soriatane (acitretin) is a pill used for the treatment of psoriasis that has a well known adverse effect of hair loss.
- Amiodarone (Cordarone or Pacerone) is used in patients with arrhythmias like atrial fibrillation and has a rare but reported side effect of hair loss.
- The anticonvulsant valproate (Depakote). Depakote is used for seizure disorders, controlling mania in bipolar disorder and for migraine prevention. Valproate does carry reports of hair loss.
- Cimetidine (Tagamet) is an over the counter acid reducer used for ulcers and reflux disease and hair loss has been reported, though infrequently, in people taking it.
- Colchicine is a medication used for the treatment of acute Gout attacks. It does carry a very small risk of hair loss.
- Hormones, but not all hormones. Hair loss is reported in people taking the androgen testosterone and in people taking progesterone. Progesterone medications like Depo-Provera (medroxyprogesterone) injections or Provera or Prometrium tablets are well described to cause hair loss as an adverse effect.
- Isotretinoin, brand names Absorica or Accutane, is a pill used in the treatment of severe acne and hair loss is a known adverse reaction.
- Ketoconazole is an oral antifungal pill that can cause hair loss.
The TRUEtrack and TRUEtest blood glucose test strip boxes look nearly identical because they are both made by the same company, Nipro Diagnostics, and they can be very difficult to tell apart. The problem is that the TRUEtrack and TRUEtest strips will only work in their respective meters and cannot be interchanged, so you need to know which type your meter takes. Here’s a quick guide:
These test strips are only used with the meter TRUETrack blood glucose meter. This meter is available under the brand name of your favorite retail store such as CVS, Walgreens, or other retail locations (it will be a store brand meter).
TRUEtrack test strips are covered by Medicare and many Medicaid plans, and have a lower average co-pay than other systems for many private insurance plans.
TRUEtrack test strips:
- Are available in 50 and 100 count sizes
- Use a small blood sample of 1 microliter
- Are usually less expensive compared to competitor’s test strips
For more information on TRUEtrack click here.
These test strips are only used with two meters: TRUEresult and TRUE2go. Both of these meters are available under the brand name of your favorite store such as CVS, Walgreens, or other retail locations (also store brand meters).
TRUEtest test strips are covered by most private insurance plans, Medicare Part B, and most Medicaid plans.
- Are available in 50 and 100 count sizes
- Use a smaller blood sample of 0.5 microliters (compared to TRUEtrack test strips)
For more information on TRUEtest click here.
Pharmacy Prescription Pick-Up Tip:
It is important to make sure you are receiving the correct strips from the pharmacy, especially since these products look very similar to one another.
I suggest double checking that you have been given the correct test strips before leaving the pharmacy counter so that you do not have to make an unnecessary trip back—or discover, when you are about to test your blood sugar, that you have the wrong test strip.
Below are some picture examples of the TRUEtrack and TRUEtest test strip boxes from different pharmacies for a side-by-side comparison of their similar packaging.
TRUEtrack test strips VS TRUEtest test strips
Is drinking coffee bad for me? For a drink as popular as coffee, its physiologic effects are something you should learn about. You will be reassured I’m sure.
Maintaining alertness is a well-known benefit and what most of us rely on caffeine for. But what else? Every day my patients ask me if coffee is bad for their heart. In addition to caffeine coffee contains polyphenols which are dietary antioxidants. Intriguing right?
Coffee and the caffeine in it do not increase your overall risk for coronary heart disease (CHD), nor does it adversely affect heart failure. Studies have actually shown that, in moderation, there may be some benefit for congestive heart failure. What surprises people to hear is that overall, there appears to be a beneficial effect and lower all-cause mortality with caffeine and coffee.
The Brain and Stroke
Doesn’t coffee raise my blood pressure and isn’t that bad? Hypertension (high blood pressure) is not increased by coffee, contrary to what many believe. In fact, there is some evidence that coffee and caffeine show a benefit in reducing stroke.
What about atrial fibrillation?
Association of coffee with arrhythmias has been a major concern though in moderation it is not a significant overall problem. Obviously if you feel worsening arrhythmic symptoms with coffee you should stay away from it.
Wait, it protects me from diabetes?
Yep. Where coffee clearly shines is decreasing the chance you will develop type 2 diabetes mellitus. We aren’t sure why this is but coffee contains an antioxidant, polyphenols, which may contribute to this benefit.
Is all of this really true?
Yes. A New England Journal of Medicine article in 2012 received a ton of attention when they found, in a very large cohort study, that coffee drinkers had lower risk of death due to heart disease, respiratory disease, stroke, injuries and accidents, diabetes and infections. Lower risk.
The bottom line on coffee is there is much to recommend it from an overall cardiovascular standpoint.
Jublia (efinaconazole) is a new medication for the topical treatment of toenail fungus, approved by the FDA in 2014 and now available in pharmacies.
What is toenail fungus?
Toenail fungus is an infection underneath the toenail in the skin of the nail bed. Symptoms include thickening of the toenail, discoloration, change in nail shape, loosening or lifting of the nail, brittleness, and crumbling of nail edges.
It can be very difficult to get rid of and an oral antifungal medication can sometimes be required to fully treat the condition. However, Jublia has been specifically formulated to reach the site of infection to effectively treat toenail fungus.
How is Jublia used?
Jublia is available as a 10% topical solution, to be applied once daily for 48 weeks. It is for fungal infections of the toenail ONLY.
One drop is applied onto the affected toenail (two for the big toe), and the attached brush is used to spread the medication around the whole nail, including the cuticle, skin next to the nail, and underneath the nail.
It should be allowed to dry completely.
What are the side effects of using Jublia?
Jublia’s most common side effects of Jublia include ingrown toenails, redness, itching, swelling, burning or stinging, and blisters.
Are there any other similar medications to Jublia?
Yes. Penlac 8% is a topical solution similar to Jublia that can be used on both fingernails and toenails. Penlac 8% solution is applied once daily to the affected nail(s), but removed with alcohol every 7 days.
Does Jublia have any prescriptions savings programs available?
Yes. If you qualify you may be eligible to receive a free-trial of Jublia. For more information, visit the Jublia page here.
If you have had stent placement after balloon angioplasty for coronary artery disease you will be placed on medications to ensure you don’t form clots inside those stents. One of them is aspirin, which you will take indefinitely after stent placement. The other one is up for debate, though most of you will take clopidogrel the Plavix generic. Now we have a firm answer for how long you take it.
Why do I have to take two antiplatelet meds after stent placement?
Because it saves lives. The risk of coronary artery stent thrombosis (clot formation) and its consequences of heart attack or death are lowered when you use dual antiplatelet therapy (DAPT) with aspirin and a platelet P2Y12 receptor blocker, compared to the use of aspirin alone. So, it’s two medications you’ll be taking.
Does it matter what kind of stent I have?
Yes, and you should have been given a card you can carry in your wallet with your type. For patients treated with drug-eluting or bare metal stents who are not at high bleeding risk, dual antiplatelet therapy (DAPT) for 12 months is the recommendation. The new recommendation is that after 12 months if there is no evidence of major bleeding or other problems with clopidogrel + aspirin, it is suggested you continue that therapy for an additional 18 months. I know, it seems long.
Antiplatelet therapy: at least 12 months, but 18 more?
The optimal duration of dual antiplatelet therapy is not known; 12 months has been the commonly recommended duration. A recent large trial changed recommendations. Rates of stent thrombosis and death from stroke or heart attack were lower when the two meds were continued for 18 more months. However, the rate of moderate or severe bleeding was increased, so assuming you are not at high risk of bleeding, an additional 18 months of treatment will benefit you.
There are two P2Y12 receptor blockers: clopidogrel and Effient (prasugrel). Patients rejoiced in 2012 when the generic version of Plavix, which is clopidogrel, became available. Clopidogrel is cheap and the preferred P2Y12 receptor blocker of the two. Effient is a very expensive brand-name-only option, so if for some reason you have a problem taking clopidogrel you can use Effient.