On February 25, 2015, the FDA approved Toujeo—a long-acting insulin indicated to improve sugar control in adults with type 1 and type 2 diabetes.
When will Toujeo be available?
According to the manufacturer, Sanofi-Aventis, Toujeo will be available at the beginning of the second quarter in 2015.
What is long-acting insulin?
Long-acting insulin can also be referred to as basal insulin. Long-acting insulin lowers blood sugar levels slowly and evenly for up to 24 hours. This means that Toujeo manages blood sugar between meals and at nighttime.
Are there other long-acting insulins available?
Is Toujeo similar to any of the other long-acting insulins?
In what dosage form and strength will Toujeo be available?
Toujeo will be available as a disposable prefilled 300 units/mL SoloStar Pen. It will be dispensed in packages of three or five pens.
How is Toujeo used?
Toujeo is to be administered subcutaneously ONCE DAILY at the same time each day.
What are the side effects of Toujeo?
The most common side effects associated with Toujeo are hypoglycemia, allergic reaction, injection site reaction, loss of body fat at injection sites, itching, rash, edema, weight gain.
Photoaging. That’s the term for skin changes that occur with sun and age. You know this as the fine and coarse wrinkles, brown spots, mottled pigmentation, loss of elasticity, and sallow color that happens as we get older.
Sun protection is the best way to prevent or improve photoaging, but other things also work. Many advertised wrinkle treatments have never been tested or been shown to be effective so don’t mess with those—go with something that works. Here are 6 things that do work.
- Tretinoin. These are topical retinoids available by prescription. Common brand name versions are Refissa,Renova and Retin-A which are the mainstay of therapy for mild to severe wrinkles and sun damage. These are used every other night, and several weeks or months of treatment are required before real improvement can be seen. Tretinoin medications come in creams or gels, and the generic form of Retin-A (tretinoin) may be your cheapest bet.
- Tazorac. Tazorac (tazarotene) also comes in a cream or a gel. It is more expensive than tretinoin as it does not yet have a generic option. In studies it is as effective as tretinoin for photoaging and wrinkles.
- Efudex is topical fluorouracil, which can improve sun damaged skin. It does this by causing skin injury, wound healing, and then remodeling of the dermis (lower layers of the skin) which results in improved appearance. The warning here is that it’s a pretty intense reaction with redness, blistering, and peeling. Most folks think the results are worth it though.
- Chemical peels. Chemical peels involve applying chemical substances to remove top skin layers. Sounds gross, I know, but the subsequent regeneration tightens the skin and evens the color.
- Sunscreen and hats. That you know, but here is something you might not know. Factors that increase the UV protection in clothing are synthetic fabric (even polyester), tightly woven, thicker fabric and darker colors.
- Last, but not least. Though more expensive, Botox, injectable fillers and laser therapy (aka ablative laser resurfacing) all work well for skin rejuvenation.
When you pick up your medications at the pharmacy you may notice that they are typically dispensed in amber colored vials or plastic containers. You may or may not be aware that these amber colored vials are not the original bottle the manufacturer dispensed the medication in.
For the majority of medications, transferring them from the manufacturer’s original bottle to the pharmacy’s amber vials is not a big deal, and lets the pharmacy purchase in bulk (which is more cost-effective)—unless you are taking certain medications.
Some drugs, per the manufacturer, are to be dispensed in their original container due to the sensitivity, integrity, and stability of the medication. Medications can be sensitive to many things including light, temperature, humidity, or moisture. It is important to properly maintain and store your medications according to the recommendations of the manufacturer.
So what are some examples of medications that need to be dispensed and stored in the original container?
- Atripla (bottle)
- Complera (bottle)
- Effient (bottle)
- Hepsera (bottle)
- Micardis (blister pack)
- Nitroglycerin (bottle)
- Sovaldi (bottle)
- Treximet (plastic container in box)
- Truvada (bottle)
- Accolate (bottle)
- Tekturna (bottle)
Orally dissolving tablets
- Aggrenox (bottle)
- Gengraf (blister pack)
- Neoral (blister pack)
- Pradaxa (bottle)
- Tecfidera (starter pack or bottle)
- Isentress (bottle)
When you think of conditions where an over-the-counter medication will help, lowering your cholesterol may not be the first thing that comes to mind. Most people think of OTC medications for minor problems like cough and cold, allergies, upset stomach, and mild aches and pains.
It may seem strange that there are medications available over the counter for high cholesterol—a problem that you may not even know you have. Unlike a cough or cold, high cholesterol is not a condition that you can physically feel, and your doctor must perform blood work to determine if you have it.
So how and why would you take a non-prescription med for high cholesterol?
First, it’s important to know what causes high cholesterol and what you can and cannot change if you’re diagnosed. High cholesterol can be a result of several factors, including poor lifestyle choices and genetics. Family history or genetics cannot be changed, but poor lifestyle choices can be!
If you are diagnosed with high cholesterol, depending on how severe it is, your doctor may start you out with lifestyle changes and OTC treatments.
Some lifestyle changes that can be helpful include:
- Quitting smoking
- Better diet
- Weight loss
- Stricter blood sugar control
And some of the OTC medications that may help:
- Red rice yeast. A traditional Chinese medication, red rice yeast is available over-the-counter and has been suggested to help lower cholesterol. However, there are various types available, which can lead to confusion and misunderstanding. For example, one of the main issues with red rice yeast: small amounts of the prescription medication lovastatin (used to lower cholesterol) have been found in some formulations. Lovastatin and red rice yeast have a very similar chemical make-up, which may explain why several brands of red rice yeast were taken off of the market by the FDA in 2007 after they were found to contain lovastatin.
- Niacin. A form of vitamin B, niacin is available over-the-counter and has been suggested to improve a component of cholesterol known as HDL (“good” cholesterol). Niacin may work to increase HDL levels—it is also available in higher strengths by prescription as Niaspan ER.
- Garlic. Not only for adding to food to enhance flavor, garlic has also been suggested to help lower cholesterol. Garlic supplements are available over-the-counter, but you still need to check with your doctor or pharmacist before using because garlic can negatively interact with A LOT of prescription medications.
- Fish oil (omega-3 fatty acids). Whether you get this from eating fish or taking the over-the-counter supplement, omega-3 fatty acids have been suggested to help lower a component of cholesterol known as triglycerides. Fish oil is more likely to work in those who have very high triglyceride levels compared to those with moderate levels. Like niacin, higher doses of omega-3 are available by prescription as Lovaza and Vascepa.
Onychomycosis is a fungal infection of the nail and the most common nail disorder. It is more common as we get older and with factors like diabetes, sweating, sports activities, occlusive footwear, and repeated nail trauma. Topical treatments eliminate the need for surveillance blood tests and cause less systemic complications. Two new nail solutions were recently approved.
Why should we care about it? It isn’t just a cosmetic problem because nail fungus can spread to other nails, cause discomfort, and spread to family members.
Why did I get it? The same fungi that cause athlete’s foot also cause toenail fungus. Often toenail onychomycosis (fungal infection of the nail) spreads from athlete’s foot. The infection starts on the skin and then spreads to the toenails. Onychomycosis can also spread from toe to toe, from toe to finger, and to other people.
How do I know if the changes on my nail are from a fungus? Nail clippings are sent for microscopic evaluation. Diagnosis should be made on a nail clipping to distinguish it from psoriasis or nail bed trauma.
Do topical medications for nail fungus work? It is important to understand that no matter what antifungal medication you are prescribed, the medication is not going to fix the nail that is already abnormal looking. Effective treatment allows a new, healthy nail to come in and push out the old, abnormal nail. The rate at which your nail gets better depends on how quickly the new nail grows and in most, it takes 12 months for a new toenail to form.
What are the two new options?
- Jublia (efinaconazole) works by inhibiting an enzyme that disrupts a part of the fungal cell membrane. Jublia works, but the number of people it cures may seem a bit low: about 28% of people with mild to moderate nail fungus who applied it daily for 48 weeks had a complete or near complete (<5% of their nails still affected by fungus) cure.
- Kerydin (tavaborole) is another nail solution for fungus. Kerydin blocks fungal protein synthesis. In people with mild to moderate nail fungus who were treated for 52 weeks 26% had a completely clear or almost clear nail.
What’s better, the nail solutions or pills for onychomycosis? The two new topical nail solutions listed above are appealing because they don’t carry the potential for liver damage, and so on, but they are expensive. Pills for antifungal treatment, like Lamisil (terbinafine), achieve cure in approximately 60% of people.