The latest updates on prescription drugs and ways to save from the GoodRx medical team

Heart Patients More Likely to Skip Pills If They Look Different

by Dr. Sharon Orrange on July 22, 2014 at 9:33 am

Generic drugs are crucial to the treatment of heart disease. Generics save lives in our heart patients, ranging from blood pressure meds and blood thinners to anti-arrhythmic drugs. They are cheap and well tolerated. Why is it, then, that so many patients stop taking them? One half of patients with heart disease don’t take their meds even in the year after a heart attack. Turns out, the way they look matters. You lost me at red?

Generic drugs may be therapeutically interchangeable but they are not required to look the same as their brand name counterparts, and that bugs people . . . on a deep level.

A recent study in the Annals of Internal Medicine found that a change in the shape or color of your generic medication makes you more likely to skip it. One third of patients had a change in pill shape or color during their study with statins having the biggest changes in appearance. The odds of stopping your medication increased 34% after a change in pill color and 66% after a change in pill shape. What?!

This is a huge public health issue and I get it, if you don’t recognize the pill you don’t trust it as much. Conversations with your doctor, pharmacist, and maybe a label on your pill container to explain that your pill has changed appearance will certainly help. Or the FDA could require that compatible generic drugs look exactly the same.

Cardiovascular disease is the leading cause of death in the United States and the period after heart attack is a key time when taking proper medications saves lives. Changing the color and shape of your generic medication makes you stop taking them. So, how can we help? What would work?

Dr O.

Albuterol vs Levalbuterol HFA Inhalers: What’s the Difference?

by The GoodRx Pharmacist on July 21, 2014 at 10:00 am

Albuterol and levalbuterol can be confusing right off the bat due to the sound-alike active ingredient names. Both are available as various brand name inhalers, though there are no generic albuterol or levalbuterol HFA inhalers at the moment. Both types of inhaler treat asthma and in some cases COPD, but they have different strengths and side effects and can vary in price.

Are albuterol and levalbuterol considered rescue or maintenance inhalers?

Both albuterol and levalbuterol are rescue inhalers. These inhalers are fast-acting and to be used for short-term breathing problems such as an asthma attack. Albuterol and levalbuterol will assist in quickly opening the airways to help improve your breathing.

What are the brand names of the albuterol and levalbuterol HFA inhalers?

Albuterol HFA inhalers include ProAir HFAVentolin HFA, and Proventil HFA. Xopenex HFA is the levalbuterol HFA inhaler.

What is the difference in strength between the albuterol inhalers and Xopenex HFA?

All Albuterol HFAs (ProAir, Ventolin, and Proventil) have a strength of 108 mcg/actuation, where Xopenex HFA is 45 mcg/actuation.

Is there an advantage to using levalbuterol instead of albuterol?

Even though these medications are inhaled there is still some bodily (or systemic) absorption which can result in unfavorable side effects. Levalbuterol tends to have fewer systemic side effects compared to albuterol.

For example, albuterol can cause an increased heart rate. Therefore, patients who have a history of heart problems such as arrhythmias or heart disease may benefit from using Xopenex HFA (levalbuterol) instead of the ProAir, Ventolin, or Proventil HFAs.

Is there a price advantage to use Xopenex HFA compared to ProAir, Ventolin, or Proventil HFAs?

Depending on which pharmacy you use, you may be able to get levalbuterol and albuterol HFAs at the following discounted prices:
Xopenex HFA (levalbuterol): $58-$63
ProAir HFA (albuterol): $51-$59
Ventolin HFA (albuterol): $49-$54
Proventil HFA (albuterol): $65-$70

Ventolin HFA appears to be the least expensive option, by about $20 at the most. However, the price of Xopenex HFA is comparable to the albuterol inhalers, and less expensive than Proventil HFA.

These prices DO NOT reflect what the copayment if using your prescription insurance may be; therefore, it is always best to check with your insurance first to see if your medication is covered and if so what the copayment will be.

Only your doctor can determine which medication is right for you, but keep in mind that if you have a pre-existing heart condition using Xopenex HFA may be more favorable due its side effect profile.

Sudafed vs Sudafed PE: What’s the Difference?

by The GoodRx Pharmacist on July 18, 2014 at 3:23 pm

With a difference of only two letters in their names, Sudafed and Sudafed PE look nearly identical and can be extremely confusing to the unsuspecting patient. Both are used to treat nasal congestion—but they are available in different strengths, have different active ingredients, and are kept in different locations in your pharmacy.

What is nasal congestion?

Nasal congestion is the blockage or inability to breathe clearly through your nose due to swelling in the lining of your nasal passages. It can be due to common cold, hay fever, upper respiratory allergies, or sinus infection.

How are Sudafed and Sudafed PE available?

Sudafed (pseudoephedrine) is available as 30 mg, 60 mg, 120 mg, and 240 mg tablets. Sudafed PE (phenylephrine) is available as a 10mg tablet. Both are also available in combination drugs with other active ingredients.

How do Sudafed and Sudafed PE work to relieve nasal congestion?

Both Sudafed and Sudafed PE work by reducing swelling and pressure in your nose through squeezing or constricting the blood vessels in your sinuses. This decrease in swelling will allow for nasal drainage and easier breathing.

What is are the active ingredients in Sudafed and Sudafed PE?

The active ingredient in Sudafed is pseudoephedrine, while the active ingredient in Sudafed PE is phenylephrine. Both are available as generics under the active ingredient names.

Where can you find Sudafed and Sudafed PE products?

Sudafed and pseudoephedrine-containing products will be located behind the counter at your pharmacy, even though they don’t require a prescription in most states. You will also be asked to present a photo ID and sign due to the Combat Methamphetamine Act. Unfortunately, there are restrictions on the sale of pseudoephedrine products due to their use in the street drug known as crystal meth. It is also important to know that depending on your state, pseudoephedrine products may require a prescription from your doctor.

Check out this article for more information on Sudafed and your state laws.

Sudafed PE and phenylephrine products, however, are readily available in your local pharmacy or grocery store aisles and do NOT have the same restrictions.

Sudafed is more of a hassle—but are there any advantages over Sudafed PE?

Yes. Most patients and healthcare providers will agree that Sudafed (pseudoephedrine) is more effective for congestion than its counterpart Sudafed PE (phenylephrine).

This is likely due to the fact that the intestines will absorb only about 38% of the amount of Sudafed PE in one tablet, while Sudafed is 100% absorbed. Also, the effects of Sudafed PE do not last as long—Sudafed can be taken every 4 to 6 hours while Sudafed PE needs to be taken a little bit more often, every 4 hours.

You can find more information here.

Generic Diovan is Now Available!

by The GoodRx Pharmacist on July 17, 2014 at 10:15 am

The long expected arrival of generic Diovan (valsartan) is finally here!

I know there has been a lot of anticipation for the release of this highly popular blood pressure medication and it is now finally available. Diovan combined with hydrochlorothiazide (Diovan HCT) has been available as generic valsartan/hctz for quite some time now, and there has been plenty of speculation as to when plain Diovan would make its generic debut.

What is valsartan used for?

Diovan (valsartan) is indicated for the treatment of high blood pressure, heart failure, and use post-heart attack.

What strengths is this medication available in?

Valsartan tablets, like Diovan, are available in the following strengths: 40 mg, 80 mg, 160 mg, and 320 mg.

How is valsartan usually taken?

The usual dose is 80 mg to 320 mg once daily.

What type of medication is valsartan?

Valsartan is considered an Angiotensin Receptor Blocker (also known as an ARB). ARBs work by blocking a natural substance in your body called angiotensin II from binding to receptors on blood vessels. This results in blood vessel relaxation and a decrease in blood pressure.

What are the most common side effects?

Some side effects include headache, dizziness or lightheadedness, nasal congestion, back and leg pain, and diarrhea.

Other important information to know about Diovan and valsartan:

There is a BLACK BOX WARNING for fetal toxicity. This means that this medication can cause fetal harm and must be discontinued if you find out you are pregnant.

Tramadol Is Now a Scheduled Drug

by Dr. Sharon Orrange on July 16, 2014 at 9:56 am

The Drug Enforcement Administration (DEA) has officially declared tramadol (Ultram) a Class IV substance. This new scheduling will go into effect August 18, 2014 and means you will need a triplicate prescription to get tramadol. A scheduled drug is one whose use and distribution is tightly monitored.

Tramadol is an opioid analgesic that was initially approved in 1995 under the brand name Ultram. Ultram also came mixed with Tylenol (acetaminophen) in the drug Ultracet. Tramadol binds to the mu opioid receptor and has been available without a triplicate prescription until now—but the decision has been made to make it a schedule IV drug.

Know that though this makes it a hassle to get, you can only fill thirty days at a time, and it requires a triplicate prescription from your physician, is was not given schedule II status which is where most other opioids are, like Oxycodone, etc.

Refilling your tramadol will now be more difficult than filling a regular prescription but probably the right thing to do.

Dr O.

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