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

Do Muscle-Building Supplements Increase Testicular Cancer Risk?

by Dr. Sharon Orrange on April 24, 2015 at 8:22 am

Hidden ingredients or substances not listed on the labels of unregulated muscle-building supplements can be risky. A new study in the British Journal of Cancer found out how risky, and turns out, for testicular cancer it’s impressive. This matters because use of muscle-building supplements is increasing among younger men and rakes in billions of dollars.

What did we learn?

Men, especially 25 and younger, who use muscle-building supplements that contain creatine or androstenedione may have up to 65% increased risk of developing testicular cancer. If you used them longer, your risk was higher.

Why should we care?

Testicular cancer is the most common solid cancer in men aged 15 to 39 years. In 2014, the National Cancer Surveillance Program reported a substantial increase in testicular cancer among Hispanic adolescents and young adults in the United States. So far, we can’t explain this increase . . . that’s what makes this study on muscle building supplements so compelling.

What part of muscle-building supplements is bad?

Remember that these supplements are unregulated so we don’t really know what you are getting. Some ingredients in these supplements cause testis damage and some “natural components” could act like artificial hormones. Analysis in the British Journal of Cancer study found that using supplements containing creatine and proteins significantly increased the risk.

Haven’t we been warned about muscle-building supplements before?

Many many times. In 2013, thirty-two cases of liver failure were reported in Hawaii due to Oxy Elite Pro muscle building supplement. Again on April 13th of this year the FDA raised concerns about the use of Tri-Methyl Xtreme, which contains anabolic steroids that can cause serious liver injury. There are many more.

How did this study work?

This study included 356 men diagnosed with testicular cancer between 2006 and 2010 and 513 men without testicular cancer. Among other things, the interviewers asked about lifetime muscle-building supplement use (powders or pills). The interviews revealed that almost 20% of participants with testicular cancer had used muscle-building supplements, either pill or powder.

What were the risks of testicular cancer?

Men who had taken muscle-building supplements had significantly increased odds of developing testicular cancer. The risk was higher if you started using them before age 25 or used two or more types. Using them longer than 36 months also raised your risk even higher.

I’ve taken care of a 23 year old with liver failure from these supplements, who then survived only because of a liver transplant. Now, testicular cancer? Not worth it, not even close.

Dr O.


Sam’s Club Now Offers More Prescription Savings for Plus Members

by Elizabeth Davis on April 22, 2015 at 2:07 pm

You may already know that, like many pharmacies, Sam’s Club offers a selection of generic medications at $4 for a 30-day supply and $10 for a 90-day supply—the same savings available at Walmart pharmacies. And you don’t need to be a member to take advantage of the savings or to fill a prescription at a Sam’s Club pharmacy.

But what if you’re a current Sam’s Club member, or looking for more savings? Sam’s has just introduced a new pharmacy savings program exclusively for their Plus Members.

Now, a regular membership ($40 per year) still won’t get you access to these savings. You’ll need the Sam’s Plus Membership, which currently runs $100 per year. That’s pretty steep, and possibly not worth it if you’re just looking at some prescription savings. However, there are a few cases where it may actually still be worthwhile.

First, if you’re already a regular member, it may be easier to make back the cost of the upgrade than the full Plus Membership in savings, both at the pharmacy and in the store. If you would be purchasing a yearly membership anyway, compare and consider the cost of each membership and the savings available.

If you already have a Plus Membership through work or your business is willing to upgrade to the Plus level, there may be some good values for you in the new savings on offer. Prices on the discounted list tend to be as good or better than most pharmacy discount programs as long as you aren’t taking the cost of membership into consideration. They cover a fairly wide range of generics, brands, and supplies like test strips. Blood glucose monitors are also free.

Another factor to keep in mind: the 5 free medications. Donepezil (Aricept), pioglitazone (Actos), escitalopram (Lexapro), finasteride 5 mg (Proscar), and Vitamin D2 50,0000 IU are all available for $0 for a 30-day supply to Plus Members. These drugs can be normally be found in the $10 – $20 cash price range if you’re a smart shopper or use a GoodRx discount. Insurance co-pays should be the same or less for these typically-tier-1 generics.

For the free medications, you could be looking at a $20 – $140 per year savings as a Plus Member after the $100 membership fee. Again, if you already shop at Sam’s or if you think you might use the membership to save on other prescriptions or products in the store, it may not be a bad choice. However, this may not be worth going out of your way for.

Take a look at their list to see for yourself—there are also 200 generic meds listed at $4 for 30 days and another 400 at $10 for 30 days, along with an estimated 10% – 30% savings on some brand name drugs.


Afrezza: The New Inhaled Insulin

by The GoodRx Pharmacist on April 21, 2015 at 7:08 am

Several years ago when I was first starting out as an intern in the retail pharmacy setting, Exubera, an inhaled insulin, was collecting dust on our shelf.

The idea of inhaled insulin sounded great, especially for people who had a phobia of using needles for injection. A few years back there weren’t even as many insulin pen options as there are now, yet Exubera failed and was discontinued.

Despite the failure of Exubera back in October of 2007, a new inhaled insulin, Afrezza, has been FDA approved and is now on the market.

What is Afrezza?

Afrezza is a rapid-acting inhaled insulin used to improve sugar control in adults with type 1 and type 2 diabetes.

What is rapid-acting insulin?

Rapid-acting insulin is sometimes also referred to as meal time insulin. Rapid-acting insulin onset is within 10 – 30 minutes and peaks at 30 minutes to 3 hours. This means Afrezza is to be used at the beginning of meals.

Are there other rapid-acting insulin’s available?

Yes. Humalog, Novolog, and Apidra are also rapid-acting insulins.

Are there any other inhaled insulins available?

No. Afrezza is currently the only inhaled insulin product approved by the FDA.

When was Afrezza approved?

The FDA approved Afrezza on June 27, 2014. It became available as of February 3, 2015.

In what dosage form and strengths will Afrezza be available?

Afrezza is available to patients as a cartridge in 4 unit and 8 unit strengths.

How is Afrezza used?

Afrezza is to be inhaled at the beginning of a meal, but the dosage is individualized according to each patient.

Are there any reasons you should not use Afrezza?

Yes. Afrezza is contraindicated (should not be used) in patients with breathing problems such as COPD and asthma.

What are the most common side effects of Afrezza?

Some common side effects associated with Afrezza are hypoglycemia, cough, throat pain or irritation, headache, diarrhea, fatigue, and nausea.

Want more information on Afrezza?

Take a look at the manufacturer’s website here.


8 Reasons to Get a Standing Desk

by Dr. Sharon Orrange on April 16, 2015 at 3:03 pm

Sitting is bad, you knew that—but recent studies have confirmed that prolonged sitting is a risk factor for chronic disease. This includes heart disease, which cost the US almost $109 billion in 2010 alone according to the Centers for Disease Control and Prevention (CDC), including medications and other health care.

What has also been revealed is that physical activity outside of work doesn’t take away all the ill effects of sitting. So the weekend warrior may not be enough. More and more workplaces are opting for sit-to-stand desks, standing desks, and treadmill desks. Do you need one? Let’s take a look at the hard evidence.

  1. Sitting at a desk may be heart breaking. People really started paying attention when results from the Dallas Heart Study showed that each hour of sitting at work was associated with a 10% higher odds of having coronary artery calcium (measured by a CT scan). A surprise here was that physical activity after work didn’t counteract that risk. Moving more often is better than sitting all day, and a standing desk will help you accomplish this.
  2. Burn more energy. A recent study took 23 obese office workers and had them alternate every 30 minutes between standing and sitting desks and found a significantly higher daily workplace energy expenditure when standing to work compared to sitting.
  3. Better sleep. Another study found that workers who shared a standing/treadmill desk for three months (they had to use it for 2 hours a shift) had lower blood pressure, and sleep quality scores were significantly improved.
  4. Neck pain. Studies have shown that prolonged sitting at the workplace is associated with improper posture of the head (forward head position) and thoracic kyphosis (curvature) both of which have been found to be accompanied with neck pain. These positional problems are improved with intermittent standing during the day.
  5. Not as hungry? In a study of workers in Minneapolis sit-stand workstations reduced sitting by 8 hours in a 40 hour week and folks reported an increased overall sense of well-being and energy, decreased fatigue, and reduced appetite and dietary intake.
  6. Chronic disease and sitting. A large study from Brazil found that sitting at work was the most consistent behavior associated with chronic diseases, especially in men. High blood pressure, high cholesterol, and obesity were more common in those who sat during work.
  7. Low back pain. People who sit without taking breaks have more degenerative disc disease in the spine. Prolonged sitting without intermittent breaks at work has been shown, by lumbar spine MRI, to result in change in disk height is at the L4-5 level. The same study found there were no spine changes in those with brief positional changes every 15 minutes. Sit-stand workstations may help low back pain and disability.
  8. People like them. In yet another study, those using sit-stand desks reported a high level of satisfaction, with 96% choosing to use them permanently. Workers using sit-stand desks experienced greater energy and alertness at work and reported increased face-to-face interaction with coworkers.

Standing desks. It’s time.

Dr O.


New Anticoagulant Savaysa Is Now Available

by The GoodRx Pharmacist on April 15, 2015 at 2:16 pm

Savaysa (edoxaban) is an anti-clotting medication indicated for the treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and nonvalvular atrial fibrillation (NVAF). It was approved by the FDA on January 8, 2015, and is now available in pharmacies.

What are deep vein thrombosis, pulmonary embolism, and nonvalvular atrial fibrillation?

Deep vein thrombosis is a blood clot that can occur in a deep vein such as those of the thigh.

A pulmonary embolism is a blood clot that breaks away from its original location such as the thigh and travels to the lung where it can block blood flow.

Nonvalvular atrial fibrillation is an abnormal heart rhythm that is not caused by a heart valve problem.

What type of medication is Savaysa and how does it work?

Savaysa is part of the class of anticoagulant medications known as Factor Xa inhibitors. Factor Xa inhibitors stop a clot from forming by affecting a specific part of the clotting process.

Are there any other medications similar to Savaysa?

Yes. Some other Factor Xa inhibitor anticoagulants include Eliquis (apixaban), Xarelto (rivaroxaban), and Arixtra (fondaparinux).

In what dosage forms and strengths is Savaysa available?

Savaysa is available as a tablet in 15, 30, and 60 mg dosages.

How is Savaysa used?

Savaysa is to be administered ONCE DAILY with or without food.

What are some side effects of Savaysa?

The most common side effects associated with Savaysa are bleeding and anemia.

Want more information?

Check out the manufacturer website here.

And see the FDA approval statement here.


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