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

New Combo Drug Jentadueto XR Approved for Diabetes

by The GoodRx Pharmacist on June 23, 2016 at 12:04 pm

Jentadueto XR (metformin/linagliptin) is the newest once-daily combination drug approved by the FDA to treat type 2 diabetes.

Combination drugs can also be a convenient way to join together two drugs that work differently to treat a particular health condition, and extended release versions like Jentadueto XR mean you only need to take your prescription once per day. In addition, many medications are combined because they work better together than either medication alone.

Do your own research though—while combinations can be easier to take, they can also be pricier than taking the active ingredients as separate medications.

What is Jentadueto XR?

Jentadueto XR is an extended-release once-daily combination of metformin and the active ingredient in Tradjenta, linagliptin.

What are the advantages to using Jentadueto XR?

Convenience, for one. One pill, once per day, for two medications is much simpler than scheduling multiple doses for more than one prescription.

The all-in-one dose form also means you’re more likely to take your medication as prescribed—which means you’re more likely to keep your diabetes under control.

What are the disadvantages?

Potentially, cost. Jentadueto XR hasn’t hit pharmacies yet, but the immediate release version, Jentadueto, costs about $375 per month using a discount.

However, if you are already taking Tradjenta and extended-release metformin separately, Jentadueto XR may still be a good option for you—since Tradjenta is still brand-only, the cost is about the same.

How will Jentadueto XR be available?

Jentadueto XR will be a tablet in / and / strengths.

How is Jentadueto XR taken?

Jentadueto XR is taken once daily with food. It should be swallowed whole—don’t split, dissolve, cut, or chew the tablets.

What are the side effects of Jentadueto XR?

The most common side effects associated with Jentadueto XR include stuffy nose, runny nose, sore throat, and diarrhea.

When will Jentadueto XR be available?

At the moment, there isn’t an expected availability date for Jentadueto XR—but watch for it in pharmacies in the upcoming months.

Want more information?

See the press announcement from the manufacturer here.

FDA Safety Alert: Imodium Misuse May Cause Heart Problems

by The GoodRx Pharmacist on June 22, 2016 at 2:13 pm

The FDA has issued a drug safety alert for Imodium (loperamide), a medication used to treat diarrhea.

The FDA warns that taking higher than recommended doses of Imodium can cause serious heart problems and potentially death.

What is Imodium used for?

Imodium is used to control the symptoms of diarrhea.

Why would someone take a higher than recommended dose?

The active ingredient in Imodium, loperamide, is similar to opioids like morphine. Some people have reportedly been misusing and abusing Imodium in an attempt to self-treat opioid withdrawal symptoms or to achieve a feeling of euphoria.

Is Imodium available without a prescription?

Yes. There are both prescription and non-prescription strengths of Imodium.

What type of heart problems could high doses of Imodium cause?

Abnormal heart rhythms, a sudden drop in heart rate and blood pressure, and heart attack can all be caused by high doses of Imodium.

What signs and symptoms should I be concerned about with Imodium?

If you or someone you know takes Imodium and experiences rapid heartbeat, irregular heart rhythm, or fainting, or becomes unresponsive, seek medical attention immediately.

What is the maximum daily dose of Imodium that an adult should take?

For Imodium that you can buy in your pharmacy over-the-counter, the maximum recommended daily dose is 8 mg.

For prescription Imodium, the maximum recommended daily dose is 16 mg.

Is there anything else I should be aware of?

Yes. Imodium can interact with many common over-the-counter and prescription medications, also increasing the risk for potentially serious heart problems.

These other medications could have a negative interaction with Imodium:


What Can I Do About an Embarrassing Itch?

by Dr. Sharon Orrange on June 21, 2016 at 3:33 pm

Itchy butt, pruritus ani, itching around the anus . . . whatever you want to call it, it’s more common than you might think. Many folks try to deal with it on their own without coming to the doctor because, well, it’s embarrassing. So let me walk you through it step by step.

What is pruritus ani? It’s the medical term for itching around the anorectum (this includes outside and inside). Itching around the anus or higher up in the rectal area may bother you the most at night and can really affect quality of life.

How common is it? In one survey of 100 randomly selected individuals (aged 21 to 65), 20 percent had ongoing symptoms. The majority of those folks hadn’t talked to a doctor about it either, so you are not alone.

Why do we get itching around the anal area? Dietary factors and fecal soilage account for the majority of patients with anal pruritus but one fourth of patients have no identifiable cause. Several things can be quickly ruled out with a quick look by you or your primary care doctor: tumors, anal fissures, abscesses or hemorrhoids.

Now “fecal soilage” doesn’t sound good—what does it mean? This does not mean that you aren’t cleaning well enough. In fact some of you clean too well with witch hazel and other astringents which dry the area out, making the itching worse. Stool that is loose or sticky is more likely to cause fecal soilage than formed or bulky stools, and this will worsen the itching.

What foods make itching around the anus worse? The “Cs” of coffee, cola, chocolate, citrus, and calcium (dairy) are potential dietary contributors to itchy butt. Tomatoes and tea also may make itching worse.

Is it just a skin problem? This is where seeing your doctor can help. Skin conditions like psoriasis can also be the cause along with other types of dermatitis. Skin irritation can be worsened by scratching or by the use of additional skin products to relieve the itching, like witch hazel.

What works to ease the itch? Start by avoiding food and beverages known to make the itching worse, and if you are having loose bowel movements or diarrhea try cutting out lactose. If everything else is normal, start with keeping the area dry and clean, but without excessive wiping or use of astringent cleaners (again, like witch hazel).

Here is a stepwise plan you may try before visiting your doctor:

  • After a bowel movement, a bath or using a pre-moistened pad or tissue can be used for wiping.
  • Following bathing, the area around the anus should be dried using a soft towel with a dabbing/patting motion, or with a hair dryer set on cool. Wiping too aggressively is NOT helpful
  • Over the counter options to start with: Calmoseptine is an over the counter ointment that works really well for itchy butt—start with this. Balneol lotion or lotion packets are also a favorite of colorectal surgeons for use after a bowel movement. Zinc oxide (Desitin or Balmex) can be used also as a barrier cream.
  • You can also try talcum powder to help keep the area dry.

Ok, those didn’t work. Now what? See your doctor. An over-the-counter 1% steroid/hydrocortisone cream can be used twice daily to relieve the itching and help healing, but you don’t want to use that for very long.

If the itching is bad at night, take a 25 mg Benadryl (diphenhydramine) to help while you wait for other remedies to kick in.

Last, if the above listed interventions don’t help, your doctor may give you Protopic 0.1% ointment (topical tacrolimus) which has been shown to help.

Allergy (patch) testing is also recommended if it doesn’t get better

Dr. O

FDA Safety Alert: Zecuity Migraine Patches

by The GoodRx Pharmacist on June 16, 2016 at 4:01 pm

At the beginning of this month the FDA issued a drug safety alert for the migraine patch Zecuity (sumatriptan). At that time, the FDA planned to investigate whether the Zecuity patch came with an increased risk of serious burns and potential permanent scarring.

Now, the FDA has announced that the manufacturer of Zecuity, Teva Pharmaceuticals, has decided to temporarily stop the sales, marketing, and distribution of the Zecuity patch. Teva also plans to investigate the cause of burns and scars associated with the migraine patch.

Taking Zecuity? Here’s what you need to know.

How does Zecuity work?

Zecuity is a topical battery-powered patch system that wraps around the upper arm or thigh. The system works by delivering the migraine medication through the skin by using an electric current.

Is the FDA requiring that Teva pull Zecuity off the market?

No. Teva is voluntarily suspending the sale, marketing, and distribution of Zecuity beacuse of the reports of serious reactions. They plan to find out the cause.

How did the FDA find out about the risk of burns and scarring from Zecuity?

Since the marketing of Zecuity began in September 2015, a large number of patients have reported to the FDA that they have experienced burns or scars on the skin where the patch was worn.

Reports included descriptions of severe redness, pain, skin discoloration, blistering, and cracked skin.

Have any of the reactions healed?

Yes. Many of the reported cases got better within hours to weeks, however, there are still cases with ongoing skin reactions after several months, typically discoloration.

Can my doctor still prescribe Zecuity for my migraines?

No. The FDA has advised health care providers to stop prescribing Zecuity patches until further notice.

What should I do if I still have some unused Zecuity patches?

The FDA recommends that if you have leftover patches, you should still stop using Zecuity and contact your health care provider to find an alternate migraine medication.

The manufacturer is also offering a Migraine Support Solutions help line at 1-855-ZECUITY (1-855-932-8489) for additional information and instructions regarding leftover Zecuity patches.

I want to keep using the same medication—what are my options?

The active ingredient in Zecuity the popular migraine medication sumatriptan, so you have lots of options. Generic sumatriptan (Imitrex) is available in tablet, nasal spray, and injection forms. Other migraine medications containing sumatriptan include Alsuma, Sumavel Dosepro, and Zembrace.

Talk to your health care provider about which sumatriptan (or other migraine medication) might be a good alternative for you.

FDA Requires New Warning on Opioid Pain Medications

by The GoodRx Pharmacist on June 15, 2016 at 4:38 pm

The FDA has issued a new required warning for all opioid pain medications. If you are taking an opioid, you should be aware of a few potential side effects, including reactions with other medications, and effects on hormone levels.

What are some examples of opioid medications?

Opioids are powerful prescription-only medications, used to manage manage pain when other treatments may not work. Some common opiods include:

Why exactly was the FDA safety alert issued?

The FDA identified some safety concerns for anyone using opioid pain medications:

  • They can interact with many other medications
  • They can cause problems with a person’s adrenal glands
  • They can decrease sex hormone levels

What kind of medications can react with opioids?

Specifically, opioids may react with antidepressants and migraine medications. When used with opioids, these medications may cause a serious, life-threatening condition known as serotonin syndrome.

Serotonin syndrome is the accumulation of too much serotonin (a naturally occurring chemical in the brain responsible for mood). Symptoms may include increased blood pressure, fast heartbeat, increased body temperature, nausea, vomiting, diarrhea, and restlessness.

Examples of antidepressants that may be affected include Zoloft (sertraline), Celexa (citalopram), Effexor (venlafaxine), Cymbalta (duloxetine), and trazodone.

Migraine medications that may be affected include Imitrex (sumatriptan), Maxalt (rizatriptan), and Zomig (zolmitriptan).

How can opioids affect my adrenal glands?

Taking an opioid can also lead the a rare but serious condition where your adrenal glands don’t produce enough of the hormone cortisol. Symptoms include nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or low blood pressure.

Cortisol is the hormone responsible for the regulation of a wide variety of processes throughout the body including metabolism and immune response. Cortisol is best known for its role in helping the body respond to stress.

Why would a decrease in sex hormones be a concern?

A decrease in sex hormones can be associated with loss of sexual desire, inability to get and keep an erection, lack of menstruation, and infertility.

While these symptoms are not life threatening like serotonin syndrome or adrenal insufficiency, they can still drastically affect your quality of life.

What is the FDA doing in response to the new concerns?

The FDA is requiring changes to the labeling of all opioid medications to make sure you and your doctor are aware of the risks.

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