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

Will This Be The End of Chantix?

by Dr. Sharon Orrange on December 26, 2012 at 2:24 pm

Chantix (varenicline) is a nicotine agonist used to help quit smoking. Chantix is effective because it provides some nicotine effects to help with withdrawal symptoms while also blocking the effects of nicotine if the smoker relapses. Most other smoking cessation treatments either try to replace nicotine or mimic the effects of nicotine by inhibiting dopamine reuptake. Chantix was found to be more effective than nothing (placebo) and more effective than Zyban (bupropion sr, Buproban – with the same active ingredient as Wellbutrin) for quitting tobacco.

Chantix has been dogged by reports of depression and suicidal thoughts, and it now has a new problem. On December 12, 2012, the Food and Drug Administration (FDA) announced results of studies that revealed a higher incidence of major adverse cardiovascular events (heart attack and stroke) in patients receiving Chantix compared with placebo. It’s important to note these results did not reach statistical significance but the risk of heart attack and stroke was consistently higher in the Chantix group.

The problem for health care professionals and patients is that smoking is a major risk factor for cardiovascular disease, and Chantix is effective in helping patients to quit smoking. There is no question the health benefits of quitting smoking are immediate and substantial. So, it is worth the potential downsides to take a leap of faith on Chantix? Weigh in.

Dr O.

New Pharmacy Features on GoodRx

by Dr. Sharon Orrange on December 18, 2012 at 8:51 am

GoodRx has added enhanced pharmacy services and other information to our web and mobile experiences! Pharmacy information now includes hours, services offered like delivery and compounding, and fax numbers.

On the website, you can also use the options to the left of any search results page to include only pharmacies with options like walk-in clinics, drive-up windows, and pharmacies that are open 24 hours.

Penicillin Allergies

by Dr. Sharon Orrange on December 13, 2012 at 4:29 pm

Many patients report a penicillin allergy based on family history or stories from their parents to stay away from penicillin without a true history of allergic reaction. Penicillin and its close relatives are amazing, cheap, and effective antibiotics so here are 10 things you need to know:

1. Serious allergies to penicillin are common, with about 10 percent of people reporting an allergy.

2. Most people who believe they are allergic, however, can take penicillin without a problem. This is because they were never truly allergic or because their allergy to penicillin has resolved over time.

3. Cool fact: only about 20 percent of people will be allergic to penicillin 10 years after their initial allergic reaction if they are not exposed to it again during this time period.

4. With a reported allergy, it’s not just penicillin you have to stay away from but the close relatives too: nafcillin, oxacillin, cloxacillin and dicloxacillin, ampicillin, amoxicillin, carbenicillin, ticarcillin, and piperacillin. This is a big deal, so we really need to know if you are allergic.

5. Rashes that involve hives (raised, intensely itchy spots that come and go over hours), or occur with other allergic symptoms like wheezing or swelling of the skin or throat, suggest a true allergy.

6. Several other symptoms can indicate that you are allergic to penicillin: angioedema (swelling around the face), wheezing, coughing, and trouble breathing from asthma-like reactions.

7. Anyone with a past history of this type of reaction may develop a more severe reaction, such as anaphylaxis, if you were to take the antibiotic again.

8. The big A. Anaphylaxis is a sudden, potentially life-threatening allergic reaction. Symptoms include those of an allergic reaction, as well as very low blood pressure, difficulty breathing, abdominal pain, swelling of the throat or tongue, and/or diarrhea or vomiting.

9. What can you do to find out if you really have a penicillin allergy? Skin testing for penicillin allergy is the most reliable way to determine if you are truly allergic to penicillin. A whopping ninety percent of people will test negative (meaning they do NOT have a penicillin allergy), because they either lost the allergy over time, or they were never allergic in the first place.

10. Skin testing should be done by an allergist in an office or hospital setting. Testing takes about an hour to complete. The skin is pricked and injected with weak solutions of penicillin and observed for a reaction. A positive test indicates that you are truly allergic. If you complete the skin testing without a positive reaction, a single dose of full strength penicillin is given to confirm that you don’t have an allergy to the medication. At that point, you are in the clear.

Dr O.

The GoodRx Android App Is Here!

by Dr. Sharon Orrange on December 12, 2012 at 5:13 pm

Take GoodRx with you on your Android phone! Both Android and iOS users can download the GoodRx app from our Mobile Apps page, and you can still visit from any mobile phone.

The app is a great way to check prescription prices from the doctor’s office or on the go, and to find the pharmacy nearest you with the lowest price. You can also use the app for discount coupons – there’s no need to print, you can simply show the coupon screen to your pharmacist.

There are many other features like pharmacy contact information, savings tips, and manufacturer coupons to help you make the most of the app, and it is free to download and use!

Prolia: A New Medication for Osteoporosis

by Dr. Sharon Orrange on December 6, 2012 at 2:06 pm

The medications widely used for the treatment and prevention of osteoporosis are the bisphosphonates: Boniva (ibandronate), Fosamax (alendronate) and Actonel (risedronate). While these are safe and effective, concerns have been raised about some side effects like atypical fractures and jaw osteonecrosis (“dead” jaw bone) making some folks leery of taking these meds.

Enter Prolia. Prolia is a new medication that works quite differently then the bisphosphonates and is generating buzz for the treatment and prevention of osteoporosis. Prolia (denosumab) is what is called a monoclonal antibody and works by inhibiting the cells that break down bone (osteoclasts). Prolia decreases bone resorption, increases bone mineral density, and decreases the risk of fractures.

Sounds promising, but what else do we know about Prolia?

• It’s expensive. Really expensive. It’s about 900 dollars for an injection.

Prolia is an injection given once every six months.

• There are no studies directly comparing Prolia to Fosamax (alendronate) or Boniva (ibandronate) to see if it is more effective for osteoporosis.

Prolia has been shown to lower the risk of vertebral and hip fractures compared to placebo.

• Jaw osteonecrosis has been shown to occur in trials with the use of Prolia but this was in the group treated for longer than 6 years and it was very rare.

• In some of the Prolia studies there were a greater number of infections requiring hospitalization (pneumonia, diverticulitis, cellulitis among others) in the Prolia treated group versus placebo.

• There are no studies on Prolia for the treatment of osteoporosis in men (yet). Prolia has been shown to reduce the risk of vertebral (spine) fractures in men with prostate cancer taking lupron (or another anti-androgen).

• Given the absence of long-term safety data, Prolia is not recommended for osteoporosis prevention unless you are at high risk for fracture and have failed or cannot tolerate other available therapies.

The upshot here is until we know more about how safe and effective Prolia is, oral bisphosphonates should be used as initial therapy because of their efficacy, favorable cost and the availability of long-term safety data. Having said that, Prolia is an exciting new way of targeting bone loss and if we continue to get good news, it may be a way to go.

Dr O.

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