A new HIV medication, Tivicay (dolutegravir) was approved this month by the FDA for use in combination with standard HIV regimens.
Tivicay is part of a class of anti-HIV drugs known as integrase inhibitors. These drugs work by preventing the activity of an enzyme necessary for the virus to multiply in cells. The only other medication available in this class is Isentress (raltegravir).
Tivicay has been approved for the use in patients with HIV-1 in combination with standard HIV regimens. It can be used if whether you have previously received treatment for HIV or not. It can also be used if you have previously been taking an integrase inhibitor. It has been approved for use in adults and individuals above the age of 12 with a weight over 40 kg (88 lbs). Tivicay is available as an oral tablet that is taken twice daily.
Studies carried out in over 2500 patients compared Tivicay to Isentress, used in addition to standard HIV regimen Atripla (efavirenz/emtricitabine/tenofovir). These studies showed that Tivicay was effective in reducing viral loads. The major side effects observed during the studies were insomnia and headache. Other adverse effects included rare but serious hypersensitivity reactions, and abnormal liver function in patients with existing Hepatitis B or C co-infection.
As the approach to HIV care has shifted to chronic disease management, Tivicay offers a new option to better control the virus. Like all HIV therapy, taking the medication everyday and not missing a dose is very important.
Till next week,
The GoodRx Pharmacist
Now we know it’s ten, not five. For women with estrogen receptor positive breast cancer, recommendations have changed in the last year regarding tamoxifen. Women who are not candidates for aromatase inhibitors like anastrozole (Arimidex) and letrozole (Femara) take the daily pill tamoxifen to prevent breast cancer recurrence. This year the recommendation changed for the duration of tamoxifen for breast cancer, and it’s longer.
Tamoxifen for 10 years rather than 5 helps save lives from breast cancer. Two trials have addressed outcomes with extending the course of adjuvant therapy with tamoxifen to 10 years for women with breast cancer. Taken together, these data confirm that for women with hormone receptor positive breast cancer, tamoxifen for 10 years rather than 5 years helps, especially if you have relatively poor prognostic breast cancer (node involvement, large tumor size, or high tumor grade).
Women who took daily tamoxifen for 10 years had a significantly lower risk of recurrence and risk of death compared to women who took tamoxifen for 5 years. That, my friends, is a no-brainer, and lucky for you it’s generic and cheap.
One of my co-workers had an interesting experience at the pharmacy recently. Here’s his story:
I am an employee of GoodRx. Since I am a full-time employee, my family receives health insurance (which includes pharmacy benefits) at a cost of about $400 per month.
I’ve always just assumed that having health insurance guarantees me a better price at the pharmacy. GoodRx is great, but I have insurance . . . right?
Last Friday, I woke up with a bad case of conjunctivitis (pink eye)—yuck. I visited a local doctor, and within 5 minutes was handed a prescription for the generic version of Maxitrol eye drops. I asked the doctor how much this medicine would cost, to which he said “I’m honestly not sure.”
I jumped in my car and immediately fired up the GoodRx mobile app to find out how much this drug costs. GoodRx told me that one major pharmacy chain sold this drug for $9.99 through their Prescription Savings Club (no fee), while every other nearby pharmacy was between $15 and $35.
Still, I have insurance, so I knew my insurance would be the best price. Would it be $5? Maybe even free? I was just happy that I’d be paying lower than $9.99. I drove to the pharmacy to fill my prescription.
Five minutes later, the pharmacist handed me my prescription and said “That’ll be $11.96, please.” Now, I know it’s just a few bucks, but that’s about 20% higher than my insurance price and I pay $400 every month for my insurance to save money on my drugs!
So I said to the pharmacist “Wait a second—you have a generic discount program advertised all over the store that offers this drug for $9.99 without any insurance, but WITH insurance, it’s $11.96?” His answer: “Huh. I guess so. I didn’t know that could happen.”
I asked him to re-run my prescription with the Savings Club discount, and 30 seconds later I paid $9.99, cash, or 20% less, without my insurance.
Now, I’ve worked at GoodRx for a while, and I’d like to think that I understand prescription drug prices, but my mind was blown.
From now on, I’m checking every prescription on GoodRx. Regardless of my insurance.
Four is better than three right? The new flu vaccine, approved this week by the FDA, will cover four strains of the flu virus instead of three. The new quadrivalent vaccine, FluLaval Quadrivalent, is the second flu vaccine available that covers four strains.
Four primary influenza strains circulate each year causing the majority of influenza illness, but the influenza vaccines used for the past thirty years only covered three strains. Of course now with a shot at covering four of the strains we may get better with our vaccine, especially given that in six of the past eleven flu seasons one of the predominant strains causing illness wasn’t in the vaccine. Now, we will have broader coverage.
FluLaval Quadrivalent helps protect against the two A strains and B strains, decreasing influenza-related morbidity across all age groups (children, adults, and the elderly).
Some of the new vaccine will be available this year, but the majority of FluLaval Quadrivalent vaccine will be available in 2014.
Have you had a minor sprain, strain, or muscle ache that took some time to heal? Minor musculoskeletal injuries are a common complaint for many people. These injuries can affect your muscles, tendons, ligaments, cartilage, or bones. Your GoodRx pharmacist’s advice: get some RICE!
Minor aches, sprains and strains occur due to a variety of reasons. These can include hyperextensions, twists, blunt trauma, and many other causes. The RICE method promotes healing, and helps reduce inflammation and pain that may occur:
1. REST – For many muscles aches and injuries, including common injuries like shin splints, bursitis, and heel pain, resting is a major component in healing. Adequate resting time varies based on the type of injury, but is generally from around 1 to 2 days up to a week.
2. ICE – Providing cold therapy is the second step. This can be done using ice, cold packs, and other cooling tools. This prevents any further swelling and assists the healing process. This should be done as soon as possible, for ten to fifteen minutes at a time, up to 3 to 4 times a day.
3. COMPRESS – Compression can be done using a variety of bandages, straps, or commercially available products. This helps by limiting the injured area’s range of motion.
4. ELEVATE – Elevating the injured area for 2 to 3 hours a day is also a helpful way to promote the healing process.
The RICE method can be supplemented with medications, including:
1. Oral pain relievers: NSAIDs (like ibuprofen or naproxen) are useful at preventing inflammation and for when swelling is present. Acetaminophen (Tylenol), like NSAIDS, will help with pain. You should only use NSAIDs or acetaminophen as needed, and consult your pharmacist if you’re not sure if taking them is right for you. Acetaminophen toxicity and overuse of NSAIDs is a major problem, so follow dosing instructions and stay safe!
2. Topical creams and ointments: Over the counter creams like Bengay, Aspercreme and Icy Hot contain ingredients like salicylates (related to salicylic acid and aspirin), menthol, and camphor (amongst others), which provide temporary relief by acting as counter-irritants. These ingredients help to block the feeling of pain, providing some relief. Most creams can be used safely over a period of time, but should be limited to only three to four times a day.
It is also important to know when to get advice from a health care provider. If your injury is severe, affects your quality of life, or inhibits normal activity, make an appointment to have it checked.
Till next week,
The GoodRx Pharmacist