“Everyone in Canada is talking about Victoza for weight loss” was what I heard from a visitor last week. It’s true, the potential is there to use this new class of diabetes medications for weight loss, given that in studies folks lose weight and their appetite diminishes. So, what’s the scoop on Victoza?
Get to know GLP-1. You will hear more from this class of medications. Victoza (liraglutide) is a long-acting GLP-1 analog available for use in the United States for the treatment of type 2 diabetes. Byetta is a similar drug also available. Victoza is given daily as a shot under the skin. In diabetes trials, Victoza was associated with a significant reduction in weight (5 to 7 pounds) when compared with placebo. The role of GLP-1 as a weight loss agent in folks without diabetes is under investigation.
It gets better. Weight loss has also been reported in patients without diabetes who received Victoza (liraglutide). As an example, in a 20-week randomized trial comparing Victoza to Xenical (orlistat) the average weight loss was 10 to 15 lbs!
How does it work? GLP-1 is produced from cells of the small intestine and is secreted in response to nutrients (so when you eat, GLP-1 is secreted). GLP-1 levels are decreased in type 2 diabetes. GLP-1 exerts its main effect by stimulating insulin release from the pancreas but it also slows gastric emptying and reduces food intake. The other cool thing being investigated is that Victoza may hold promise for halting the progression of beta cell failure that often occurs in type 2 diabetes.
The downsides. With a higher dose of Victoza there’s more weight loss, but also more nausea (wonder if that’s why folks lose weight). The weight loss may be due, in part, to gastrointestinal side effects. As with most weight loss medications, people gained most of their weight back when they stopped the Victoza. Hmmm, worth it?
Manufacturer Nephron Pharmaceuticals has issued a voluntary recall of ten lots of its albuterol inhalation solution. The recall affects the 0.083% (2.5mg/3ml), 3 ml vials in 25-count packaging.
The recall is precautionary; there haven’t been any reported reactions, complaints, or adverse effects at this time.
Nephron is working with patients and pharmacies to make sure supply isn’t disrupted; you can contact them at 1-800-443-4313 ext. 2292 or at email@example.com with any questions.
The affected lots (A3A33A, A3A33B, A3A34A, A3A35A, A3A36A, A3A37A, A3A38A, A3A40A, A3A41A, and A3A42A) have the NDC number 0487-9501-25.
You can now find prices, comparisons, and descriptions for blood glucose test strips on GoodRx.
You can search for your preferred brand of test strips from our homepage, or from the search bar at the top of any page on the site. Each page will show you the Amazon.com prices available for your strips, which may be much lower than what you will pay walking in to a pharmacy.
There aren’t pharmacy discount coupons available for the test strips at the moment, but in some cases there are manufacturer coupons that can reduce your co-pay or get you a free meter. You can find links to those offers where available on the test strip pages right above the prices.
Let us know at firstname.lastname@example.org if your brand isn’t listed, or if you have any other test strip questions or suggestions!
What is niacin ER?
Niaspan (Niacin ER) is used to treat high cholesterol, along with diet and exercise. Niacin decreases triglyceride levels, lower bad cholesterol (LDL) and increase good cholesterol (HDL). High triglycerides and LDL levels, and low LDL levels, are risk factors for heart disease. Very high triglycerides are also associated with pancreatitis, a painful condition in which the pancreas becomes inflamed.
Why extended-release niacin?
Immediate-release (commonly over-the-counter) niacin can cause flushing (hotness under the skin, irritation, and redness). The extended release causes less flushing, though it can still happen. Niacin ER is also taken less frequently than the immediate release OTC versions, making it easier to take.
The cost implications:
Like all generics, in the long term, niacin ER should be available at a cheaper cash price or copay than the brand name Niaspan. However, this may not be true initially. Many insurance companies have yet to add the new generic to their formulary, and may only be covering brand name Niaspan. So to start with, you may see higher co-pays for the generic. This is not uncommon when a generic first hits the market, but prices will eventually drop over the next several months.
I actually saw a case this week where the brand was almost $30 cheaper than the generic through one particular insurance. Initially, compare the cost of the generic versus the brand to see if you can save. Over the next couple of months though, be prepared to switch, as the generic will eventually save you more.
Talk to your health care provider or pharmacist if you have any questions.
Till next time,
The GoodRx Pharmacist
You aren’t alone. The reason we hear so much about gout is that the prevalence of gout has increased greatly over the past 30 years. It’s more common in men than women but women start to catch up after menopause.
Why is there more gout? There are 3 reasons: we live longer, there is more high blood pressure, and common medications like aspirin and diuretics increase risk of gout.
What are we doing wrong? Increased consumption of carbs, proteins, and drinks containing fructose contribute to gout.
What causes gout? Gout is a problem of too much uric acid in the bloodstream leading to crystal formation of monosodium urate crystals which deposit in the joints. Big toe, ankle, and knees are the most common areas.
Where do I start if I don’t want another attack? Just decreasing intake of shellfish, beer, and red meat can lower the uric acid in your bloodstream. Yet, 60% of patients who have an attack of gout will get another one in a year, 78% in two years, and 84% in 3 years. Odds are you will have another one so be ready.
When I have an attack what do I take? NSAIDS (non steroid anti-inflammatory drugs) like Indocin, naproxen, ibuprofen and Celebrex will all work for the swelling pain and inflammation during an acute attack. These are your savior with that red, hot painful joint. Steroids aren’t a great option for many reasons and when you stop them they are likely to give you a rebound gouty attack.
Prevention is the key to success. Allopurinol is the medication you take to prevent gouty attacks. A common mistake patients make is that symptoms of your gout attack MUST RESOLVE before you start on allopurinol.
What’s new in gout? Uloric (febuxostat), like allopurinol, is the newer medication used for the prevention of your next attack. Uloric (febuxostat) is a brand name medication with the same indication as allopurinol so it works to lower your uric acid level. Uloric can help lower uric acid level when allopurinol hasn’t worked and is safer in folks with kidney disease but it will cost you. It’s very expensive.
Allopurinol is included in many pharmacy discount generic programs for under $5 for 30 tablets. Coupons are available at most other pharmacies for under $10, and most insurance plans will cover it under Tier 1, meaning you’ll pay only your lowest co-pay. In contrast, Uloric will cost over $220 for 30 tablets out of pocket at most pharmacies, and you may end up paying your highest co-pay.