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

A Blood Test to Diagnose Concussions!

by Dr. Sharon Orrange on March 31, 2014 at 11:19 am

There is a new appreciation for concussions and the long-term effects they can have on younger adults. How can you really tell if you or your child had a concussion, and what would you do differently? A very cool study published in JAMA Neurology reveals a potential blood test for concussion. This matters because there is evidence that kids with sports-related concussions need to give their brains a rest by avoiding physical activity and abstaining from cognitive challenges such as reading, texting, or playing video games for several days. The brain heals faster that way.

Blood levels of a protein that signals damage to the axons in the brain, called total-tau (T-tau), could be used as a blood test to discern the severity of concussions in athletes and help decide when it is safe to return to play. The authors report that T-tau is a promising biomarker for the diagnosis and prognosis of concussion in athletes.

Hockey players were the subject of this study, which showed that players with sports-related concussions had higher levels of T-tau. The highest levels of T-tau (5 to 10 times normal) were measured immediately after the injury, then the levels continued to decline back to normal. Another key finding was that T-tau concentrations 1 hour after concussion predicted the number of days it took for the concussion symptoms to resolve and the players to return to play safely.

Why T-tau? The protein T-tau is usually found only in the cerebral spinal fluid (CSF), but gets into the bloodstream after concussion if the blood-brain barrier is damaged (yuck). So, raised levels are a marker of brain injury. You may remember hearing about T-tau because it is increased in the CSF in Alzheimer’s disease. In any case, more studies need to be done to sort out the usefulness of the blood test for T-tau to diagnose concussion, but it’s an interesting start.

Dr O.

Alli for Weight Loss Recalled

by Elizabeth Davis on March 28, 2014 at 10:04 am

Manufacturer GlaxoSmithKline has voluntarily issued a recall for all of its non-prescription Alli weight loss products in the United States and Puerto Rico. The recall is due to concerns that the product packages may have been tampered with, and do not actually contain Alli.

Tablets and capsules that were not Alli have been reported in Alli bottles in seven states, and in some cases, bottles were missing labels and had fake tamper-evident seals. The tampered bottles were sold in retail stores.

Authentic Alli capsules are turquoise blue with a dark blue band, imprinted with “60 Orlistat.” The authentic bottle has a label and an inner foil seal imprinted with “Sealed for Your Protection.”

Tampered packaging may have an authentic-looking outer carton, but the bottle may not have a label; the seal may not be intact, made of foil, or have the correct imprint; and the bottle may contain tablets and capsules of various shapes and colors.

Some bottles from the following lots and expiration dates have been reported to contain products other than Alli:

  • Lot 14372, expires 02/28/2016
  • Lot 14395, expires 02/28/2016
  • Lot 14124, expires 09/30/2015
  • Lot 14267, expires 01/31/2016
  • Lot 14442, expires 04/30/2016

For more information, and images of the authentic Alli packaging and capsules, see the announcement from GlaxoSmithKline here.

Qudexy XR: Another New Extended-Release Topiramate

by The GoodRx Pharmacist on March 27, 2014 at 1:31 pm

Qudexy XR is indicated for initial or adjunctive therapy (treatment alone or with other medications or treatment options) in certain patients with partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome. It was approved by the FDA on March 11, 2014.

When will Qudexy XR be available to patients?

According to the manufacturer, Upsher-Smith, Qudexy XR will be available in the second quarter of 2014.

What strengths will be available, and how should it be taken?
Qudexy XR is available as an extended-release capsule in the following strengths: 25 mg, 50 mg, 100 mg, 150 mg, 200 mg. Depending on the dose your doctor decides is right for you, it should be taken once daily. The capsules may be swallowed whole or opened and sprinkled on a spoonful of soft food.

Who should not take Qudexy XR?
Qudexy XR should NOT be used by anyone with metabolic acidosis or anyone also taking metformin at the same time.

What are the common side effects of Qudexy XR?

The most common side effects associated with Qudexy XR include but are not limited to: tingling of the arms and legs, irregular eye movement, loss of appetite, nausea or indigestion, a change in the way foods taste, diarrhea, weight loss, nervousness, and upper respiratory tract infections.

Are there any other similar products currently available?

Yes. Trokendi XR is also an extended-release topiramate capsule available in 25 mg, 50 mg, 100 mg, and 200 mg strengths. However, it uses what is known as Microtrol technology. Microtrol technology uses uniquely engineered beads to deliver the medication consistently over a 24-hour period. More information on Trokendi XR can be found here.

An immediate release version also available as brand name Topamax and generic topiramate, which, if it works for you, may be less expensive.

Homeopathic Recall: What Are Homeopathic Remedies, and Are They Safe?

by The GoodRx Pharmacist on March 26, 2014 at 10:47 am

Certain Terra-Medica homeopathic products were recalled by the FDA on March 18, 2014. A complete list of the products recalled can be found here. 

The recalled products were found to contain undeclared trace amounts of penicillin, which could cause a potential reaction in someone who is allergic to this class of antibiotics. This is extremely important; even if you are aware that you have a penicillin allergy, you would not have been aware that small amounts were contained in these various products.

You can find the complete FDA report on the recall here.

So, what are homeopathic remedies?

Homeopathic remedies are medications that use highly diluted non-toxic substances in order to trigger the body’s natural healing processes. Homeopathy is based on the principal “like treats like,” meaning a substance which causes symptoms when taken in large doses can be used in small amounts to treat those same symptoms. This practice has been around for more than 200 years and is a widely used form of complementary medicine practiced today in Europe and the UK.

Who uses homeopathic remedies?

Typically, homeopathic remedies are used by those seeking “safer” or “natural” alternative therapies. However, that does not always mean that these medications are in fact safe or natural.

Are these remedies safe and effective?

Unfortunately, the FDA does not evaluate these products for their safety or effectiveness; more testing would be needed in order to reach a conclusion.

Are homeopathic remedies FDA regulated?

Yes. The FDA does regulate the production of these remedies; however, the FDA does not evaluate them for safety or effectiveness, as mentioned above.

What ingredients do these homeopathic remedies contain?

Most remedies contain highly diluted substances depending on the condition that they claim to treat; however, some products labeled as homeopathic can contain considerable amounts of active ingredients and could cause side effects as well as drug interactions.

Is a recall of a homeopathic medication the same as a recall of a prescription product?

Yes. Homeopathic medications are regulated by the FDA and can be recalled just like prescription products. Check out more information on the FDA and homeopathic products here.

How is Terra-Medica notifying customers who have purchased their products?

Terra-Medica is notifying its customers by letter and email and is arranging for return of all recalled products.

How do I reach Terra-Medica if I have recalled product or questions?

If you have any questions regarding the recall, you can contact Terra-Medica’s Customer Service Department at 1-888-415-0535, ext. 1, Monday through Friday between 8 – 5 PM, Pacific.

Gabapentin: A Successful Treatment for Alcohol Dependence

by Dr. Sharon Orrange on March 25, 2014 at 11:50 am

Relapse remains a prevalent and significant problem in alcoholism, even after long periods of abstinence. Vulnerability to relapse is associated with an intense craving or desire to drink, so if we can help those cravings that’s great, right? Well new studies show that gabapentin, already used for neuropathic pain and seizure disorders, may reduce cravings and thus alcohol consumption in patients with alcohol dependence.

In a new large study, patients with alcohol dependence receiving gabapentin were more likely to remain abstinent or avoid heavy drinking and were less likely to have cravings. These results suggest using gabapentin 900 – 1800 mg a day worked better than placebo in patients with alcohol use disorder.

Gabapentin has been around forever, is well tolerated, and is available as a generic so that’s encouraging news. Naltrexone (Revia) and acamprosate (Campral) are also used for alcohol dependence to reduce cravings but both are more expensive than gabapentin. There are no head to head studies comparing these three medications for this purpose so we don’t know which one is better.

Dr O.

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