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

Get Tested: Rapid Testing Now Available for Hepatitis C

by The GoodRx Pharmacist on May 30, 2014 at 4:22 pm

National Hepatitis Testing Day in the United States was this month, and you might be surprised how easy it is to get tested. Many tests which used to be performed only by doctors and conducted in labs are now available to the public—including the OraQuick HCV rapid antibody test made by OraSure Technologies, Inc. for the hepatitis C Virus. The test is FDA approved for detecting hepatitis C virus antibodies using a finger stick (and a typical blood draw).

What is hepatitis C?

Hepatitis C is a viral infection that affects the liver and causes swelling and inflammation. It is contracted through contact with blood from another person who is infected with the hepatitis C virus.

Most patients with hepatitis C do not show any signs or symptoms of the infection. However, in the later stages of the disease, patients that do have symptoms may have fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, joint pain and yellowing of skin known as jaundice.

Hepatitis C may be self-limiting and last only a few weeks or it can lead to complications such as liver disease, cirrhosis of the liver, or liver cancer.

Who is at risk for contracting hepatitis C?

Healthcare professionals can be exposed to the virus from a needle stick or if the blood of a person who has hepatitis C comes into contact with their eyes, mouth, or a cut. Risky behavior such as recreational intravenous drug use and sharing needles with others puts you at a greater or increased risk for contracting hepatitis C than others. Other people at risk for hepatitis C include long-term dialysis patients, anyone who has regular contact with blood products in their workplace, anyone who has had unprotected sexual contact with someone who is infected, infants born to a mother with Hepatitis, patients with HIV, and anyone with abnormal liver tests or liver disease.

Who is the rapid antibody test for?

This test is for anyone who thinks that they may have been exposed to the hepatitis C virus regardless of route of transmission.

How accurate is the test?

The OraQuick HCV rapid antibody test is 98% accurate. Make sure to follow-up with your doctor if you receive a positive result. There is a small margin for error and the test could produce false results.

How long does it take to get the test results?

Healthcare providers are able to deliver an accurate results within 20 minutes.

Where can you get the test?

You can’t test yourself at home just yet, but the Oraquick Rapid HCV test is available in a variety of locations, including:

  • Public health settings (like hospitals, colleges and universities, or community organizations)
  • Doctors’ offices
  • Local health clinics
  • Laboratories
  • Emergency rooms

When is National Hepatitis Testing Day?

May 19th has been designated National Hepatitis Testing Day in the United States.

What if I missed the national testing day? Can I still get tested?

If you missed the national testing day on May 19th this year, no fear! It’s never too late to get tested—there are year-round testing events conducted across the nation. Find out more about year-round events here.

If you’d prefer to get tested at your doctor’s office, never hesitate to ask—doctors, nurses, physician assistants, and other healthcare providers are always there to help!

What do you do if your test is negative?

If the result of your rapid antibody test is negative but you feel that you are an at-risk patient, it would be a good idea to follow-up with your doctor for further blood testing. There is always the chance of false-negatives and false-positives with rapid testing, so a follow-up with your doctor is always encouraged and recommended.

What do you do if your test is positive?

If you receive a positive result from your initial hepatitis C screening, you should also follow up with your doctor to confirm the results. Start by explaining that you think you may have been infected with the hepatitis C virus based on a rapid antibody test performed at your local clinic or pharmacy and that you would like to confirm the diagnosis. Your results will then be confirmed by traditional blood testing from your doctor.

A positive test has been confirmed, now what?

Once you’ve had further blood tests and there is a positive confirmation of hepatitis C antibodies, this means that you have been infected with the hepatitis C virus at some point and will always have antibodies in your blood. This is true even if you have cleared the hepatitis C virus on your own or through treatment. Your doctor will talk to you about the various treatments available if needed.

What treatment is available?

Once it has been confirmed that you do have the hepatitis C Virus, your doctor will talk to you about your treatment options. Treatment is dependent upon the genotype (the genetic structure) of the disease. Depending on the genotype you’ve been diagnosed with, the treatment is usually a combination of pegylated interferon, ribavirin, and a protease inhibitor (for one genotype) for as long as 12 months.

Although this has been the gold standard for treatment in the past, two new drugs have recently been approved that may bring some big changes. The two new medications, Sovaldi and Olysio, are taken orally and will hopefully decrease some of the side effects patients experience with pegylated interferon by eliminating it completely from their treatment regimen, or by decreasing the duration of treatment from 48 weeks to 12 – 24 weeks for some patients.

What support is available for anyone diagnosed with hepatitis C?

There are some great websites and organizations that can provide support and answers for anyone newly diagnosed with hepatitis C:

Hepatitis C can lead to complications later in life if it is not detected and treated. Access to testing is now readily available, increasingly accurate, and can even be found at your local pharmacy. With testing, treatment options, and cure rates at an all-time high, it’s time to get tested if you think you or a loved one may have been exposed to the virus.

Nexium, Prilosec, Zegerid: Which Non-Prescription Heartburn Med Is Best?

by Dr. Sharon Orrange on May 29, 2014 at 11:24 am

Nexium 24HR is now over the counter, joining the other proton pump inhibitors (PPIs) available without a prescription. This class of medications work well for the treatment of heartburn, gastroesophageal reflux disease (GERD), and gastric ulcers. Nexium as a brand name drug made over 6 billion dollars in one year so does that mean that it’s better than the others? Um, no.

Several PPIs are available over the counter: Zegerid OTC (omeprazole with sodium bicarbonate), Prilosec OTC (omeprazole OTC) and Prevacid 24HR (lansoprazole 24HR) and now Nexium 24HR (esomeprazole). Nexium has never been shown to be superior to any of the other PPIs, with some small exceptions. In a few studies paid for by the drug company that made Nexium, they found that for “maintenance of healing of erosive esophagitis” Nexium 20 mg edged out lansoprazole 15 mg a day.

For the most part, all PPIs are created equally. Of the over-the-counter PPI options listed above, there is no proof there is any significant difference between them. Interesting right?

Dr O.

Entyvio Now Approved for Ulcerative Colitis and Crohn’s

by The GoodRx Pharmacist on May 28, 2014 at 9:57 am

Entyvio (vendolizumab) was approved by the FDA on May 20, 2014 for the treatment of ulcerative colitis and Crohn’s disease in patients where other treatments have not worked or cannot be tolerated.

What are ulcerative colitis and Crohn’s disease, and how do they differ?

Ulcerative colitis and Crohn’s are branches of a larger umbrella term known as inflammatory bowel disease (IBD). Ulcerative colitis is the inflammation of the lining of the large intestine (colon) and rectum. Crohn’s disease is inflammation that can occur anywhere in the digestive tract with the ability to spread affected tissues.

The signs and symptoms for ulcerative colitis and Crohn’s disease are very similar and can often be confusing. Your doctor may perform a test called a colonoscopy to determine where the inflammation is occurring within your body.

Can Entyvio or other medications cure ulcerative colitis or Crohn’s disease?

No. Currently, there is a not a cure for any type of IBD. However, there are treatments which can reduce the signs and symptoms of these diseases and even lead to long-term remission.

What are some of the other treatment options for ulcerative colitis and Crohn’s disease?

Yes. There are various treatment options available to help with ulcerative colitis and/or Crohn’s disease.

Some of the various types of medications available to help manage ulcerative colitis and/or Crohn’s disease include aminosalicylates, corticosteroids, immunomodulators, or biologic therapies.

  • Aminosalicylates are derivatives of aspirin that help treat inflammation associated with mild-to-moderate ulcerative colitis and Crohn’s disease. These are typically used first-line. Examples of aminosalicylates include sulfasalazine (Azulfidine) and mesalamine (Asacol HD, Delzicol).
  • Immunomodulators are used to suppress the immune system which in turn decreases inflammation. These medications can take between 3 to 6 months to take their full effect. They are sometimes used in patients who do not respond to aminosalicylates. Immunomodulators include azathioprine, mercaptopurine, or cyclosporine.
  • Biologic therapies, like immunomodulators, are used when aminosalicylates or other treatments can’t be used or aren’t effective. These medications are the most popular and widely used treatments today. Examples of biologic therapy include Remicade, Enbrel, Humira, Cimzia, or Simponi.

Biologic treatment with Humira or Enbrel is typically preferred by insurance companies and provides convenient patient-administered dosing with prefilled syringes or injectable pens.

So when should Entyvio be used?
Entyvio is going to be considered a second- or third-line treatment option. Entyvio also works by decreasing inflammation and treats moderate-to-severe ulcerative colitis or Crohn’s disease, but it will be used after other options have been tried and exhausted (when previous medications didn’t work, didn’t work well enough, or when someone has shown dependence on corticosteroids).

Entyvio, unlike most of the biologic options, will require visits to the doctor’s office for 30 minute infusions. However, after the initial infusions, Entyvio will only be used once every 8 weeks, where most biologic treatment options are more frequent with once-weekly, every other week, or once-monthly dosing.

Some important information about Entyvio:
Entyvio is a specialty medication, and must be infused over a period of 30 minutes at your doctor’s office.

See this article for more information on specialty medications.

How is Entyvio used?
Entyvio is infused over 30 minutes initially, then at 2 weeks and 6 weeks, then every 8 weeks thereafter.

In what strength and dosage form is Entyvio available?
Entyvio is available for injection as a 300 mg single-use 20 mL vial.

What are the common side effects of Entyvio?

The common side effects of Entyvio include common cold, headache, joint pain, nausea, fever, infections of the nose/throat, tiredness, cough, bronchitis, flu, back pain, rash, itching, sinus infection, throat pain, and pain in extremities.

Where can I find more information on Entyvio?

For now, you can find more information on the official Entyvio page, and watch for prices, images and more info coming soon here.

Nexium Now Available Without a Prescription!

by Elizabeth Davis on May 27, 2014 at 3:03 pm

The over-the-counter version of Nexium (esomeprazole magnesium) is now available without a prescription! You can find Nexium 24HR in stores now, which may be great news if you’ve been paying for the expensive, brand-only heartburn med.

Only the 20 mg capsule has made the switch, so if you take a different dose or if you use the packets for oral suspension, you’ll want to talk to your doctor about whether you can use Nexium 24HR. All of the regular prescription strength versions of Nexium are still available.

Nexium 24HR is approved to treat frequent heartburn, so you should also discuss with your doctor or pharmacist if you take Nexium for any of the other conditions the prescription version is approved to treat, like ulcers or GERD.

Nexium 24HR will be significantly less expensive than prescription Nexium, priced as low as $25 for three 14-day courses of treatment. Some types of insurance plans will also cover the cost of over-the-counter medications if you have a prescription from your doctor. If you have prescription insurance, you may also want to consider Nexium’s manufacturer savings card, which could reduce your cost for one month of prescription Nexium to $25.

What about generic prescription Nexium? At the moment, a generic version of prescription Nexium is uncertain. For the next 180 days, manufacturer Ranbaxy has the exclusive rights to launch a Nexium generic. However, Ranbaxy is currently limited from importing pharmaceutical ingredients into the US, and may not be able to make and launch a generic by that date. The slightly better news? Other manufacturers could still be able to apply for approval of their Nexium generics by the end of this year.

What’s the Best Iron Supplement?

by Dr. Sharon Orrange on May 22, 2014 at 9:33 am

There is a new iron supplement trending in the medical community called pur-Absorb and it’s worth getting to know. Not everyone needs to take iron supplements, which is a good thing because they can be constipating and irritating to the stomach. Many folks taking iron stop it because of side effects. Ferrous sulfate (FeSo4) is a common supplement used for iron deficiency but there is a new kid on the block. For iron deficient men and women, vegetarians and vegans and pregnant women, pur-Absorb may be something for you.

What should you know about taking iron:

  • The recommended daily allowance of iron is 18 mg, which corresponds to 3.15 mg of absorbed iron. This is because only 18% of iron you eat in your diet is actually absorbed and available for your body to use.
  • pur-Absorb has done their research and published results, which is unusual for a supplement. Pur-Absorb is much better absorbed than other iron supplements allowing you to take less iron. Results published in the Scand J Haematol showed that one dose of Pur-absorb had a high absorption rate of at least 40% (2mg), providing the daily absorbed iron needs for 80% of menstruating women.
  • Because of this higher absorption rate one dose of pur-Absorb (5 mg) meets the daily iron needs for 80% of menstruating women. One dose.
  • The lower the dose of iron consumed, the less likely you are to have side effects.
  • Compare this (5 mg) to traditional over the counter iron supplements which contain 65 mg of iron (ferrous sulfate) or 45 mg of iron (Feosol). That much iron can cause constipation and GI upset.
  • pur-Absorb (and no, I don’t have a stake in this company nor do I know them) comes with 28 doses in 1 box and can be taken straight from the packet or mixed with orange juice.

Good deal . . .

Dr O.

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