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

What’s the Difference? Flovent HFA vs Flovent Diskus

by The GoodRx Pharmacist on June 30, 2014 at 1:02 pm

Flovent HFA and Flovent Diskus can be tough to tell apart, with similar names and the same active ingredient. However, although both types of Flovent inhaler treat asthma, they are available in different strengths and most importantly, are used differently.

What type of medication is Flovent?

Flovent (in both the HFA and Diskus forms) is a corticosteroid.

How does a corticosteroid work for asthma?

When inhaled, corticosteroids decrease inflammation and swelling within the airways.

Is Flovent considered a rescue or maintenance inhaler?
Flovent HFA and Diskus are both maintenance inhalers. Maintenance inhalers help to control your asthma symptoms before they even start. Your asthma is better controlled and you are able to breathe easier when you use your maintenance inhaler(s) properly.

Can I skip my maintenance inhaler dose if my breathing is okay?

NO. Maintenance inhalers need to be used as prescribed on a daily basis even if you do not have trouble breathing that day.

How long will it take for Flovent to begin working?

Flovent (from either type of inhaler) can take 2 weeks or longer before you may notice an improvement of your asthma.

In what strengths are Flovent HFA and Flovent Diskus available?
Flovent HFA is available in 44 mcg, 110mcg, and 220 mcg inhalation strengths. Flovent Diskus is available in 50 mcg, 100 mcg, and 250 mcg inhalation strengths.

What is different about how the medication is delivered with the Flovent HFA versus the Diskus inhaler?
Flovent HFA is an inhalation aerosol, which means that the inhaler uses a propellant or mechanism to help disperse the medication so that the liquid particles make it into your lungs.

Flovent Diskus, on the other hand, is a powder for inhalation and does not use a propellant to get the medication into your lungs. The Diskus inhaler relies on your ability to inhale the powder medication in order for it to be dispersed properly.

What are of the advantages of using Flovent HFA?
Flovent HFA is a more traditional inhaler, which could be a plus if you’re already familiar with how to use one. It can also be used with a spacer if you need or prefer one, where Flovent Diskus cannot.

What are the disadvantages of using Flovent HFA?
Flovent HFA may also have some of the difficulties associated with a traditional inhaler—particularly because it requires hand-breath coordination. This technique can be troublesome for a new asthma patient when trying to use an inhaler.

If you are concerned about using your inhaler correctly, please reference the Flovent HFA website for guidance. Ask your doctor or pharmacist for further instructions if it still isn’t clear.

What are the advantages of using Flovent Diskus?
Flovent Diskus doesn’t need to be primed before use, or after a long time between uses. Also, the hand-breath coordination required for traditional inhalers like Flovent HFA isn’t necessary–you don’t have to be able to depress the canister and inhale at the same time with the Diskus, since your breath is doing the work to pull the medication into your lungs, rather than a propellant from the inhaler.

What are the disadvantages of using Flovent Diskus?

Once you take the Flovent Diskus inhaler out of the foil package, you must use it within 6 weeks to 2 months depending on the strength. It can’t be used with a spacer, while Flovent HFA can. If you’re used to a traditional inhaler, using the Diskus may be challenging initially.

If you are concerned about using your inhaler correctly, please reference the Flovent Diskus website for guidance. Ask your doctor or pharmacist for further instructions if it still isn’t clear.


What Is a FODMAP Diet?

by Dr. Sharon Orrange on June 27, 2014 at 9:32 am

A low FODMAP diet equals a happy gut for some. FODMAPs are carbohydrates (sugars) found in food. FODMAPs are substances that cause problems in two ways: they aren’t absorbed well so they tend to suck water in to the gut and they stick around longer so they are fermented by bacteria. The result is gas, bloating, cramping, and diarrhea in some people.

A diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) has been recommended in patients with irritable bowel syndrome (IBS). In a recent study people with IBS had significantly lower overall gastrointestinal symptoms with less abdominal pain, bloating, and flatulence. So what is this diet?

Here are some sources of common FODMAPs:

Fermented foods and drinks

Oligosaccharides (fructans, galacto-oligosaccharides) are found in wheat, barley, rye, onion, leek, the white part of spring onion, garlic, shallots, artichokes, beetroot, fennel, peas, chicory, pistachio, cashews, legumes, lentils, and chickpeas.

Disaccharides (lactose) are found in milk, custard, ice cream, and yogurt.

Monosaccharides (free fructose) are found in apples, pears, mangoes, cherries, watermelon, asparagus, sugar snap peas, honey, and high-fructose corn syrup.

And

Polyols (sorbitol, mannitol, maltitol, and xylitol) are found in apples, pears, apricots, cherries, nectarines, peaches, plums, watermelon, mushrooms, cauliflower, and artificially sweetened chewing gum and candies.

Dr O.


Patanol vs Pataday for Allergic Eyes

by The GoodRx Pharmacist on June 26, 2014 at 10:41 am

Patanol (olopatadine) and Pataday (olopatadine) can be confusing right off the bat due to the look-alike, sound-alike drug names. Although these medications have the same active ingredient and treat the same thing, allergic conjunctivitis, they come in different strengths and are used differently.

What is allergic conjunctivitis?

Allergic conjunctivitis is when the lining of your eyelid becomes swollen due to allergens such as pollen, dander, or mold. Symptoms include swollen, red, or itchy eyes; burning or tearing of the eyes; and discharge from the eye.

In which strengths and forms are Patanol and Pataday available?
Patanol and Pataday are both ophthalmic solutions (eye drops), but Patanol is available as a 0.1% solution, where Pataday is a 0.2% solution.

How is Patanol used?

One drop of Patanol is applied into each affected eye twice daily.

How is Pataday to be used?

When naming this eye drop ‘Pataday’ the manufacturer decided to give a hint directly in the name for how often this medication is to be used: one drop of Pataday is applied into each affected eye once daily.

The advantage of Pataday over Patanol:

It boils down to patient compliance—how likely you are to remember to take your medication, and whether you take it as prescribed by your doctor.

Pataday has the advantage of only being used once daily, which is easy to remember than Patanol which needs to be used twice daily at a 6 to 8 hour interval.

Another advantage of using Pataday is—believe it or not—price! Pataday will cost you as little as $145 while Patanol will cost you around $160 at the minimum.

Are there any disadvantages to taking Pataday?

At this time there doesn’t seem to be a real disadvantage to using Pataday. However, in December 2015, the patent will expire on Patanol which will allow a generic to be manufactured. A generic form of Patanol will most likely be less expensive than Pataday. Then you may want to consider whether the convenience of once-daily dosing is worth the trade-off in price.


The Best Treatment for MRSA Infections!

by Dr. Sharon Orrange on June 25, 2014 at 11:43 am

The staph aureus superbug that is resistant to most antibiotics (aka MRSA) is the cause of many difficult to treat skin and soft tissue infections. Methicillin resistant staph aureus (MRSA) infections often get worse despite oral antibiotics, and when that happens it has meant admitting people to give daily treatment with vancomycin in the hospital. Not any more.

Two long-acting antibiotics effective against MRSA skin infections allow for once a week injections, replacing daily intravenous Vancomycin.

Dalvance (dalbavancin) is now available in the U.S. with oritavancin to follow shortly. These two antibiotics have a similar mechanism of action and coverage as vancomycin, but either can be administered as once weekly intravenous doses because of long half-lives.

Patients with cellulitis, wound infections and abscesses due to MRSA (and other bacteria) were studied using dalbavancin given once weekly for two doses or single-dose oritavancin. When compared to Vancomycin twice daily for 7 to 14 days outcomes were the same and they were generally well tolerated.

This is great news. For all the folks stuck in hospitals receiving daily vancomycin for their infections, these two once a week options allow many of you to stay home.

Dr O.

Another option, Sivextro (tedizolid), has just been approved by the FDA for either oral or intravenous use, which may also offer more convenience—however, it is still used once daily for six days.


A Gene That Protects You From Heart Attack?

by Dr. Sharon Orrange on June 24, 2014 at 9:35 am

Triglycerides are free fatty acids circulating in your blood. When you have your cholesterol panel checked with your doc you will see: triglycerides, HDL cholesterol and LDL cholesterol. Triglycerides fluctuate depending on what you have to eat or drink but normal fasting triglycerides are < 160. Unlike with LDL cholesterol, studies haven’t shown that high triglycerides are an important marker of risk of stroke and heart disease. That is why the findings of this gene are interesting, and surprising.

What did they look for?

Genes from 3734 people were tested for mutations associated with triglyceride levels in their blood. The authors of this study also looked at whether the same mutation that raised triglycerides was associated with heart disease.

What did they find?

The gene most strongly associated with blood triglyceride levels is a gene that codes apolipoprotein C3 (APOC3). LOSS of function of this gene was a good thing, and 1 in 150 persons carried a mutation that caused loss of APOC3 function, lucky them. If you carry one of the loss of function genes you had lower triglycerides (33% lower), higher HDL levels (the “good cholesterol”) and lower LDL levels.

Take home message.

In people who had lower circulating APOC3 levels, their risk of heart disease was reduced by 40%. So LOSS of APOC3 function protects you from heart disease.

Why is this surprising?

Well, because studies done using medications that lower triglycerides (Tricor, fenofibrate, gemfibrozil, fish oils) have failed to show a reduced risk of heart disease. In other words, lowering triglycerides with medications has never been shown to lower your risk of heart attack.

Why is the “loss of function of APOC3” protective exactly?

We don’t know why. You see, having this loss of function gene does a few things for you: lower triglycerides, higher HDL cholesterol and lower LDL cholesterol All of those are good things. Which of those three is protecting you from heart disease we aren’t sure.

The future:

What is cool is that medications down the line can target this loss-of-function APOC3 gene, leading to therapies that reduce risk of heart disease. What scientists will hope to come up with next are monoclonal antibodies that target APOC3. Now that, would be cool.

Dr O.


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