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

OTC Isn’t Always Cheaper: When It Pays to Get a Prescription

by The GoodRx Pharmacist on October 30, 2015 at 1:15 pm

Over the past several years many medications that once required a prescription can now easily be obtained in the aisles of your pharmacy or grocery store. You may be familiar with allergy meds like Claritin, Zyrtec, and Allegra, or heartburn drugs like Prilosec, Prevacid, and Nexium. All are now available exclusively over-the-counter, or have both OTC and prescription versions.

This is great for you in many ways. It’s easier to walk over to the shelf and pick up what you need, and you don’t need to visit your doctor for every minor illness. A prescription medication needs FDA approval to make the jump to OTC status, and must meet certain requirements, so you can know you are still getting a safe, effective treatment:

  • Their benefits outweigh the risks.
  • The potential for misuse and abuse is low.
  • They can be used for self-diagnosed conditions.
  • They can be adequately labeled.
  • A health care provider is not needed for safe and effective use.

On the other hand, you could also be paying—literally—for the convenience. Many people hand over the money and don’t think twice because of the luxury of having easy access to these medications.

What’s there to think about? You may not know that you can often get the same medication with a prescription for less. This is especially true for the new drugs making their over-the-counter debut, like allergy nasal sprays Flonase Allergy Relief and Nasacort Allergy 24HR.

These lower prices do come with the inconvenience (and potential cost) of requiring a prescription from your doctor. The savings will also depend on the type of prescription insurance you have, your co-pay, and what your plan will cover.

It can still pay to do the research though. For example, many insurance companies will pay for omeprazole 20 mg capsules—the generic capsule version of Prilosec OTC tablets. The OTC version can cost $10 for only 14 tablets, while you could get a full month supply of the prescription generic for that amount (or less) with insurance or a GoodRx discount.

A newer example is Flonase Allergy Relief, which can cost upwards of $20 per bottle without a prescription. In contrast, the generic prescription version (fluticasone propionate) is $10 – $15 at most pharmacies with GoodRx, and on most insurance plans.

The takeaway? Before choosing convenience over cost, take some time to speak with your pharmacist about potential savings.

Watch for more information on OTC medications and how to save in future posts.

First Antidote to Blood Thinner Pradaxa Now Approved

by The GoodRx Pharmacist on October 29, 2015 at 1:02 pm

Praxbind (idarucizumab) was approved on October 16, 2015 as the first drug to reverse the effects of one of the newer blood thinning medications, Pradaxa (dabigatran).

You may be prescribed a blood thinner for various reasons, including blood clot, heart attack, or stroke.

Coumadin (warfarin or Jantoven) is a common “first-line” blood thinner. It’s been around for a long time, and it’s one of the first options your doctor will try. However, there are many newer blood thinners now available, including Pradaxa, Xarelto, and Eliquis.

Why might one of the newer options be better? Warfarin requires regular blood tests to make sure your dose is correct, and comes with dietary restrictions. The newer blood thinners don’t have as many requirements.

The disadvantage of the newer drugs is that their blood thinning effects aren’t easily reversed if you have trouble with bleeding, or need emergency surgery. Warfarin, on the other hand, can easily be reversed in an outpatient setting with oral Vitamin K, also known as Mephyton. You can read more about the differences between the current options here.

What exactly is Praxbind used for?
Praxbind is used to reverse the effects of Pradaxa when needed—for example, if you need emergency surgery or an urgent procedure, or in a life-threatening or uncontrolled bleeding situation.

Is there anything unique about Praxbind?

Yes. Praxbind is the first agent approved specifically for the reversal of Pradaxa (it is not approved to reverse the effects of any of the other blood thinners).

Praxbind was approved faster than usual under the FDA’s accelerated approval program because no other medications existed that could reverse the effects of Pradaxa. It was shown in clinical trials that Praxbind could achieve complete blood thinning reversal of Pradaxa with a single 5-minute infusion and continue working for more than 24 hours.

How is Praxbind used?
Praxbind is given through an IV in 5 gram doses. It is available as a sterile, preservative-free injectable solution and it comes packaged in two single-use 2.5 g/50 mL vials (for a total dose of 5 grams).

When will Praxbind be available?
Praxbind, is expected to become available as quickly as possible, but it will be for hospital use only. You can see this press release from the manufacturer for more information.

Are there side effects associated with Praxbind?

Yes. Praxbind’s side effects can include headache, low potassium, confusion, constipation, fever, and pneumonia.

Still want to find out more about Praxbind?

The FDA announcement has more details here.

Miacalcin vs Fortical: What’s the Difference?

by The GoodRx Pharmacist on October 28, 2015 at 5:04 pm

Miacalcin and Fortical have very similar active ingredients, and are both used to treat osteoporosis. However, they are two different drugs and can’t be substituted for each other.

Here are the 5 major differences:

  1. Approved uses. Miacalcin (calcitonin salmon) is approved by the FDA to treat Paget’s disease, hypercalcemia, and postmenopausal osteoporosis. Fortical (calcitonin salmon, rDNA origin) is only approved to treat postmenopausal osteoporosis.
  2. Dosage forms. Miacalcin is available as a nasal spray or an injection; Fortical is only available as a nasal spray.
  3. Active ingredients. Although both Miacalcin and Fortical contain calcitonin salmon as their main ingredient, there are some slight differences in the type of calcitonin salmon. They are NOT bioequivalent and therefore NOT interchangeable.
  4. How they’re made. Miacalcin and Fortical are both man-made forms of the hormone calcitonin salmon. However, Fortical(calcitonin salmon, rDNA origin) is created by recombinant DNA technology while Miacalcin(calcitonin salmon) is created through a chemical reaction.
  5. Generic available. ONLY Miacalcin has a generic nasal spray. Fortical is still brand-only. With a GoodRx discount, Fortical runs about $20 more expensive than generic calcitonin salmon ($70 vs $50), so you may want to consider the cost when talking to your doctor.

Have you had any experiences with Miacalcin or Fortical?

Should I Take a Calcium Supplement?

by Dr. Sharon Orrange on October 27, 2015 at 3:54 pm

Calcium is good for your bones right? Well, the science on calcium supplements and dietary calcium just got fuzzier—and it was already pretty fuzzy.

Osteoporosis is a decrease in bone mass that occurs because, after the age of 30, we resorb bone but don’t make any new. Unlike pain and stiffness from osteoarthritis, osteoporosis doesn’t hurt or cause pain—that is, until you have a hip or spine fracture. One in five of us will be dead in a year after a hip fracture; that’s why osteoporosis matters.

Many people take calcium thinking they are helping their bones, but that may not be true. calcium with vitamin D, Caltrate, calcium citrate, Citracal and Viactiv are among the many types of calcium supplements people take. You might not need them.

Here are 10 surprising facts about calcium supplements.

  1. A recent meta-analysis of 70 studies in the British Medical Journal found that neither calcium supplements nor dietary calcium in people over 50 prevented fractures, and only minimally raised bone density.
  2. Taking calcium supplements (without vitamin D) has been found in some studies to raise the risk of heart attack, possibly by increasing calcification (hardening) of the arteries and veins.
  3. Most recommendations agree that you should try and get your calcium intake through diet not supplements.
  4. Nobody should exceed more than 2000 mg in calcium supplements a day, and many folks do, thinking it’s a good idea.
  5. There is no question that adequate nutrition is important.
  6. While the optimal intake of calcium and vitamin D is uncertain, in general 800 mg of calcium in your diet and 800 – 1000 IU of vitamin D is recommended.
  7. A rough way to calculate your dietary calcium intake is to think of each serving of dairy as 300 mg of calcium. Eight ounces of yogurt or milk and 1 oz of hard cheese each give you 300 mg calcium per serving.  
  8. Cottage cheese and ice cream have less calcium per serving than milk or yogurt.
  9. Dark green veggies (always a good idea) also provide you with calcium, but only about 150 mg per serving.
  10. In women 65 and over and men over 70 (or between 50 and 70 if they have risk factors) a bone density scan is recommended to screen for osteoporosis. If you have bone thinning or osteoporosis, talk to your doctor about options for treatment.

Dr O.

FDA Approval: First New Long-Acting Insulins in 10 Years

by The GoodRx Pharmacist on October 23, 2015 at 1:57 pm

There have been several new insulin products approved over the past year, including Toujeo, Humalog U-200, Afrezza—and now Tresiba and Ryzodeg.

The other recent insulin approvals are what I like to call spin-off insulin products. For example, Toujeo has the same type of insulin as Lantus (insulin glargine), but is more concentrated. Humalog U-200 is the same exact product as Humalog U-100 (insulin lispro), but once again, more concentrated. Afrezza (insulin human) is the same as regular insulin but in a new inhaled form.

Tresiba and Ryzodeg, on the other hand, contain a new type of insulin—insulin degludec.

Tresiba is a long-acting insulin while Ryzodeg is mixed containing a combination of both long-acting (insulin degludec) and rapid-acting insulin (insulin aspart).

When were these new insulins approved?
Tresiba and Ryzodeg were both approved by the FDA on September 25, 2015.

How is Tresiba usually taken?

Dosing for Tresiba will be different for every person, but it’s typically injected subcutaneously once daily at any time of the day.

For more information take a look at the manufacturer website here.

How is Ryzodeg usually taken?

Dosing for Ryzodeg will also be different for each person, but it will usually be injected subcutaneously once or twice daily with any main meal. Ryzodeg doesn’t have an official website yet, but look for more information to come.

What dosage form(s) and strength(s) will Tresiba and Ryzodeg be available in?
Tresiba will be available as a FlexTouch disposable prefilled pen in two strengths: U-100 (100 units/mL) in 5-pen packages, and U-200 (200 units/mL) in 5-pen packages.

Ryzodeg will also be available as a FlexTouch pen, but only in the U-100 (100 units/mL) strength, and only in 5-pen packages.

What are the common side effects of Tresiba and Ryzodeg?

Some common side effects of both Tresiba and Ryzodeg include injection site reactions, skin thickening or pits at injection sites, itching, rash, swelling of hands or feet, and weight gain.

Is there anything unique about Tresiba or Ryzodeg?

Yes! Insulin degludec (Tresiba, and one of the active ingredients in Ryzodeg) is the first new long-acting insulin to be approved by the FDA in 10 years.

Are there any benefits of using Tresiba compared to other long-acting insulin products?
Tresiba has a more flexible dosing schedule. According to the manufacturer Tresiba can last up to 42 hours which allows you to use it at any time of day.

The Tresiba FlexTouch disposable pens also last up to 56 days (8 weeks) once in-use at room temperature—which is longer than both long-acting insulin products Lantus and Levemir.

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