Gout is a form of arthritis that affects the joints and can cause severe pain, redness, tenderness, and inflammation. Typically, gout is caused by a build-up of uric acid.
Recently, the FDA approved Duzallo, a new combination medication for the treatment of gout.
What is Duzallo indicated for?
Duzallo is a combination medication indicated for the treatment of hyperuricemia associated with gout. It is specifically for patients who have not achieved target serum uric acid levels allopurinol alone.
Duzallo combines tw0 gout medications, Zurampic (lesinurad) and Zyloprim (allopurinol), into a convenient once-daily regimen. Duzallo is the 1st FDA approved fixed-dose combination treatment for patients with gout that addresses both the increased production of uric acid as well as the decreased elimination of uric acid.
Who is at risk for gout?
The following conditions may put you at risk for gout: led exposure, high blood pressure, kidney problems, hypothyroidism, psoriasis, cancer, Kelly Seegmiller syndrome, and Lesch-Nyhan syndrome.
How is Duzallo to be taken?
The recommended dose of Duzallo is one tablet once daily. It is available as a combination tablet in the strength of 200 mg/200 mg and 200 mg/300 mg Be sure to stay hydrated while taking this medication.
What are the common side effects associated with Duzallo?
The most common side effects associated with Duzallo include headache, influenza, higher levels of blood creatinine, and heartburn.
When will Duzallo be available?
Proper disposal of sharp medical objects—like syringes, needles, or lancets—is important to prevent injury. The improper disposal of needles or sharps is dangerous and can increase the risk for a needle stick injury, which can spread blood-borne diseases like HIV or various forms of hepatitis.
Many states have laws regarding sharp disposal, so it’s important to understand proper disposal practices.
What are examples of sharps that require proper disposal?
Examples of types of medications that will require proper disposal include the following:
- Vitamin B-12 injections
- Testosterone injections
- Insulin injections like Humalog, Lantus or Toujeo
- Blood thinner injections like Lovenox (enoxaparin)
- Epinephrine injections like Epipen or Adrenaclick
- Migraine injections like Imitrex (sumatriptan)
How should I dispose of my sharps?
- Check for free options. Contact the manufacturer of your drug, or your health department to see if they have a free mail-back program, or free sharps containers. Trulicity, for instance, gives away free sharps containers on their website.
- Find a drop-off location. Hospitals, doctors offices, and health clinics are a good place to start. Oftentimes they have a sharps disposal drop-off box, but be sure to call first. You can also contact your state’s department of public health to find a drop-off location close to you.
What type of container can I use to dispose of my sharps?
You can use one of the following types of containers to dispose of your sharps or needle-containing products in your household:
- FDA-cleared sharps container
- Empty laundry detergent container
- Empty bleach container
- Empty Drano container
If you use an empty household container, be sure that you are following FDA guidelines. Proper sharps containers should be able to be properly closed and stand on its own, leak resistant, made of heavy-duty plastic, and should be properly labeled to warn of hazardous waste.
You can purchase an FDA-cleared sharps container without a prescription or you can ask your doctor to write a prescription for you so that your local pharmacy can try to bill your insurance to see if it’s covered.
Does each state have their own guidelines regarding sharps disposal?
Yes. If you have questions or would like more information specific to your state call Safe Needle Disposal at 1-800-643-1643 or e-mail at firstname.lastname@example.org.
Vyvanse (lisdexamfetamine),a long-acting stimulant medication used in adults with ADHD, is one of the most commonly prescribed brand name drugs in the U.S. Given that 60% of adults who were children with ADHD have symptoms that persist to adulthood, long-term treatment may be necessary. If you’re taking Vyvanse long term, or thinking about starting it, what are some lesser known but important things you should know?
- In addition to being FDA approved in the U.S. for the treatment of ADHD, Vyvanse was the first medication ever approved for binge eating disorder.
- How is Vyvanse different from Ritalin, Adderall, or Concerta? There are two types of stimulants used to treat adult ADHD: methylphenidate and amphetamines. Concerta and Ritalin (either short or long-acting) are methylphenidate, while Adderall and Vyvanse are amphetamine stimulants.
- What made Vyvanse stand out was the long-term release. Taken once daily, Vyvanse is released at the same levels over time, which allows for a similar effect 90 minutes to 14 hours after taking it.
- Abuse potential. Vyvanse carries a smaller risk of abuse than shorter acting medications like Adderall, Ritalin, or Focalin, due to the longer duration of action. The longer effect of Vyvanse also leads to less rebound symptoms throughout the day compared to the shorter-acting ADHD meds.
- It doesn’t matter if you take Vyvanse with food or not.
- It does matter if you take Vyvanse with acidic meds or supplements. Some examples include vitamin C, aspirin, penicillin, or furosemide, which will all decrease the level of Vyvanse in your bloodstream. The opposite is true if you take Vyvanse with basic drugs like sodium bicarbonate (found in Zegerid or Alka Seltzer), Benadryl, codeine, or metoprolol, which may increase levels of d-amphetamine, the active metabolite of Vyvanse. Your pharmacist can help you with potential interactions.
- Most common side effects? The most commonly reported side effects in adults taking Vyvanse are decreased appetite, dry mouth, and insomnia, which occur in 1 in 5 folks taking it.
- Will it affect blood pressure and heart rate? Vyvanse leads to an increase in noradrenergic and dopaminergic neurotransmission—sympathetic nervous system effects, which means your “fight or flight response.” While increases in blood pressure and pulse may occur, changes in vital signs are usually small and changes in ECG (heart tracing) are not clinically relevant.
- What about driving when taking Vyvanse? In young adults with ADHD, treatment with Vyvanse had a positive effect on reaction time with significantly fewer accidents. Studies show Vyvanse was associated with significantly faster reaction times (91% faster) and lower rate of simulated driving collisions.
- Parenting. Interesting studies have been done looking at treatment with Vyvanse when both parent and child (age 5-12) have been diagnosed with ADHD. The parents with ADHD taking Vyvanse showed a significant reduction in “negative talk” and an increase in praise of their children. Results also showed reductions in the ratio of commands to verbalizations—less yelling, more talking.
What has your experience been?
It’s the beginning of the school year, which means that it is time to prepare for the little bugs that get passed around the classroom, lice!
Head lice are parasitic insects that can be found on the head, eyebrows, and eyelashes. Preschool and elementary school-aged children, as well as their parents and caregivers, are at the greatest risk for lice infestation. The most common way to spread lice is through head-to-head contact, which can easily happen when children are playing.
Here are some tips from the pharmacist to help prevent and treat head lice.
Try over the counter options first
There are over the counter (OTC) options that can be used if your child has lice. OTC items like Nix are available at your local grocery store. Using an OTC option first can save you money, as many of the prescription-only items can be costly, and may not be covered by your insurance.
Prescription treatment is available
If you’re unable to get rid of lice using OTC products, your doctor can write you a prescription for lice treatment. The following are examples of prescription-only lice treatment.
- Sklice is for children 6 months of age and older. It is a 10-minute treatment that doesn’t require any nit combing. The manufacturer offers a savings program that can reduce your co-pay to at least $30. For more information, visit their website here.
- Ovide is a lotion used on children 6 years of age and older. Keep in mind that it is flammable, and a second treatment may be required after seven days if lice are still present.
- Ulesfia is for children 6 months of age and older. Be sure to repeat the treatment after seven days. The manufacturer offers a savings program that can reduce your co-pay to as little as $10. For more information, visit their website here.
- Natroba is a topical solution indicated for children 6 months of age and older. Nit combing is not required, but using a fine-tooth comb may be helpful to remove dead lice and nits.
Don’t share personal items
Teaching your child to share is an important life lesson; however, some personal items should not be shared in order to protect against spreading lice. Make sure your child knows that personal items like brushes, hats, helmets, headbands, and towels should not be shared.
Check with your state department of health
Each state department will have information on symptoms, treatments, and guidance for lice prevention and treatment. Refer to your state’s department of health website for more information.
Cialis, approved to treat both ED and benign prostatic hyperplasia (BPH), has about a year left on the countdown to its generic. Generic Viagra (sildenafil) hit the market in Dember 2017, bringing prices down by as much as 50% per tablet.
Here’s all you need to know about the upcoming generic launch and how to keep your costs down while you wait.
When will generic Cialis be available?
After a patent dispute was resolved in the summer of 2017, Cialis is expected to be available as generic tadalafil as early as September of 2018. Previously, Cialis was expected to remain brand-only until 2020.
How popular is Cialis?
On GoodRx, Cialis is currently the second most popular PDE5 inhibitor, the class of medications that also includes Viagra and Levitra. It’s the most popular of the medications specifically used to treat ED (sildenafil / Revatio is the most popular in the class, but it is only approved for pulmonary arterial hypertension).
Have Cialis prices changed recently?
Cialis prices have moderately increased. Cialis is already expensive, and as a brand with no generic, there isn’t much competition. Like many brand-only drugs, Cialis prices have crept up slowly. Over the past 6 months, cash prices for Cialis have increased from about $370 to over $400—based on actual pharmacy claims for fills of thirty 5 mg tablets.
What will generic Cialis cost?
Generally, generic drugs first appear on the market at about a 15% discount to the brand. Unlike the brand, however, generic drug prices typically decrease very quickly. Within a year of release, many generics versions of prescriptions can become very affordable, especially if multiple companies are making the generic.
Cash prices for Cialis—thirty 5 mg tablets, the most common dosage—are currently about $400.
The latest GoodRx estimate is that generic Cialis will initially cost between $300 – 350. While this is still not affordable for most people, keep in mind:
- Discount prices will also decrease, probably by a similar amount. That could mean GoodRx prices at less than $275 for the same prescription, a savings of almost $100.
- Generics are more likely to be covered by insurance, so you may end up with a far lower out-of-pocket cost if you’re insured.
- Again, generic prices tend to go down quickly. Many generics drop to about 50% of the brand price after more than one manufacturer enters the market—increasing competition.
Are there any cheaper medications I can try for ED?
While Cialis doesn’t have a generic yet, there are other options to consider.
- First and possibly most important—Viagra has gone generic, and it is much more affordable. Prices with a GoodRx coupon are as little as $25 per pill, depending on which pharmacy you choose. For more information on Viagra’s generic, sildenafil, see our blog post here.
- Compare prices (whether you have insurance or not). Look at Cialis vs Viagra (sildenafil) or Levitra (vardenafil)—other common choices in the same class—along with Stendra (avanafil) and Staxyn (vardenafil). They may or may not be cheaper now—but both do offer manufacturer coupons and patient assistance programs, which Cialis does not. See manufacturer offers for Viagra here and Levitra here.
- If you have insurance, check your coverage. Many plans don’t cover ED drugs, but some will offer coverage for one or two preferred brands. You may be able to pay less at the pharmacy for Viagra or Levitra.
- For more information on Cialis side effects, and how Cialis compares to other ED medications, check out Iodine’s comparisons with Viagra here and Levitra here. As always, you’ll want to discuss with your doctor if you think another medication might work better for you.
Cialis still works best for me—how can I save before the generic is released?
- Filling a 90-day supply at once can often help shave a little more off your out-of-pocket costs. You may also need a new prescription from your doctor, or approval from your insurance to fill a higher quantity, so check with your doctor, pharmacist, and/or insurance.
- Splitting a higher dosage pill can also help decrease costs, especially if two strengths are priced similarly. You’ll want to ask your doctor to make sure this is safe and a good option for you.
- Use a Cialis coupon. GoodRx does offer discounts for Cialis online. While this may not make it affordable for everyone, a coupon can still knock at least 15% off the full retail price.
- Try again to get it covered. If you have insurance and your plan doesn’t cover Cialis, ask your doctor about submitting an appeal. For conditions like ED this may not always work, but could still be worth a try.