Heartburn, also known as acid reflux or gastroesophageal reflux disease (GERD), is a digestive disease in which stomach acid of bile irritates the food pipe lining.
These days, many heartburn medications are conveniently available over-the-counter. However, some of these medications still require a prescription from your doctor. Common treatments include medications like Nexium (esomeprazole), Protonix (pantoprazole) and Dexilant—which now has a generic.
On May 16th, 2017, the FDA approved the generic for Dexilant, dexlansoprazole, which can help you save at the pharmacy!
What is Dexilant (dexlansoprazole) indicated for?
Dexilant (dexlansoprazole) capsules are indicated for healing and maintenance of erosive esophagitis, heartburn relief, and treatment of symptomatic gastroesophageal reflux disease (GERD).
Dexlansoprazole will be available as a capsule in a strength of 60 mg. Brand name Dexilant is also available as a 30 mg capsule, but it has not been approved in a generic form yet.
Dexlansoprazole is unique in that it delivers 2 releases of medicine in one capsule. The first release occurs within an hour of taking dexlansoprazole and the second occurs 4 – 5 hours later.
What are the most common side effects of Dexilant (dexlansoprazole)?
The most common side effects associated with dexlansoprazole include diarrhea, nausea, stomach pain, vomiting, common cold and gas. Be sure to speak with your doctor if you experience any of these side effects for a prolonged period of time.
Can I continue to use brand name Dexilant?
If you would like to continue taking brand name Dexilant, make sure your doctor hand writes “brand medically necessary” on your prescription. This means the pharmacy is not permitted to substitute and give you the generic product. If your doctor doesn’t indicate this on your prescription, you can also request it from your pharmacist before having your prescription filled.
Keep in mind that because the generic product is now available, your insurance company may not be willing to cover the cost of the more expensive brand medication. Be sure to check your prescription insurance company to find out if it is covered before taking a trip to the pharmacy.
Does Dexilant have any cost saving programs?
Yes! The manufacturer of Dexilant, Takeda Pharmaceuticals, has an instant savings card available for commercially insured patients. Eligible patients can pay no more than $20 for their dexilant capsule prescription and refills.
Yet another brand-name drug manufacturer is dramatically raising their prices.
In recent years, we’ve seen numerous cases of manufacturers increasing brand drug prices at an astronomical rate without any reasonable explanation. The makers of life-saving drugs like EpiPen (epinephrine), Nitropress (sodium nitroprusside), and many popular insulins have dramatically increased prices, causing some patients to go without treatment or turn to the black market. You’d think that all the recent bad press might prevent these kinds of increases, but apparently not.
The price of Gleostine (lomustine), a popular anti-cancer drug used to treat brain tumors and Hodgkin’s disease in both humans and pets, has increased by more than 500% in just four years. Here’s the story:
Back in 2013, GlaxoSmithKline discontinued production of CeeNu, the brand name for the generic drug lomustine. With Glaxo out, NextSource Biotechnology, the only manufacturer of the generic version, was left as the only maker of the drug. At the time, NextSource charged about $100 for one dose.
You’ll never guess what happened next. NextSource’s Gleostine, the exact same product they had sold previously, has a retail price of over $600 just four years later.
Although the increase occurred in 2014, until recently lomustine had been available in pharmacies as NextSource slowly phased the generic off the market. Today, Americans are just starting to experience sticker shock at the pharmacy for this life-saving medication.
What does this mean for me?
Unfortunately, all this drama means a higher cost for patients. When generic lomustine was available, patients were paying an average cash price of around $100 for one 100 mg dose. Now that only brand name Gleostine is available, the average retail price for one 100 mg dose is $648.88. That’s a markup of $548, for the exact same drug.
In fairness, NextSource does a patient assistance program which can offset this cost for qualifying patients.
How often does this happen?
The good news is that these dramatic price increases don’t happen often. However, this case resembles the strategy that some pharmaceutical companies are adopting—acquiring older generics and turning them into expensive specialty drugs.
You might remember this happening with Daraprim (pyrimethamine), which was bought by Martin Shkreli of Turing Pharmaceuticals—who promptly raised its price from $13.50 to $750 per tablet. Before it was bought, Daraprim was a 62-year old anti-parasitic drug that had long treated conditions like malaria and other infections.
How can I save on Gleostine?
Now that only Gleostine is available, finding opportunities to save is important! Unfortunately, there is no co-pay card for insured patients. As mentioned, NextSource offers a patient assistance program, NextSource Cares. This program provides Gleostine free of charge to uninsured eligible patients. Call 1-855-457-8880 for more information and instructions on enrollment.
If you have insurance, check with your provider. Some (but definitely not all) insurance plans will cover a portion of your cost.
GoodRx will continue to monitor the price of Gleostine (and every other prescription drug) to alert you to price increases and ways to save. We’re on the case!
Attention deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder starting in childhood and sometimes carrying into adulthood. This disorder is characterized by inattention, hyperactivity, and impulsivity. Common treatments include medications like Adderall (amphetamine salt combo), Ritalin (methylphenidate), and Strattera (atomoxetine) – which now has a generic alternative!
Common side effects associated with Strattera (atomoxetine) vary between children/adolescents and adults. Typically, children may experience side effects like upset stomach, decreased appetite, nausea or vomiting, dizziness, and mood swings. On the other hand, adults may experience side effects like constipation, dry mouth, nausea, decreased appetite, dizziness, problems passing urine, and some sexual side effects.
Be sure to speak with your doctor if you experience any of these symptoms for a prolonged period of time.
What companies will manufacture atomoxetine?
What if I want to continue using brand name Strattera?
If you would like to take brand name Strattera, make sure your doctor handwrites “brand medically necessary” on your prescription. This means the pharmacy is not permitted to substitute and give you the generic product. If your doctor doesn’t indicate this on your prescription, you can also request it from your pharmacist before having your prescription filled.
Keep in mind that because the generic product is now available, your insurance company may not be willing to cover the cost of the more expensive brand medication. Be sure to check your prescription insurance company to find out if its covered before taking a trip to the pharmacy.
How can I save on brand name Strattera.
The manufacturer of Strattera, Eli Lilly, has a savings card available for commercially insured patients. Most eligible patients will pay as little as $25 per month for their Strattera prescription wth a maximum savings of $75.
In an effort to compete with the popular asthma medication Advair, Teva Pharmaceuticals announced their simultaneous release of the dry powder inhaler AirDuo RespiClick, and its authorized generic fluticasone/salmeterol. Although manufacturers don’t typically release both the brand and the generic simultaneously, this is big news, as fluticasone/salmeterol is the first and only combination inhaler!
AirDuo and its authorized generic are both indicated for the treatment of asthma in patients 12 years of age and older. Asthma is a condition in which a person’s airways becomes inflamed, narrow, swollen, and filled with mucus. Signs and symptoms of asthma can include wheezing, shortness of breath, cough and chest tightness. Asthma is considered a reversible airway disease meaning that the problems can generally be solved with treatment.
Both of these inhalers are considered maintenance or controller inhalers, so they must be used consistently to help your breathing and prevent asthma flare-ups.
What is an authorized generic?
According to the FDA, an authorized generic “is most commonly used to describe an approved brand-name drug that is marketed as a generic product, without the brand name on its label.”
An authorized generic is the exact same drug as the branded product, yet in most cases, the generic is significantly cheaper than the brand product. In this case, generic fluticasone/salmeterol is the exact same as AirDuo RespiClick.
Why were the brand and the generic released simultaneously?
Teva Pharmaceuticals released both the brand and the generic at the same time to address the need for more affordable asthma treatment options in the United States.
In a press release, Teva discussed their decision to release both Airduo RespiClick and its authorized generic. The President and CEO of Global Specialty Medicines at Teva Discussed that their “intent is to meet the needs of patients, providers, and payers in the U.S. seeking greater access to lower-cost asthma inhaler technology, while also allowing Teva to compete in the highly competitive asthma combination controller market.”
How should you use a drug powder inhaler?
AirDuo RespiClick and fluticasone/salmeterol will be available as a dry powder inhaler in strengths of 55 mcg/14 mcg, 113 mcg/14 mcg, and 232 mcg/14 mcg. Regardless of your strength, you should be taking one inhalation twice daily.
Dry powder inhalers are different from typical inhalers that require hand-breath coordination, like aerosol inhalers. When using a dry powder inhaler, it is important to breathe in quickly and deeply through your mouth to deliver the dose of medicine to your lungs.
Make sure that you rinse your mouth with water, and spit, after using these inhalers to prevent thrush, a fungal infection in the mouth. AirDuo and its authorized generic must be disposed of 30 days after removal from the foil pouch, and should not be used with a spacer or holding chamber device.
The most common side effects include headache, cough, thrush, back pain or the common cold.
Are there any other medications similar to AurDuo RespiClick and fluticasone/salmeterol?
Yes. Advair Diskus, Advair HFA, Dulera, and Symbicort are examples of other similar controller inhalers. These medications can be very expensive, especially since they are not available as a generic yet.
If you are currently using any of these inhalers and would like to switch to AirDuo RespiClick or its authorized generic, be sure to speak with your doctor.
Working with prescription drugs every day, I constantly find myself pausing over their obscure names that are oftentimes impossible to pronounce. Xeljanz? Idarucizumab? Tecfidera? How did these crazy names come to be, and who can we blame? I was interested, so I went down the rabbit hole…
Drugs have (at least) three names.
Right when a drug is developed, the naming process begins, starting with the chemical name.
- Chemical name: This is usually the first name a drug is given and is the most complex! This name usually describes the atomic or molecular structure of the drug. For example, the chemical name for Sudafed is dl-threo-2-(methylamino)-1-phenylpropan-1-ol. Don’t worry, I can’t pronounce it either.
- Generic name: This is also referred to as the non-proprietary name. On GoodRx we often show the generic in parenthesis after the brand name; for example, Motrin (ibuprofen). Generic names are assigned by the World Health Organization and the United States Adopted Names council (USAN), and are usually a shorthand version of the drug’s structure or mechanism of action (how it works). Generic/nonproprietary names were created to eliminate the use of the chemical names in the clinical setting. For instance, ibuprofen’s clinical name is (RS)-2-(4-(2-methylpropyl)phenyl)propanoic acid. I would much rather talk to my doctor about taking ibuprofen, than trying to pronounce that. Wouldn’t you? Yeah, I thought so. So although the generic name can sometimes be confusing, just remember, it could be way worse.
- Brand name: Also called the proprietary name, this is the name that is intended for you, the patient! The brand name is intended to suggest the drug’s function, and is ultimately approved by the FDA. However, like most things in the pharmaceutical world, coming up with the brand name is a long and arduous process.
The confusing world of branded drug names
A drug’s brand name is developed by the company manufacturing the drug. However, more often than not, drug manufacturers work with companies that specialize in naming drugs. As you might expect, gaining approval for the brand name is the most difficult step to clear in the naming process. Good brand names should work in every country, be easy for doctors to spell and remember, and shouldn’t cause any trademark disputes.
Branded drug names should be unique
The FDA also requires that brand names be unique and distinct from others in every language. This is to prevent drug-mix ups by doctors and patients, and is usually the more time consuming step in the naming process. Manufactures often come up with as many as 3,000 potential names before they narrow it down to one.
This may seem like a silly guideline, but take Celebrex and Celexa for example. Yes, these two look different, but one bout of messy handwriting or mix up in pronunciation could cause your pharmacist to give you an antidepressant over your arthritis medication. In fact, drug mix-ups like this one are so dangerous that the Institute of Medicine has estimated that around 1.5 million people are injured or killed each year by prescription mix-ups, which can be caused by confusing naming. So, it is in your best interest that the naming process be this complex!
Creating a marketable name
In addition to creating names that adhere to the FDA’s guidelines, manufacturers also aim to create names that are marketable. Take Viagra for instance. It has become such a household name that it is even in the Oxford English Dictionary. Created by Pfizer, the goal was to name their drug for erectile dysfunction (ED) with a word that conjured images of its desirable effect, and they succeeded. Although there are many theories as to where the name Viagra came from, it sounds similar to words like “vigor” and “vitality,” adjectives that may convince those suffering from ED to give it a try. Although most drug names can’t possibly become as household as Viagra, it is yet another factor that manufacturers must consider in the drug naming process.
What is the moral of the story from all of this? Don’t feel bad if you cant pronounce your medication. You’re not alone.
Institute of Medicine. Medication Errors Injure 1.5 Million People and Cost Billions of Dollars Annually; Report Offers Comprehensive Strategies for reducing Drug-Related Mistakes. July 2006.