Weekly Pharmacy Updates...
History Files.
"New Drug Information"

A hint about searching the history files...Use the find function under edit menu on most browsers so that you can search for a specific word...Newest information is nearer to the top. NOTE These are HISTORY FILES and may not contain the most accurate up to date information on prescription medications. All information is provided by pharmacist, but is old "history information".

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Glyset (miglitol) from the Bayer Corporation, a new alpha-glucosidase inhibitor, is now available from your doctor with a prescription. It is used to treat patients with Type 2, adult onset, diabetes. It may be used alone or in combination with other oral diabetes treatments. Glyset asserts its action in the small intestine by inhibiting enzymes to reduce glucose absorption. It should not be used in patients with diabetic ketoacidosis, inflammatory bowel disease, or various other intestinal diseases. The most common side effects include abdominal pain, diarrhea, flatulence, and skin rashes. Talk to your doctor or pharmacist for more information about Glyset.

Comtan (entacapone) tablets from Novartis is a new catechol O-methyltransferase (COMT) inhibitor to be used in conjunction with  levodopa/carbidopa therapy in Parkinson's disease patients who are experiencing "off" time. In studies treatment with Comtan and levodopa/carbidopa showed a 10-24% reduction in off time. This off time is a period when the levodopa stops working for minutes or hours and can cause in coordination including falling upon walking. Comtan works to stop this off period from occurring by inhibiting an enzyme that normally metabolizes levodopa thus potentiating the action of levodopa. Side effects from Comtan include nausea, uncontrolled movements (dyskinesias), diarrhea, urine discoloration, abdominal pain, dizziness, constipation, fatigue, and pain. 

Lotronex (alosetron hcl) is a new treatment for irritable bowel syndrome in women who have diarrhea diarrhea as their main symptom. The drug is manufactured by Glaxo-Welcome. Lotronex has not been shown to work in men with irritable bowel syndrome. Irritable bowel syndrome also called spastic colon or irritable colon is a medical condition that causes cramping abdominal pain and discomfort, bowel urgency (a sudden need to have a bowel movement), and irregular bowel habits like diarrhea and constipation. Lotronex acts to treat irritable bowel syndrome by blocking a chemical called serotonin. This chemical is thought to be responsible for the overactivity of the colon that occurs in irritable bowel syndrome. Thus Lotronex block serotonin activity reducing abdominal cramping, discomfort, urgency, and diarrhea. Do not use Lotronex if you are pregnant, breast feeding, or if you are constipated most of the time. Important notice concerning Lotronex...Important safety update about Lotronex which is used to treat Irritable Bowel Syndrome in women only. GlaxoWellcome the manufacturer of Lotronex has issued new safety warnings about the drug. The new information pertains to reports of severe constipation that in a few cases has resulted in serious sequelae and possible ischemic colitis with the use of Lotronex. Since the approval of Lotronex in February 2000 there have been reports of a few cases of serious complications of constipation including obstruction, perforation, impaction, toxic megacolon, and secondary ischemia with the use of Lotronex. Please report to your doctor immediately if you are experiencing severe constipation. Lotronex should not be used in patients with constipation, with a history of chronic or severe constipation, or with a history of sequelae from constipation, with a history of intestinal obstruction, stricture, toxic megacolon, GI perforation and/or adhesions, with a history of ischemic colitis, with a current or a history of Crohn's disease or ulcerative colitis, and with active diverticulitis. THIS DRUG HAS BEEN PULLED FROM THE MARKET.

Breaking Information concerning Baycol...Bayer the maker of Baycol is voluntary removing Baycol from the market. The drug along with all other "statin" cholesterol lowers (Zocor, Mevacor, Pravachol, Lipitor ect) can cause rhabdomylosis. Normally this condition occurs when the statin drugs are used in combination with Lopid (gemfibrozil), but in the case of Baycol it was occurring with the drug alone and in higher cases. This condition which is characterized by muscle pain can lead to kidney failure and death. In this condition the muscle deteriorate away from the bones.  THIS DRUG HAS BEEN PULLED FROM THE MARKET.

Actiq is a new dosage form of the pain medication fentanyl. Fentanyl was previously only available in a transdermal patch marketed under the trade name Dura-Gesic. Actiq is available in either a buccal lozenge or an oral transmucosal swab. Fentanyl, a synthetic opiate agonist, is approximately ten times as potent as morphine, but has a shorter half-life. Actiq's primary indication is for breakthrough cancer pain management. It is intended to be used concurrently with other long-acting pain medications. The buccal and transmucosal dosage forms are designed to be absorbed from the high blood flow region of the mouth. This allows for better absorption and increased effects of the medication. The most common side effects include anxiety, confusion, hallucinations, and diarrhea. Actiq should not be used in patients on coagulative therapies (Coumadin, Ticlid ect) without the doctor's consent or in patients with thrombocytopenia. For more information on Actiq, contact your doctor or pharmacist.

The new non-amphetamine drug Provigil (modafanil) from Cephalon is now available from your doctor with a prescription. It is used to treat patients with narcolepsy or narcolepsy-like symptoms. These symptoms may include daytime drowsiness or a constant feeling of fatigue. Provigil is unlike other drugs used to treat this condition, such as Didrex (benzphetamine), in that it is not an amphetamine or amphetamine derivative. The actual mechanism by which Provigil exerts its effects is unknown. However, it is known that it does not utilize the same receptors as the amphetamine drugs. The most common side effects include headache, nausea, and nervousness. Provigil should not be used in patients with arrhythmias, ischemic heart disease, and various other heart conditions. Talk to your doctor or pharmacist for more information on Provigil.

Vioxx (rofecoxib) is new anti-inflammatory/arthritis medication from Merck and Company. Vioxx is the newest of what will be a growing marketplace of COX-2 specific inhibitor. Celebrex was the first of this new class of drugs to reach the marketplace. As you recall anti-inflammatory drugs (NSAID) work to reduce inflammation by inhibiting certain enzymes that produce chemicals leading to inflammatory actions. This enzyme called cyclooxygenase (COX) exists in at least 2 forms. Type 1 ( called COX-1) is responsible for producing chemicals that are beneficial for kidney and gastric (stomach ect) function while type 2 (COX-2) is responsible for producing the chemicals in the inflammation reaction. The goal of the NSAIDs is to inhibit COX-2 which would provide relief to arthritis sufferers without inhibiting COX-1 which is the beneficial enzyme that protects the stomach and kidneys. The earlier NSAIDs inhibited both COX-1 and COX-2 to some extent which can lead to potential side effects such as stomach ulceration. Vioxx is administer once daily with food. It is available in both tablets and an oral suspension. With the release of Celebrex and now Vioxx we have a new class of drugs called COX-2 specific NSAIDs which will reduce anti inflammatory conditions with fewer side effects. Talk to your doctor or pharmacist about this new class of drugs.

Pletal (cilostazol) is a new drug for intermittent claudication, which simply is muscle pain from poor circulation. Usually this pain is in the legs or other muscles that is brought on by brief and or simple activity such as walking. Pletal works to reduce this pain by increasing the oxygen supply to the muscles. The oxygen supply is increased by dilating the blood vessels bringing more blood, which carries oxygen, to the muscles. Pletal seems to be more effective than Trental (pentoxifylline) which is another drug available for intermittent claudication. This effectiveness is determined by the distance patients can walk without pain. The most common side effects from Pletal are headache, diarrhea, and dizziness. Pletal is taken twice a day on an empty stomach. Pletal should not be taken by those who have heart failure. Pletal can interact with erythromycin, Nizoral, Sporanox, Cardizem (diltiazem), Prilosec, and grapefruit juice. Talk to your doctor or pharmacist for more information about Pletal.

Glyset (miglitol) is a new drug for adult onset or type 2 diabetes. Glyset is very similar to Precose (acarbose). These drugs work to lower the chance of hyperglycemia after meals by slowing down intestinal absorption of carbohydrates. This "slow down" allows the body to better control sugar levels with the smaller amounts of insulin present in a type 2 diabetic patient. Glyset can be used alone as initial therapy or in combination with other type 2 diabetic drugs. Glyset is usually give three times a day just before meal times. Glyset itself does not cause hypoglycemia. The drug will only slow the absorption of complex sugars not the simple sugar glucose. If hypoglycemia occurs in a patient using Glyset glucose tablets can and should be used. With Glyset's site of action in the stomach most of the side effects are GI related. Glyset can cause gas, diarrhea, and abdominal discomfort.

Celebrex (celecoxib) is a new non-steriodal anti-inflammatory drug (NSAID) for the treatment of arthritis. There is a lot of excitement about this drug because Celebrex shows a lot of promise for those who suffer from arthritis who are looking for relief without the large potential for side effects. NSAIDs like Celebrex work by inhibiting enzymes that normally produce chemicals that lead to the inflammatory actions. These enzymes exist in two forms. Type 1 ( called COX-1) is responsible for producing chemicals that are beneficial for kidney and gastric (stomach ect) function while type 2 (COX-2) is responsible for producing the chemicals in the inflammation reaction. The goal of the NSAIDs is to inhibit COX-2 which would provide relief to arthritis suffers without inhibiting COX-1 which is the beneficial enzyme that protects the stomach and kidneys. All NSAIDs except Celebrex inhibit both enzymes (COX-1, COX-2) to some extent. Celebrex though is specific for COX-2 so this drug provides relief from inflammation (inhibits COX-2) without causing side effects to the stomach and kidneys which is brought on by the inhibition of COX-1. This means that Celebrex has less potential for stomach upset and ulceration. Celebrex is available 100 and 200 mg capsules. The major side effects of Celebrex include abdominal pain, diarrhea, headache, and upset stomach.  Celebrex should be used with caution in those who have pre-existing renal disease, asthma specifically aspirin induced asthma, and those with fluid retention problems and/or heart failure as Celebrex can lead to fluid retention. For more information on Celebrex ask your doctor or pharmacist.

Arava (leflunomide) is a new drug for rheumatoid arthritis. Arava is one of two new drugs for rheumatoid arthritis. The other is Enbrel (etanercept) and is now available. These two drugs represent the first disease modifying drugs for rheumatoid arthritis to be approved in over 10 years. Arava reduces pain and swelling and slows joint damage unlike aspirin and NSAIDs which only reduce swelling and pain. Avara is believed to be as effective as methotrexate or sulfasalazine. The drug slows joint damage by reducing the production of immune cells that attack the joints. Remember rheumatoid arthritis is a disease where our own immune system which normally helps fend off disease and sickness attacks our own body. Avara can reduce this attack. Avara can cause diarrhea, hair loss, rash, and liver problems. It is probably a good idea to check liver function tests during the course of therapy to insure that no damage is occurring to the liver. Avara should not be taken by women who plan to become pregnant because the drug can cause birth defects. If you plan to become pregnant in the near future talk to your doctor about alternatives to Avara. Enbrel is an injection which is usually given twice a week while Arava is taken by mouth. Be prepared to get out your pocketbook with both of these drugs.

Celexa (citalopram) is a new antidepressant from the drug companies Forest Labs and Parke-Davis. Celexa is classified as an SSRI (serotonin specific reuptake inhibitor). Other SSRIs on the market include Prozac, Paxil, and Zoloft. Celexa works just as well as these drugs and has similar side effects including nausea, drowsiness, and sexual dysfunction. The manufacturers of the drug are trying to grab a piece of the market share for antidepressants by touting Celexa as safer than the other SSRIs. Celexa is said to have fewer drug interactions to worry about than the other SSRIs. The drug is available in a 20 and 40mg tablet that is dosed once a day.

Prometrium is the first commercially available form of oral micronized progesterone. The structure of Prometrium is identical to natural progesterone, but is micronized to increase absorption. The addition of Prometrium gives women a choice about what to use for hormone replacement therapy. Provera which is a synthetic form of progesterone has been available for sometime because it was thought that it would be more well absorbed than natural progesterone. That statement has proved not to be true with the development of Prometrium. Reportedly women like the way that natural progesterone makes them feel compared to the synthetic forms of progesterone. Prometrium works as well as Provera to prevent endometrial hyperplasia and the natural progesterone has a more favorable effect on lipids. Be aware though that Prometrium can cause dizziness and/or drowsiness and thus should be taken at night. Women who are allergic to peanuts cannot take Prometrium because the capsules contain peanut oil. Ask your doctor if Prometrium is right for you.

Micardis (telmisartan) is a new angiotensin II receptor blocker indicated for high blood pressure. Micardis is another addition to this class which includes Cozaar, Avapro, Diovan, and Atacand. Micardis has the longest half life of this class but this may be to little advantage because all of these drugs are dosed once a day. Micardis tablets should not be broken because of sensitivity to moisture.  Angiotensin II receptor blockers have been proven effective in reducing blood pressure with the potential for fewer side effects than ACE Inhibitors. Specifically this class of drugs does not cause the irritating cough that is common with ACE Inhibitors.

The first oral drug for chronic hepatitis B will soon be available. Epivir-HBV contains lamivudine which is the same antiviral drug in Epivir which is used to treat the HIV infection. The difference between the two drugs is the strength of the active drug lamivudine. Patients being treated for hepatitis B will take Epivir-HBV which contains 100mg of lamivudine once daily compared to the 150mg of lamivudine in Epivir twice a day needed to treat the HIV infection. Lamivudine has been proven effective in suppressing the growth of the hepatitis B virus. Take to your doctor about using Epivir-HBV orally for the treatment of hepatitis B.

Periostat is a new oral drug for the treat of periodontitis. This is a gum disease that causes chronic inflammation of the gums and leads to the destruction of connective tissue which may cause tooth loss. This is a common condition among adults. Periostat contains the tetracycline antibiotic doxycycline in a very low dose of 20mg. In this low dose doxycycline does not have antibacterial activity but rather it inhibits an enzyme called collagenase which is responsible for the breakdown of connective tissue in the gums. Periostat is taken by mouth twice a day and is to be used in conjunction with regular dental treatments. This oral product is unique from other products used for periodontitis. Other preparations are mostly topical used for their antibacterial effects. Periostat can improve tooth attachment up to 50%. As with other tetracycline products Periostat should not be taken directly with antacids or vitamins that contain calcium, magnesium, ect.

Maxalt (rizatriptan) from Merck becomes the fourth "triptan" migraine headache treatment on the market. Maxalt is available as a oral tablet and as a tablet that dissolves in the mouth called Maxalt MLT. Maxalt's onset of action and duration is similar to Imitrex and Zomig. Amerge the other "triptan" on the market has the slowest onset of action, but the longest duration. Maxalt MLT dissolving tablets do not have a quicker action than the oral Maxalt tablet. Remember none of the triptans should not be taken by those with heart disease or those who have uncontrolled high blood pressure because of the potential of these drugs to constrict the arteries of the heart. Like the other triptans, Maxalt has side effects including dizziness, angina, flushing, hypertension, hypotension, weakness, vertigo, muscle pain, and heart rhythm changes. Maxalt along with the other triptans should not be taken within 24 hours of an ergot or another triptan.

Atacand (candesartan) is a new angiotensin II receptor blocker for the treatment of hypertension. This is the fourth agent (Cozaar, Diovan and Avapro) in this new class of drugs. These drugs are similar to ACE inhibitors (Vasotec, Lotensin, Zestril, ect) in that their goal is to lower a chemical called angiotensin II which is a potent constrictor of blood vessels. By lowering angiotensin II, blood pressure is decreased and sodium and water retention is also decreased. The advantage that these angiotensin II receptor blockers such as Atacand have over ACE inhibitors like Vasotec is that they are less likely to cause of cough which is a common side effect of ACE inhibitors. Atacand is taken once a day with or without food. Side effects may include swelling, back pain, muscle cramping, cough, insomnia, congestion, dizziness, and upset stomach. If your blood pressure is currently controlled by an ACE inhibitor but you are experiencing a nagging cough while taking the drug ask your doctor about switching to a angiotensin II blocker such as Atacand.

Xeloda (capecitabine) is the first oral therapy indicated for the treatment of metastatic breast cancer in patients whose tumors are resistant to Taxol (paclitaxel) and anthracycline drugs or who can no longer tolerate these therapies. Xeloda is formulated to be metabolized by enzymes in tumor cells to its active form called 5-fluorouracil which is a cancer drug that is normally administered IV for various cancers. Xeloda due to its special "pro-drug" formulation where it becomes active by the tumor offers an advantage of fewer side effects including including less bone marrow toxicity and hair loss than 5-FU. The most frequently reported adverse effects from Xeloda included lymphopenia, anemia, diarrhea, pain and swelling of the hands and/or feet, and nausea. The drug is normally given in a three week cycle that is 2 weeks of taking the drug twice a day with 1 week of not taking the drug. Xeloda should be administered with water at the end of a morning and evening meal. Xeloda should not be taken by women who become pregnant.

Fareston (toremifene citrate) is a new oral first-line treatment for metastatic breast cancer in postmenopausal women with estrogen receptor-positive or unknown tumors from Schering-Plough. Fareston reduces breast tumor size by binding to estrogen receptors on breast cancer cells, blocking estrogen from feeding the tumor and stimulating further tumor growth. Fareston is a derivative of tamoxifen (Nolvadex) and is believed to be as effective as the highly publicized tamoxifen. Fareston appears to have an advantage over tamoxifen though in that it has a more positive effect on lipids. Tamoxifen reduces the good cholesterol (HDL) while Fareston seems to actually increase HDL. Like all of the antiestrogen drugs for breast cancer, Fareston has many side effects and drug interactions. Fareston is available as a 60mg tablet that is dosed once a day. For more information on Fareston ask your doctor or pharmacist.

Plavix (clopidogrel bisulfate) is a new oral drug indicated for the reduction of atherosclerotic events such as myocardial infarctions (MI), strokes, and vascular death. The drug is intended to be used by those with documented arteriosclerosis proven by recent stroke, MI, or established arterial disease. Plavix is an inhibitor of platelet aggregation (blood clotting) through a process related to inhibition of ADP platelet activation. This is a different mechanism of action then aspirin although Plavix's effectiveness is comparable to that of aspirin's. Plavix has a favorable safety and tolerability profile compared to aspirin with a lower incidence of GI irritations such as ulcers and hemorrhages. The most common side effects associated with Plavix were chest pain, purpura, infection, rash, headache, and diarrhea. The use of Plavix is contraindicated in patients with chronic bleedings from conditions such as peptic ulcer disease, intracranial hemorrhage and should be used with caution in patients who may be at risk for increased bleeding from surgery, injury, or other drug therapy. Plavix is dosed once daily with or without food and is effect in both men and women. For more information on this new antiplatelet drug ask your doctor or pharmacist.

Merck is now marking Cosopt ophthalmic drops for glaucoma. This drug is a combination of Merck's timolol (Timoptic) and dorzolamide (Trusopt) and is indicated for patients who don't respond to timolol alone. Cosopt offers a more convenient dosage form than using Timoptic and Trusopt alone. Cosopt is dosed twice a day compared to using Timoptic twice a day and Trusopt three times a day. Cosopt can cause blurred vision for several minutes after use along with ocular stinging or burning. Cosopt can also cause a bitter taste in the mouth. There is also a new alternative to Merck's Trusopt now available from Alcon called Azopt (dorzolamide). Azopt like Trusopt lowers intraocular pressure by reducing the production of fluid in the eye. Azopt reportedly causes less burning and stinging than Trusopt, but Azopt can also cause blurred vision for several minutes after instilling the drop.

Tricor (fenofibrate) is a new antihyperlipidemic agent from Abbott Labs and Groupe Fournier. Tricor is similar to Lopid (gemfibrozil) and Atromid-S (clofibrate). The new drug is indicated for the treatment of adults with very high serum triglyceride concentrations whose condition is not controlled by diet alone and who are at risk for pancreatitis. Tricor's usual inital dose is 67mg daily (one capsule) along with a triglyceride lowering diet. The dosage should be adjusted for the individual according to response to therapy and the risk of pancreatitis. The maximum daily dose is 201 mg. Tricor should be taken with food to increase its effectiveness. Tricor is contraindicated in patients with preexisting gallbladder disease, hepatic disease, or renal dysfunction. Side effects associated with Tricor include rash, fatigue, infections, flu syndrome, pain, and headaches. The drug also can increase liver enzymes so it is recommended that liver function is monitored during treatment. For more information ask your doctor or pharmacist.

Prandin (repaglinide) is a new oral antidiabetic agent for people with type 2 (adult onset) diabetes from Nordisk and Schering. The drug may be used alone or with Glucophage for control of diabetes. Prandin represents a new class of oral hypoglycemic drugs called the meglitinides. Prandin works like a sulfonylurea by stimulating the pancreas to secret insulin, but is structurally different than the sulfonylureas. Prandin's quick onset of about 15 minutes and short duration of about 4 hours offer it the ability to be dosed with each meal. Prandin does offer the convenience of skipping a dose if a meal is skipped or adding a dose if a meal is added. The most common side effects from Prandin were hypoglycemia and weight gain.

Tasamar (tolcapone) is a new drug from Hoffmann-LaRoche for the treatment of Parkinson's disease. Tasamar represents a new class of Parkinson's drug called the COMT (catechol-O-methyltransferase) inhibitors. COMT is an enzyme that is known to breakdown levodopa in the periphery reducing the amount of levodopa or dopamine that reaches the central nervous system. Parkinson's disease is from a lack of levodopa or dopamine in the central nervous system and thus the goal in the treatment of the disease is to increase the amount of the transmitter that reaches the CNS. Using Tasamar along with levodopa (Sinemet or generic) will potentially increase the amount of levodopa that reaches the central nervous system because Tasamar will reduce the amount of levodopa that is destroyed by the COMT enzyme before it reaches the CNS. Using Tasamar along with Sinemet reduces the "off time" associated with dwindling doses of Sinemet and improves the activities of daily living in Parkinson's patients. Tasamar is given three times daily along with Sinemet (carbidopa-levodopa). Tasamar may cause liver damage thus liver enzymes should be monitored while the drug is being used. The most common side effects associated with Tasamar where hallucinations, anorexia, dizziness, diarrhea, and  nausea especially at the start of treatment. Tasamar may also cause an excess of dopamine leading to involuntary movements which may be a sign for a need in dosage adjustment of Sinemet. Tasamar should not be used with a nonselective MAO inhibitor such as Naridil or Parnate, but may be used with Eldepryl (selegiline).

Viagra (sildenafil) is now available at your local pharmacy. After being approved this new impotence drug has drawn a lot of interest as being the only oral drug for the treatment of impotent men available on the market. Viagra works by inhibiting an enzyme called phosphodiesterase in the penis. Blocking this enzyme allows for smooth muscle relaxation leading to more blood flow to the penis and thus an erection. This drug which was being tested in early studies for the treatment of angina is effective and about 70% of the men who tried the drug in studies got improved erections. The tablet will help, but sexual stimulation is still needed to cause the erection. Don't expect just to get an erection from just taking the tablet alone, you still need to be sexually stimulated for the errection to occur. Viagra is normally dosed one 50mg tablet by mouth one hour before sex. Men over the age of 65 and those with liver or kidney impairment may need to start with a 25mg tablet. These tablets are expensive, expect to pay about $9 or more for each tablet, but remember only one tablet is needed to cause an erection. Common side effects to be expected from the drug include facial flushing, indigestion, headache, and temporary vision disturbances. The vision problems relate to the ability to distinguish between blue and green colors. Also tell your doctor or pharmacist if you are taking erythromycin, Nizoral, or Sporanox because of potential drug interactions between Viagra and these drugs. For more information ask your doctor or pharmacist.

Evista (raloxifene) from Eli Lilly and Company is a new oral drug for the prevention of osteoporosis in postmenopausal women. Evista is the first of a new line of drugs called selective estrogen receptor modulators (SERMs). Evista acts as a SERM by working at some of the same receptors as estrogen  does leading to less bone loss and thus the benefit in osteoporosis prevention, but does not have the same effects on the breast or the uterus and thus may not increase the risk cancers like estrogen does. Evista also has a positive effect on lipid metabolism decreasing the total LDL (bad cholesterol), but does not increase the HDL (good cholesterol). Evista lacks the estrogen effects that may lead to endometrial proliferation, breast pain, breast enlargement, or an increased risk in breast cancer. Evista is not effective in reducing hot flashes or flushes like estrogen replacement therapy is. Common side effects associated with Evista include hot flashes, leg cramps, gas, muscle pain, weight gain, swelling, rash, sweating, and urinary tract irritations. Evista is given once daily with or without food. The drug should not be administered to anyone who is immobilized for any reason because of the increased risk of venous clots. A supplement of calcium with vitamin D is recommended during therapy and weight bearing exercise is encouraged. Evista is not be used with estrogen replacement therapy. For more information ask your doctor or pharmacist.

Singulair (montelukast sodium) is a new pill for the prevention and chronic treatment of asthma in adults and children six years of age or older. This drug is similar to both Accolate and Zyflo. Singulair works to improve asthma by blocking receptors in our bodies that would normally cause inflammation in our airways reducing our ability to take in air and thus to breath. In asthma certain chemical mediators called leukotrienes bind to these receptors causing airway inflammation, smooth muscle contraction, and other activities which lead to the signs and symptoms of asthma. Singulair prevents these leukotrienes from binding to these receptors and leading to asthma symptoms by blocking the receptors. Singulair is given once daily, 10mg in the evening for adults or 5mg (chewable tablets) in the evening for children 6 to 14 years old. Singulair is a safe drug with few side effects. The most common adverse reactions in studies were GI disorders, fatigue, headache, and dizziness. Of note Singulair or any other oral drug is not for the immediate treatment of an asthma attack. Patients using oral drugs for asthma should continue on their inhalers as instructed by their physicians and keep their rescue inhaler available for the treatment of any attack. Singulair is not a cure for asthma.

Meridia (sibutramine hydrochloride) is a new serotonin, dopamine, and norepinephrine reuptake inhibitor specifically indicated for treating obesity that is now available. Meridia is indicated along with a reduced calorie diet for weight loss or the maintenance of weight loss in obese patients that meet certain requirements relating to body mass index. The drug works to suppress hunger similarly to Redux and Pondimin (through modification of the chemicals serotonin and norepinephrine), but unlike Redux and Pondimin causes less serotonin toxicity because it does not increase the release of serotonin from nerve cells. This reduces the risk of heart problems(in pre-marketing studies no cases of pulmonary hypertension, PPH occurred). The drug does have risks though. Side effects that may occur from Meridia include headache, rapid heart beat, an elevation in blood pressure, constipation, nausea, back pain, thirst, dry mouth, insomnia, dizziness, nervousness, and sweating. Meridia like other diet aids does carry a warning to monitor blood pressure regularly because the drug can cause an increase in blood pressure in some people. Meridia should not be used with SSRI antidepressants such as Prozac, Paxil, Luvox, and Zoloft, MAOI antidepressants, certain migraine headache agents such as Imitrex, Zomig, and certain ergot drugs, nor with Demerol, Talcen, Talwin, fentanyl, and lithium. Meridia should be used with caution with Nizoral, erythromycin, and drugs that may increase blood pressure. The starting dose for Meridia is 10mg (1 capsule) daily given with or without food. The dose may be decreased to 5mg daily if the 10mg capsule is not tolerated. The dose of Meridia may be increased to 15mg daily if sufficient weight loss does not occur in 4 weeks.

Regranex (becaplermin gel) is a new topical drug for the treatment of diabetic foot ulcers. Regranex is a biotech drug that contains a growth factor that stimulates the growth of new tissue. The growth factor is taken or derived from a blood cell (platelet). Regranex is to be applied as directed once daily to the ulcer. It should be used in the instructed amount and using more of the gel does not improve healing. Regranex by itself is not a cure. The drug is to be used only as an additive to proper foot care including timely dressing changes, removal of dead skin, and reduced use of the affected foot (or no use of the foot in some cases).   Regranex should be kept in the refrigerator.

Floxin otic (ofloxacin) is a new antibiotic ear drop. It is the first new antibiotic ear drop to hit the market in over 20 years. Floxin otic is to be used twice a day for 10 to 14 days and is approved for external ear infections, acute middle ear infections in children with tubes, and otitis media in teens and adults with perforated ear drums. Floxin should be slightly warmed by holding the bottle in the hands or close to the body. Warming the drops prevents the potential for dizziness that can sometimes occur by instilling cold drops. Floxin is a broad spectrum antibiotic that is very effective. It should be a major factor in the rising rate of ear infections.Cipro HC (ciprofloxcin/hydrocortisone) ear solution will also be available soon.

Propecia (finasteride) the new male baldness pill from Merck is receiving a lot of publicity. Propecia is actually the same drug (finasteride) as Proscar, which has been used for years for the treatment of an enlarged prostate. Propecia works to prevent hair loss by suppressing a hormone that shrinks hair follicles. Propecia is to be taken once daily and taking more than one pill a day does not improve hair growth. In studies the drug worked for about half the men who used it. The problem is that it may take 6 months to 1 year to find out if it will be effective or not because the drug works very slowly. The main side effects in studies were decreased sex drive and impotence which occurred in about 2% of the men who participated in the studies. This drug is not to be used by women because it can cause birth defects

Fortovase (saquinavir) is a new stronger version of Invirase which is a protease inhibitor for the treatment of HIV. Fortovase and Invirase both contain 200mg of saquinavir but Fortovase is formulated to have a better absorption. Fortovase accomplishes this improved absorption from its special soft gel capsule. Patients have to take more doses of Fortovase, 4 caps three times a day compared to 2 caps three times a day of Invirase. Be aware that Invirase will soon be phased out in favor of the better absorbed Fortovase.

Avapro (irbesartan) tablets from Sanofi, a Bristol Myers Squibb Company, is the latest of the rapidly growing class of angiotensin 2 receptor antagonist for the treatment of high blood pressure. The other drugs in this class are Cozier and Diovan. Avapro works by reducing angiotensin 2 formation in our bodies. Angiotensin 2 is a chemical in our bodies known to cause vasoconstriction which can lead to high blood pressure, fluid retention, and heart problems. Avapro does not work on ACE (angiotensin 2 converting enzyme) the enzyme involved in the formation of angiotensin. By working directly on angiotensin 2 and not on ACE, Avapro causes fewer side effects than the ACE inhibitors such as Vasotec, Zestril, and Lotensin. Avapro is given once daily is indicated as a first line therapy for hypertension. Avapro is a very safe drug with no known drug interactions and a side effect profile similar to sugar pill. The potential side effects were most commonly diarrhea, heartburn, and fatigue.

Requip (ropinirole) joins Mirapex as the second new drug for the treatment of Parkinson's disease this year. Requip like Mirapex is classified as a second generation dopamine agonist that is more selective for dopamine than the earlier Parkinson's drugs such as Permax and Parlodel. Being more selective means the drug is more effective with fewer side effects. Requip can be used as initial therapy to delay the use of levodopa or may be used with levodopa for advanced Parkinson's patients. Requip is dosed on an ascending schedule starting with 0.25mg three times a day and increasing weekly to 1.0mg three times a day at week four. The slow increase in dosage is to help reduce Requip's potential side effects which are most commonly nausea, dizziness, drowsiness, and headaches. Requip like other dopamine drugs can cause movement disorders and hallucinations. For more information on Requip ask your doctor or pharmacist.

Duract (bromfenac sodium) is a new non-steriodal anti-inflammatory drug from Wyeth Labs. While Duract is an anti-inflammatory drug it is being marketed simply as an analgesic (pain reliever). Wyeth claims that Duract which is a non-narcotic drug has the pain reliving power equal to two tablets of the powerful narcotic pain medication Percocet. Duract is also claimed to have an onset of pain relief within 30 minutes while it is said to last 8 hours. Duract should be taken 1 (or 2 in some cases) capsules every 6-8 hours not to exceed 150mg (6 capsules) in 24 hours. Duract is intended to be given only for a short period of time usually less than 2 weeks, but may be given for longer periods of time if it is deemed necessary. The major limitation to long term treatment with Duract is the potential for liver damage. Thus it is recommended that if Duract therapy continues beyond 4 weeks that liver enzymes be monitored. This monitoring will help to identify potential liver damage that may otherwise go undetected. The most common side effect from Duract is GI irritation which can lead to ulceration and perforation. Although Duract works better when it is not taken with food if GI irritation is normally a problem it is recommended that Duract be taken with food to reduce this irritation. Other adverse effects from Duract may include constipation, diarrhea, gas, nausea, dizziness, sleeplessness, and headache. Duract should be used with caution in people with preexisting liver problems, GI problems, kidney problems, fluid problems, blood problems, asthma, and pregnancy. Duract may interact with Tagamet (OTC and RX), Lithium, Dilantin, and Coumadin.

You asked for it so here is a comprehensive look at Mirapex (pramipexole dihydrochloride). The benefit of Mirapex from UpJohn in Parkinson's disease is believed to be related to its ability to stimulate dopamine receptors in the striatum (portion of the brain). Mirapex can be used in early or advanced stages of Parkinson's disease with or without levodopa. Mirapex studies were based on the UPDRS or Unified Parkinson's Disease Ration Scale which is broken down into four parts. Part 1 is intended to evaluate the mental aspects, part 2 includes daily living, part 3 is designed to assess motor performance(tremor, rigidity, bradykinesia, postural instability ect.), and part 4 evaluates the complications of therapy. The studies proved a significant difference using this scale as the measurement after six months of treatment for patients using Mirapex versus a sugar pill (placebo). Mirapex is dosed three times a day to achieve a total daily dose of 1.5mg to 4.5mg. Dosage should be slowly increased to the total daily dose based on the doctors orders to avoid adverse reactions and orthostatic hypotension or severe dizziness and syncope. Mirapex can be taken with or without food although food can slow absorption but not decrease the amount of absorption. Dosing changes are needed based on age and weight and especially for those with renal insufficiency because the drug is 90% eliminated in the urine. Hepatic (liver) insufficiency does not necessarily require a dosage adjustment. Adverse reactions from Mirapex were orthostatic hypotension (dizziness), hallucinations (9% in patients with early Parkinson's disease and 16.5% in patients with the advanced disease and taking levodopa...in studies 3% of the patients had to stop the treatment because of severe hallucinations), dyskinesias and extrapyramidal symptoms (involuntary movement disorders), insomnia, dry mouth, arthritis, twitching, confusion, agitation, thirst, eye disorders, urinary difficulties among others. Not everyone will experience all or any of these side effects. Talk to your doctor or pharmacist if you desire more information.

Zyban (bupropion HCl sustained-release tablets) from Glaxo-Welcome is the first non-nicotine tablet indicated as an aid for smoking cessation treatment. The mechanism of action of Zyban is believed to be related to the modification of chemicals in the brain (noradrenergic and dopaminergic mechanisms). This modification enhances the ability of one to abstain from smoking. Zyban is dosed 1 tablet (150mg) twice a day. (note: the normal start up for Zyban is 1 tablet in the morning for 3 days and then 1 tablet twice a day starting on the 4th day.) It is not recommended that more than 300mg be taken a day for smoking cessation because this drug is associated with a dose-dependent risk of seizures. Zyban should not be taken by anyone has a seizure disorder. Zyban should be used for 7 to 12 weeks or according to your doctor's instructions. Patients may smoke while using Zyban although it is best to set a date approximately a week after beginning to Zyban to quit (Zyban begins working in about a week). By setting a date there is a stronger commitment to quit which increases the success of the treatment. Zyban will exert its effects in about a week after the initial dose reducing the cravings for nicotine by the chemical modification described above. In studies 36% of the people taking Zyban quit smoking by the 7th week compared to 17% of the people taking a sugar pill. Zyban may be used with the nicotine patches. The possible side effects from Zyban include dry mouth and difficulty sleeping most commonly while the drug may also cause shakiness, skin rash, nausea, constipation, dizziness, runny nose, difficulty concentrating, anxiety, and nervousness. The most common side effects normally dissipate after the first week or so of treatment, but if they persist or become problemsome contact your doctor or pharmacist. Zyban should not be used by anyone who has a seizure condition, anyone who is currently taking Welbutrin or another antidepressant, a MOAI, or an antipsychotic, or anyone who has a eating disorder (bulimia, anorexia nervosa). Drug interactions with Zyban include antidepressants, antipsychotics, theophylline, certain steroids, carbamazepine, phenytoin, cimetidine, and Phenobarbital. Contact your doctor or pharmacist if desire more information.

Flomax (tamsulosin HCl) is a new a drug for the treatment of benign prostatic hypertrophy (BPH) from Boehringer Ingelhelm. Flomax works to reduce the symptoms of BPH and increase urine flow by selectively blocking the alpha receptors. Flomax was developed specifically for BPH and is not indicated for hypertension like other alpha blockers (Hytrin, Cardura). The recommended dosage of Flomax is 1 capsule (0.4mg) once daily taken approximately half an hour following the same meal each day. Normally a response to Flomax is seen after one week. If treatment fails in 2 to 4 weeks therapy can be changed to 2 capsules (0.8mg) daily. The potential side effects associated with Flomax were orthostatic hypotension (postural hypotension, dizziness, vertigo) including the risk of fainting, headache, back pain, chest pain, difficulty sleeping, a runny nose, diarrhea, and sexual dysfunction. Flomax has the potential to interact with the following drugs: Coumadin, theophylline, Lanoxin (digoxin), Lasix (furosemide), Tagamet (cimetidine). If you desire more information please ask your doctor or pharmacist.

Crinone (progesterone vaginal gel 4%) from Wyeth-Ayerst is new drug approved for the treatment of amenorrhea (no period) in women of reproductive age who have experienced regular cycles in the past. Their is also an 8% formulation that has been approved for use in infertile women with a progesterone deficiency. Crinone prepares the endometrium for pregnancy and helps to maintain a pregnancy and has also demonstrated effectiveness in providing progesterone replacement and supplementation. This drug offers a unique delivery system for progesterone to the endometrium. This system is a bioadhesive gel that comes in prefilled vaginal applicators that provides a sustained release action by binding to vaginal tissue delivering natural progesterone to the endometrium with low levels of systemic absorption. This form of delivery eliminates the pain and inflammation of traditional IM injections of progesterone. The recommended dose of Crinone is twice daily for progesterone replacement and once daily for supplementation or as directed by your doctor. The most common side effects from Crinone include breast enlargement, constipation, difficulty sleeping, nausea, headache, and perineal pain. Crinone should not be used by anyone with undiagnosed vaginal bleeding, liver problems, known or suspected malignancy of the breast or genital organs, missed abortion, active blood or embolic problems, or those with sensitivities to hormones.

Combivir from Glaxo Welcome is the first combination drug to be approved for the treatment of HIV the virus that causes AIDS. The combination tablet contains two of the most widely dispensed antiretroviral prescriptions, AZT (zidovudine or by brand Retrovir) and 3TC (lamivudine or by brand Epivir). Combivir can be dosed twice a day instead of up to eight tablets a day when the two tablets are taken separately.

Diastat (diazepam rectal gel) from Athena neurosciences is now available and is intended to for rectal administration in the management of selected, refractory patients with epilepsy, who are stabilized on drug therapy but require intermittent use of diazepam to control bouts of increased seizure activity (clusters). Diastat is intended to be used by the caregiver in the live-in setting to control clusters thus avoiding the requirement of emergency treatment at a medical facility. Diastat is uniquely formulated in a rectal gel that is administered easily by a ready-to-use, prefilled syringe that is available in unit dose strengths ranging from pediatric to adult. The administration of Diastat reduces the seizure frequency and also reduces the likelihood of additional events that could occur within a cluster. For more information ask a pharmacist. Only your doctor can determine if Diastat is right for your situation.

Renova (tretinoin emollinet cream) is a new cream from Ortho Pharmaceuticals that is very similar to the acne cream Retin-A also containing the retinoid "tretinion" which is a derivative of vitamin A. Although the chemical in these drugs is similar Renova is being marketed as a drug for photodamage instead of acne. Renova is clinically proven to treat fine wrinkles, hyperpigmentation, and surface roughness when combined with comprehensive skin protection and sun avoidance techniques (sunscreens, protective clothing). Renova is better formulated to be applied to drier and aged skin (Renova is a water-in-oil emulsion) while Retin A is designed to be used on young, oily (acne) skin. Ask your doctor or pharmacist if you desire more information on Renova.

Tazorac (tazarotene topical gel) is a new drug from Allergan that is indicated for the topical treatment of patients with psoriasis. Tazorac is also indicated for the treatment of patients with facial acne of mild to moderated severity. The main side effects from Tazorac were drying, itching, pain, and erythema. If you suffer from acne or psoriasis talk to your doctor about using Tazorac as an alternative.

Look for another "statin" cholesterol lowering drug to be released soon. Baycol (cerivastatin sodium) is the newest of the growing line of HMG-Co A reducatse inhibitors (others Lipitor, Mevacor, Pravachol, Zocor, and Lescol). Baycol from Bayer Pharmaceuticals is a once a day cholesterol lowing drug that has shown to cause up to a 28% reduction in LDL cholesterol, a 13% reduction in triglycerides, and a 10% increase in HDL cholesterol. The main action of the "statins" is to reduce the amount of cholesterol made in the liver by inhibiting enzymes that are involved in the production of cholesterol.

Posicor (mibefradil) is a new calcium channel blocker from Roche Pharmaceuticals. Posicor offers an advantage over other calcium channel blockers in that it blocks two types of calcium channels while other drugs only block one. Posicor is available for the treatment of both blood pressure and chronic stable angina. It is reported to lower blood pressure without weakening the heart's force of contraction.

Galzin (zinc acetate) is an orphan drug for the long term treatment of Wilson's disease. This is an inherited disease in which patients are unable to excrete copper which accumulates in the brain and the liver and can be potentially fatal. Galzin works by preventing the absorption and reabsorption of copper from the gut thus leading to lower levels of copper in the body.

Coreg (carvedilol) is a new beta-blocker class drug used to treat congestive heart failure (CHF). It is the first beta blocker to be approved to treat CHF or heart failure normally doctors prescribe Lanoxin or ACE inhibitors. But studies have shown that adding Coreg to Lanoxin and an ACE inhibitor can actually slow the progression of heart failure and improve survival. Coreg works by causing vasodilatation and blocking excessive stimulation that causes an overload of work on the heart. Only your doctor will know if Coreg is right for you.

Zyflo (zileuton) is a new oral prescription medication from Abbott Laboratories for the added control of asthma. This drug is similar to another new asthma drug called Accolate from Zeneca which inhibits leukotrienes. Zyflo works to inhibit leukotrienes by actually inhibiting precursors and enzymes which lead to the formation of these leukotrienes. What are theses leukotrienes? Well these are chemicals that lead to airway inflammation and the closing of airways which cause the difficulty of breathing in asthma. Remember that Zyflo is not meant to help during an asthma attack (only your emergency inhaler can do this), but rather this drug is meant to be taken everyday to help control and prevent future asthma attacks. Zyflo is generally a safe drug, but is not meant for people who have liver trouble. Ask your doctor or pharmacist for more information on Zyflo.

Zanaflex (tizanidine hydrochloride) from Athena Neurosciences is a new prescription medication for the relief of muscle spasticity. This drug relieves muscle hyperactivity or spasms by stimulating receptors that increase inhibition of muscle tone. The drug works in the central nervous system and thus can cause drowsiness and alterations of mood. Also Zanaflex can cause dizziness, hypotension, and an increase in liver function tests. Tell your doctor or pharmacist if you have any cardiovascular, liver, ophthalmic, or kidney problems before using Zanaflex. Women taking oral contraceptives should also be careful using Zanaflex. For more information contact your doctor or pharmacist.

There is a new alternative for smokers wishing to kick the habit, the Nicotrol Inhaler. The inhaler consists of a two part mouthpiece in which a nicotine plug that is inserted between the two pieces. The smoker puts the mouthpiece in the mouth just like a cigarette giving this device an advantage over the patches and gum. That advantage is obvious in that it allows smokers to continue in the hand to mouth routine that many smokers have trouble with during quitting because the smoker in all senses "smokes" the inhaler. The Nicotrol inhaler will only be available by prescription and is due out soon so talk to your doctor for more information.

Aphthasol (amlexanox oral paste) is new drug for the treatment of canker sores. This is the first prescription medication for this use. Unlike fever blisters or cold sores, canker sores are not caused by a virus so an antiviral drug like Zovirax won't help to heal them. Aphthasol works to reduce inflammation and the allergic reaction believed to be involved in canker sores by inhibiting chemicals that cause this reaction like histamine and leukotrienes and this leads to faster healing along with pain relief. Aphthasol is due out in the fall.

Look for a new obesity drug to be out soon. The drug will carry the trade name Xenical (orlistat) and is being manufactured by Roche Pharmaceuticals. Xenical is unlike the other diet drugs like the popular Phen-Fen treatment which are appetite suppressants. Xenical is a lipase inhibitor or a fat blocker. Lipase is the enzyme in our bodies that breaks down fats to be absorbed so by inhibiting this enzyme the drug can reduce the amount of fat absorbed by up to 30%. Xenical has also shown to cause a slight DECREASE in blood pressure, blood sugar, and cholesterol. More news on this drug when it becomes available.

Zyban (bupropion HCL) from Glaxo-Welcome is the first non-nicotine treatment for smoking addiction to be approved by the FDA. Zyban works to increase certain chemicals in our bodies that nicotine would also increase. So smokers get the feeling of having nicotine without the the dangerous chemicals in cigarettes. Zyban is actually the same as Glaxo-Welcome's antidepressant drug with the name of Wellbutrin.

Stromectol (ivermectin) from Merck is a new antiparasitic agent. It is used to treat only certain parasites such as strongyloidiasis (roundworm) and onchocerciasis. Stromectol can treat most of these type of infections with a single dose. This marks a great advantage to patients with a weak immune system who would suffer greatly from a parasitic infection.

Denavir (penciclovir) is a new cream from SmithKline Beecham that is approved for the treatment of recurrent cold sores. It is a new alternative to Zovirax. Denavir is an antiviral that should be applied every 2 hours for 4 straight days. Studies have shown that Denavir can heal cold sores in an average of 4 days when applied early on in the development of the sore.

Amaryl (glimepiride) from Hoechst, Marion, Roussel is a new second generation sulfonylurea for the treatment of type 2 diabetes (adult onset, non-insulin dependent). Amaryl works to decrease blood glucose concentrations by stimulating the release of insulin from the pancreas while increasing the ability of body to use this insulin. Amaryl is to be taken once daily with a meal and is meant to be a adjunct to diet and exercise in the treatment of type 2 diabetes. For more information ask your doctor or pharmacist.

Condylox Gel (podofilox) is an improvement of the older form of Condylox which was a solution. Condylox is used to treat external genital warts. With the introduction of Condylox gel patients can now treat both genital and perianal warts with simple finger tip application.

Norco from Watson Labs is a new combination of hydrocodone and Tylenol used for pain management. This combination includes 10 mg of hydrocodone and 325 mg of acetaminophen which has the advantage over other pain medications in that it contains the highest single tablet dose of hydrocodone and the lowest level of acetaminophen in all 10 mg hydrocodone tablets. This can help those who are unable to have the large amounts of Tylenol because of liver problems but enables them to have a large amount of hydrocodone to control severe pain.

Viracept (nelfinavir mesylate) from Agouron Pharmaceuticals is another new anti-viral drug for the treatment of HIV infections. Viracept makes the fourth HIV protease inhibitor to be approved and joins Crixivan, Invirase and Norvir. Viracept along with the other protease inhibitors are to be used in combination with other HIV drugs permitting this combination to fight the virus using different mechanisms. Combination treatments with protease inhibitors are showing promising initial results including lowering the virus below detectable levels. Viracept is approved to treat both adults and children and is available in a pediatric powder. The side effect profile of Viracept includes nausea and diarrhea. For more information on this drug ask your doctor or pharmacist.

Skelid (tiludronate disodium) from Sanofi is a new drug for the treatment of Paget's disease. Symptoms of Paget's disease which is a chronic bone disease are similar to that of arthritis which are painful, aching bones. Skelid is classified as a biphosphonate drug similar to another drug used to treat Paget's disease Didronel (etidronate). Skelid, though, is considered more powerful and the treatment time versus Didronel is shorter. Skelid works by inhibiting bone breakdown which occurs in Paget's disease leading to abnormal formation of a weakened, enlarged bone. For more information of Skelid ask your doctor or pharmacist.

Alora (estradiol transdermal system) is a new estrogen patch from Proctor and Gamble for the treatment of menopausal side effects. Alora is beginning tagged as the "consistent, well tolerated" patch. Studies with Alora have shown that day 4 on the patch is equally as effective as day 1 after 2-3 weeks of therapy. This patch also offers three convenient sites of application unlike the others. Those sites include the lower abdomen, the hip, and the buttocks. The most common side effects from Alora are headache, infection, and vaginal bleeding.

Flomax (tamsulosin) from Boehringer Ingelheim is a new drug for the treatment of benign prostatic hyperplasia (BPH) or an enlarged prostate. Flomax is a alpha antagonist that is similar to other drugs used to treat both blood pressure and BPH (Hytrin and Cardura). Flomax is not indicated to the treatment of blood pressure. Flomax has shown to provide some relief of the symptoms of BPH within a week of beginning therapy. Expect Flomax to cause significant dizziness and drowsiness upon beginning therapy. For more information contact your doctor or ask a pharmacist.

Fosamax (alendronate) from Merck has received a new indication to prevent bone loss or osteoporosis. The new 5 mg tablets may be given once daily to post menopausal women to prevent the onset of osteoporosis. Be aware that Fosamax must be taken in a special way. Fosamax is intended to be taken first thing in the morning with a big glass of water 30 minutes before eating and without lying down for at least 30 minutes. This special way of taking Fosamax ensures proper absorption of the drug. For more information contact your doctor or pharmacist.

Monurol (fosfomycin tromethamine) from Forest Pharmaceuticals is a new single dose treatment for a urinary tract infection (UTI). Monurol represents the only one-time treatment for UTIs and has been used and proven effective in many over 11 million cases in Europe. Monurol comes as a sachet or pouch full of powdered drug that should be mixed in water before ingestion. Monurol is not effective in all types of UTI, but only in adults (18 and older) with an uncomplicated urinary tract infection. Monurol has a good safety profile with the most common side effects being diarrhea and vaginitis although it should not be used in pregnant women. Ask your doctor or pharmacist for more information.

Alesse from Wyeth is another new birth control pill alternative. It is a new low dose contraceptive. It contains just 20 mcg of an estrogen component (ethinyl estradiol) and 100 mcg of a progesterone component (levonorgestrel). In fact Alesse has 1/3 less estrogen than Nordette but is considered to be just as effective and less estrogen means less nausea, vomiting, and other irritations.

More news on the new birth control pill Estrostep which represents an entirely new class of oral contraceptives. As reported earlier on the WEEKLY PHARMACY UPDATE Estrostep provides a constant amount of progesterone in the form of norethindrone acetate while having an increasing amount of estrogen in the form of ethinyl estradiol. This new class of oral contraceptives more closely mimics the woman's nautral cycle and thus should produce less side effects. Most of the undesirable side effects such as formation of blood clots leading possible strokes and heart attacks is from the estrogen component in oral contraceptives and thus lower doses of estrogen are desired. The manufacturer of Estrostep, Parke-Davis, reported the incidence of side effects such as nausea, vomiting, and headaches from this pill is less than 1 percent. If you are considering beginning the pill or are having trouble maintaining your current oral contraceptive therapy ask your doctor if the well tolerate Estrostep oral contraceptive is right for you. Remember there are still dangerous with Estrostep as with all oral contraceptives such as blood clots, strokes, ect.

Patanol (olopatadine HCl 1%) is a new eye preparation from Alcon. This drug is used for temporary relief and prevention from itchy, watery eyes from allergies. Patanol is an antihistamine and mast cell stabilizer (cells that release histamines that cause allergic reactions) and thus can provide fast relief in fact it may provide relief in minutes and work for upto eight hours. If you have allergies that lead to irritations in your eyes talk to your doctor about Patanol.

Astelin (azelastine HCl) from Wallace is a new prescription nasal spray for the treatment of allergies that lead to a runny nose, and itchy nose and sneezing. It is approved for children 12 and older as well as adults. It should be used by spraying two puffs in each nostril twice daily during allergy season. Astelin works by inhibiting histamines and other chemicals that lead to swelling and allergies. Adverse reactions from Astelin are rare but may include nasal irritation, a drying effect in the mouth, eyes, and nose and the possibility of nausea/vomiting. An oral form of this drug may also be available soon.

Rezulin (troglitazone) tablets from Parke-Davis is the first of a new class of drugs used for type 2 diabetics who have to use insulin. Type 2 diabetes is also called "adult onset diabetes" and differs from type 1 diabetes, which is child onset diabetes, in that people with type 2 diabetes normally have a functional pancreas which produces insulin. Type 1 diabetics usually do not produce insulin. People with type 2 diabetes problem is that the insulin that is made is not enough or the body just is unable to use the insulin that is made by the pancreas for various reasons. This drug is then given to type 2 diabetics that require insulin injections to help them to be able to utilize insulin in the body. Rezulin does this by improving insulin sensitivity in muscles and fat tissues and also reduces the amount of glucose produced in the liver so that the need for additional insulin is reduced or eliminated. THIS DRUG HAS BEEN PULLED FROM THE MARKET.

Proventil HFA (albuterol sulfate) from Key Pharmaceuticals is new oral meter dosed inhaler for the relief of asthma. Actually it is not a new drug, but rather a new delivery system. This inhaler delivery system contains a non-CFC propellant (remember CFCs have been shown to be dangerous to our ozone). If you have asthma or require the use of albuterol you may consider asking your doctor about the environmental friendly inhaler Proventil HFA. If you do not have insurance that pays for your medications Proventil HFA may not be such a great choice. There is no generic for it and it is more expensive than the CFC containing inhalers and much more expensive than the generic albuterol inhaler.

Estrostep (norethindrone acetate and ethinyl estradiol tablets in an estrophasic regimen) is the first of a new class of oral contraceptives or birth control pills. Estrostep varies from other birth control pills in that it provides a gradual increase of estrogen over 21 days with a constant dose of progestrogen. Ask your doctor about whether Estrostep is right for you.

Lexxel (Astra Merck) is a new combination anti-hypertensive drug that combines an ACE Inhibitor (in this cause enalapril maleate or by brand Vasotec) and a calcium channel blocker (felodipine or Plendil). Studies have shown that this combination has more benefical effect than either of the two drugs alone. Other drugs that include this combination are Tarka (Knoll Pharmaceuticals), Teczem (Merck), and Lotrel.

Allegra (fexofenadine) is a new non-sedating antihistamine from Hoechst Marion Roussel. Allegra is actually an improvement on the company's first antihistamine Seldane. Allegra doesn't appear to have the dangerous side effects of cardiac arrhythmias when mixed with other drugs such as Nizoral, Sporanox, Diflucan, and the erythromycins like Seldane, but is just as effective in providing antihistamine activity without drowsiness.

If you desire more information Ask a Pharmacist or check out the AllerDays Allergy Resource Center

Redux (dexfenfluramine) from Wyeth Labs is a new prescription weight-control/loss medication. This is half of the popular fen-phen diet that is sweeping the United States. Redux is replacing the older diet pill Pondimin (fenfluramine) because it is dosed less frequently and is considered stronger. You will notice that the generic names of Redux and Pondimin are vary similar that is because the drugs are actually sisters. Redux is what they call an isomer of Pondimin that has been discovered to be stronger. A lot of people are losing weight using Redux (or Pondimin) in combination with the drug phentermine (various brand names including Fastin, Adipex-P, ect). The combination of these two is considered complementary. Redux's action in providing weight control is to modify a chemical in the body called serotonin, its action is to increase this chemical similar to anti-depressant drugs such as Prozac or Zoloft. Note these diet pills should be used with caution or not at all with certain Antidepressant pills. For a complete list a drug interactions with the diet pills. This action is thought to decrease a person's appetite. Phentermine drugs enhance the activity of chemicals called catecholamines. This action provides increased metabolism. So this combination provides for effective weight control. Most people will lose weight will taking these pills thus decreasing the risk of diabetes and heart disease, but unless a lifestyle modification occurs the weight will come back after the pills are stopped. Life style modifications include a reduced calorie diet and a regular program of physical exercise. Of course talk to your doctor before beginning an exercise program. THIS PRODUCT IS NO LONGER AVAILABLE IN THE US.

Redux therapy does have some risks especially for those with high blood pressure because the phen-fen treatment with Redux can elevate blood pressure even further. Redux is most known to cause an increase in pulmonary hypertension that can cause lung damage and difficulty in breathing. While these are less common side effects, the more common side effects include insomnia, fatigue, general weakness, headache, and depression.

Claritin a popular prescription non-drowsy antihistamine has introduced a new dosage form called reditabs. Claritin reditabs are designed to dissolve almost instantly when placed on the tongue and are great idea for children (approved for children 6 and older) with allergies. This dosage form is fun to use and doesn't require swallowing a pill and a liquid that doesn't taste so great. Ask your doctor or pharmacist about Claritin.

Accolate (zafirlukast) from Zeneca is the first of a new class of drugs for the treatment of asthma. This drug is a pill that is taken by mouth. It is designed to stop chemicals in the body called lukotrienes from causing inflammation. Asthma after all is an inflammatory process that reduces one's capacity to hold oxygen. In studies patients using Accolate had improved daytime symptoms, decreased nighttime awakenings, and did not require the use of their rescue inhalers (Proventil, Ventolin, or albuterol) as much. Accolate does not cure asthma, but can improve asthma symptoms in patients usually in one week after starting therapy. Patients should still carry their rescue inhalers with them always to protect them in an acute asthma attack. Adverse effects from Accolate include headache, infections (usually respiratory in nature), nausea, and diarrhea. Accolate should be used with caution in patients with liver problems. If you are interested in Accolate talk to your doctor about getting a prescription. If you have further questions about Accolate ask a pharmacist.

Lodine XL (etodolac extended-release tablets) from Wyeth is now available. Lodine XL is simply a new extended-release form of Lodine which is in the class of drugs called NSAIDs (non-steriodal anti-inflammatory drugs) that are used to treat any type of inflammation especially those involved in arthritis or bursitis. NSAIDs are also used to treat the pain associated with inflammatory injuries. Lodine XL has several advantages over Lodine. Most obviously is that it only has to be taken once daily instead of two to three times like Lodine. The other advantage is that it could save you money over Lodine or another brand name NSAID that you may be taking. Ask your doctor about a prescription for Lodine XL or ask your pharmacist if it will be less expensive for you to take Lodine XL. Note: Lodine is now available as a generic which may save you more money over Lodine and Lodine XL.

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4/28/97