Weekly Pharmacy Updates...
History Files.
"Pharmacy News and Notes and OTC History"

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 closer to the top. NOTE These are HISTORY FILES and may not contain the most accurate up to date information on prescription medications.

Look for generic Cataflam (diclofenac potassium) to be available soon. Cataflam is an NSAID indicated for acute and chronic treatment of signs and symptoms of rheumatoid and osteo arthritis along with the management of pain and dysmenorrhea. Always ask your pharmacist for money saving generic equivalents.

Good news for heart patients wanting to try out Viagra, the new drug for male impotency. A new report from the American College of Cardiology and the American Heart Association will give recommendations for the use of Viagra in patients with heart disease. The report though will include cautions about using the impotence drug in patients with angina, congestive heart failure with low blood pressure, and patients using multiple drugs for hypertension. These patients are at a higher risk for a serious drop in blood pressure or a heart attack after using Viagra. Remember not to mix nitrates (nitroglycerin) with Viagra. Wait at least 24 hours after Viagra use before using a nitrate. Talk to your doctor about using Viagra and about alternatives to nitrates for angina such as a beta blocker drug.

There is a new UTI test on the market called Azo Test Strips. This test kit is similar to the one doctors use because it test for both nitrites and white blood cells while earlier OTC test kits only tested for nitrites.

Monistat now has a OTC 1 day treatment for vaginal yeast infections. Monistat 1 contains tioconazole, not miconazole like the other Monistat products. Ticonazole is the same ingredient in Vagistat 1. Remember both of these products do not cure the infection in just 1 day, but rather you only treat the infection for one day while the symptoms will not clear up for several days.

Merck and Company are currently testing their popular cholesterol lowering agent Mevacor for a potential RX to OTC switch. Merck must prove that Mevacor in a lower OTC dose would be not only safe, but effective. Should the FDA allow the switch it would not be for some time now.

There is some early evidence that Vitamin B2 (Riboflavin) may help prevent migraine headaches. The studies that are going are 400mg of vitamin B2 daily which is nearly 200 times the RDA, but toxicity doesn't seem to be a problem with this dose in patients that have normal kidney and liver function. In studies the vitamin taken daily has reduced headache frequency from 4 episodes a month to 2 per month. The vitamin takes about 3 or 4 months to begin working.

For some time it has been thought that SSRI antidepressant drugs (Paxil, Luvox, Prozac, Zoloft) caused weight loss. In fact some people were combining phentermine and an SSRI such as Prozac to form "Phen-Pro" to lose weight. Now comes word that SSRI drugs can cause weight gain. It seems that the weight loss from these drugs is only temporary and due to the inital nausea and anorexia from the SSRI.

You will be hearing a lot about a new class of pain relievers that will take the market by storm early next year. The class is called COX-2 specific inhibitors. This new class is improvement on the NSAID class of drugs (Cataflam, Ibuprofen, Daypro, Naproxen, ect) that have been on the market for years. These new COX-2 inhibitors reduce pain and inflammation like NSAIDs do, but they do it with less risk of GI irritations including ulcers and bleeding. The reason why is that these drugs are specific for COX-2 which is a chemical that is responsible for producing other chemicals which cause pain and inflammation. NSAIDs and aspirin also inhibit this COX-2 but they are not specific so they also inhibit COX-1 which the chemical responsible for protecting the GI from irritations.

New warning are being issued about Propulsid (cisapride) a drug that is used for certain stomach irritations and motility problems. This drug has the potential to cause serious heart arrhythmias in patients with certain predisposing factors and/or when the drug is mixed with certain other medicines. Some of the arrhythmias have even lead to deaths. Propulsid should not be mixed with erythromycin, Biaxin (clarithromycin), Diflucan (fluconazole), Sporanox (itraconazole), Nizoral (ketoconazole), and certain drugs for the treatment of the HIV infection. Propulsid should be used with caution or probably not at all  in patients who are using antiarrhythmic drugs or problems associated with the heart that may increase the chances of an arrhythmia. Ask your pharmacist or doctor for more information.

6/22/98...Wyeth-Ayerst Laboratories has started the voluntary withdrawal of their short term pain management drug Duract. Wyeth sites Duract causing liver damage leading to 4 deaths and the requirement of 8 liver transplants as the reason Duract is being pulled from the market. Duract came on the market with a warning of potential liver damage and later Wyeth changed their labeling to include a stern warning about liver toxicity in Duract treatment. Wyeth sites that those who have used Duract for the recommended short term (10-14 day) treatment have had little to no problems during the therapy, but point out that those who have ignored the warning about long term use have encountered liver damage. Wyeth encourages those with questions about Duract to call 1-800-281-9260.

6/8/98...Roche Labs announced that they are pulling Posicor off the market because of potentially dangerous drug interactions. “PATIENTS should promptly consult with their physicians about appropriate alternative therapy,” the FDA said. “In addition, patients now taking Posicor should not add any new medication to their current treatment without consulting their physicians.” If you are currently on Posicor therapy you should consult your doctor immediately for an alternative therapy. Do not stop taking Posicor until you speak to your doctor.

Tegertol suspension (carbamazepine) should not be administered with other liquid medicines of any type. This new finding comes after a recent interaction between Tegertol suspension and Thorazine (chlorpromazine) solution. The Tegertol suspension was given just before the Thorazine solution and the patient who was administered these two drugs passed an orange rubbery mass in their stool. This finding was also see with other liquid medicines that were given in close proximity to Tegertol suspension resulting in this warning. This only occurs with the liquid Tegertol not the tablets.

Enamelon Anticavity Fluoride Toothpaste is now available. This toothpaste contains soluble calcium and phosphate and is formulated to help strengthen the tooth enamel by enhancing remineralization activity of fluoride, stopping cavities before they begin.

Effervesent Zantac will soon be available. This marks the first OTC effervescent H2 antagonist. Look for more effervescent acid blockers (H2 antagonist) to follow.

Venastat is a new OTC herbal supplement to help relieve leg swelling due to varicose veins. Venstat contains chestnut seed extract which is approved in Germany for treating venous insufficiency and varicose veins. It is to be taken twice a day with results in 4-8 weeks.

New generics are now available for Capozide and Cordarone. Ask your pharmacist about these cost saving generically equivalent products.

Look for an addition to the Novartis Pharmaceuticals Diovan (valsartan) line soon. Diovan HCT will soon be available in a once a day dose of 80 mg and 160 mg combined with 12.5 mg of the diuretic hyrdochlorthiazide.

DDAVP tablets can now be used for bedwetting rather than the nasal spray. This offers a more convienent dosage form for those who need the antidiuretic hormone. The usual dose is 0.2mg orally at bedtime but it can be increased to 0.6mg if needed.

The FDA has asked Wyeth the makers of Duract (bromfenac sodium) to include a box warning on their packing of the pain reliever to increase the awareness of the potential liver damage associated with long term use of the drug. Duract is indicated for short term management of pain which is defined as 10 days or less and using the drug longer than this has resulted in hepatitis and liver failure according to the FDA. The drug may be used for longer than 10 days if liver enzyme monitoring is done frequently during the course of treatment ensuring that liver damage is not occurring.

Differin (adapalene) solution 0.1% is now available joining Differin gel as another topical antiacne formulation. Differin exerts a drying effect for those with oily skin to help reduce acne formation. Differin is also effective for acne on the chest or back.

Nasal-Ease is a new nasal moisturizer spray with zinc gluconate. The nasal spray thus provides a soothing protective coating and zinc which may help find off germs that lead to colds.

Choice dm Nutrition Bars are another option for diabetes who need to eat healthy foods at regular times to maintain blood sugar levels. The bars which are available in Peanutty Chocolate and Fudge  Brownie contain a resistant start which acts as a controlled release source of carbohydrates.

Radiance is a new once-a-day multi vitamin and mineral complex with antioxidants and herbs. Radiance provides a great alternative to those who want a single pill that contains a little of everything.

The FDA has issued new warnings about Hismanal causing potentially life threatening reactions when used with other prescription medicines. The new labeling on Hismanal will include warning against using the antihistamine with Posicor, Biaxin, TAO, Zyflo, and certain protease inhibitors and SSRI antidepressants.

Betadine Antibiotic Plus is a new OTC ointment that will contain the beatdine antibiotic plus the pain reliever pramoxine HCl. This product is following suit with Neosporin Plus which came out last year.

Citrol oral spray is a new product that is formulated to help reduce the desire to smoke. Citrol is a dietary supplement containing citric acid that when sprayed to the back of the throat is believed to mimic the throat sensations produced when smoking. Citrol contains no nicotine and is not intended to be a nicotine replacement.

The government is proposing an increase in the recommendation of calcium of vitamin D intake for adults and especially people over 50 to help prevent the risk of osteoporosis. The new recommendation is 1000mg/day of elemental calcium for adults and 1200mg/day for people over 50.The new vitamin D recommendation is 400 IU/day for adults and 600 IU/day for people over 50.

Men one day may take estrogen as a heart protectant. A recent study conducted in 20 middle aged men suggests that estrogen may prevent heart disease in men by increasing blood flow to the heart. Research is now underway to develop a non-feminizing estrogen product.

Transderm Scop (scopolamine) has been approved for the prevention of nausea and vomiting associated with opiods and anesthesia. So now there is an alternative to pills and suppositories, a patch for nausea and vomiting.

Hoechst Marion Roussel Pharmaceuticals has announced that they will discontinue production of the non-sedating antihistamines Seldane and Seldane-D on February 1, 1998. Seldane (terfenadine) was the first of the line of non-sedating antihistamines now available but has fallen out of favor because of its dangerous interactions with other medications. This was an easy decision for the the pharmaceutical manufacturer who now will turn to marketing their newest non-sedating antihistamine Allegra which is the active metabolite of Seldane. Although Allegra is related to Seldane it lacks the dangerous drug interactions.

Novartis Pharmaceuticals the maker of the oral antifungal drug Lamisil has been approved to market Lamisil Solution. This new solution comes in a 30ml non-aerosol pump bottle. The solution is approved for the treatment of ringworm (tinea corporis), athlete's foot (tinea pedis), jock itch (tinea cruris), along with tinea versicolor. The solution is to be sprayed to the effected areas twice daily for one week when treating tinea pedis and versicolor, and once daily for 7 days when treating tinea cruris and corporis.

The maker of Rezulin, Parke-Davis, are warning patients that the drug may cause liver toxicity. There are numerous (~35) reports from patients taking Rezulin of liver damage including one that resulted in a liver transplant and one resulting in a death. Symptoms to be aware of if you are taking the drug that liver damage may be occurring are abdominal pain, fatigue, dark urine, nausea, and jaundice.

Look for two new oral drugs next year for the treatment of impotence. These drugs don't directly cause an erection like MUSE or Caverject, but facilitate an erection. The two new drugs are Viagra and Vasomax. Viagra will be available from Pfizer Pharmaceuticals probably by the spring of 98. This drug was originally studied for the treatment of angina but during tests men reported that it improved their erections. Vasomax is an oral form of a vasodilating drug that is commonly given by injection for impotence.Vasomax is expected to be available by the end of 1998.

Migraine relief may just be a spray away with new Imitrex (sumatriptan) nasal spray from Glaxo Welcome. Imitrex nasal spray is now available in a ready to use unit that is non-narcotic and non-sedating.

The popular Scopolamine (Transderm Scop) patch is returning to the market and is expected to be available by November. The patch returns after a three year absence from the market after the company voluntarily withdrew the product because of quality assurance problems. The patch should not be used in by those who have glaucoma or difficulty urinating. The patch may cause drowsiness in some people. Transderm Scop will only be available by prescription.

Two new OTC products you may be hearing about are Evolve and Cardiem which lower cholesterol. These products contain the same active ingredients which are tocotrienols. Tocotrienols are found in rice bran and palm oil and they resemble alpha tocopherol which is Vitamin E. Both tocotrienol and alpha tocopherol are antioxidants. Evolve and Cardiem work by decreasing the activity of an enzyme called HMG-CoA reducatase that is involved in the production of cholesterol. This is the same way that the "statin" prescription cholesterol pills (Mevacor, Lipitor, Zocor, Lescol, Pravachol) work. Talk to your doctor about using one of these products to help lower your cholesterol.

Vitamin E is a popular antioxidant and is also getting a lot of attention lately for its use in heart disease, Alzeheimer's, and Parkinson's. The problem with Vitamin E is that their are so many forms of it. Most people think that natural is better and pay extra money to get a natural vitamin compared to a synthetic one. But in the case of Vitamin E the natural and the synthetic are the same. The natural does contain more of the d-alpha tocopherol which is more proven to more active than the l-alpha tochopherol. The synthetic form of Vitamin E is a mixture of both d and l tocopherol, but the key is that both the synthetic and the natural forms are standardized by the I.U. you see on the bottle. The I.U. stands for international units and means that if you by a natural Vitamin E with 400 I.U. on bottle you are not getting more Vitamin E than a synthetic Vitamin E 400 I.U. because they are standardized to be the same. Now with all that said the latest news says that mixed alpha tocopherols (natural or synthetic it doesn't matter) may be the best bet to use. The mixed tochopherol Vitamin E contains not only the d and l forms of tocopherol, but many other forms that are found in foods.

Vitamin D may be useful for some people suffering from psoriasis. Most who have tried using oral Vitamin D have reported an improvement in psoriasis symptoms within months of taking the supplement. Topical Vitamin D may also be helpful in reducing inflammation, epidermal proliferation, and keratinization. Before you start a supplement of Vitamin D though, be warned that Vitamin D is a fat soluble vitamin and thus has a potential for toxicity. With this in mind those who wish to take a supplement of Vitamin D should not exceed 800-1200 IU for long periods of time within the doctor's consent.

One popular alternative to the phen-fen diet plan is the combination of St. John's Wort, which works like Redux and Pondimin (on seritonin), along with Ma huang, or ephedra which is a herbal stimulant that suppress appetite (like phentermine). This combination seems to be working, but be warned that ephedra (ephedrine) can and has cause dangerous side effects and even death. A few recent studies have suggested the use of Prozac (which modifies seritonin like Redux, and Pondimin) and phentermine together (phen-Pro). This combination has shown to be effective, but the manufacturer of Prozac (Lilly) is in disagreement with this combination. There are also numerous other so called alternatives to the phen-fen treatment each with its on unique, and "so called" effective formula. Most of these diet alternatives are not effective and are only good for making your wallet thinner.

St. John's Wort which is getting a lot of publicity these days being labeled as "nature's Prozac". The herbal supplement has shown in studies to be as effective for mild depression as many prescription drugs with fewer side effects. St. John's Wort can also be used for anxiety and insomnia. St. John's Wort works like prescription antidepressants through the prolongation of certain chemicals in the body (serotonin, dopamine, and norepinephrine). St. John's Wort should not be used with prescription antidepressants. The herb may also cause photosensitivity and a dry mouth. St John's Wort may also be added to some popular herbal or OTC diet products to get a natural phen-fen effect.

Novartis the makers of the popular Ex-Lax products has announced that they will reformulate their products to contain the natural laxative senna replacing the controversial ingredient phenolphthalein. The company felt pressure to change their products after the FDA proposed to reclassify phenolphthalein to "not generally recognized as safe and effective" after recent studies have showed that the product caused cancer in lab rats.

The FDA has asked manufacturers of products containing topical diphenhydramine (Benadryl) to change their labels to reflect a proposed rule that would warn patients not to use these products to treat chickenpox, poison ivy, or sunburns that cover large areas of the body. The label changes would also include a warning to not to use these products more frequently than recommended or on oozing or blistered skin or in conjunction with other diphenhydramine containing products such as oral formulations. These proposed changes have been brought on by over use of diphenhydramine leading to toxic levels causing psychosis especially in children. The topical product is absorbed through the skin and spreading the product over large surfaces of the skin leads to more absorption

Two of America's most popular diet drugs have been recalled because of new research showing they can cause dangerous damage to the heart. These drugs were Pondimin (fenfluramine) and Redux (dexfenfluramine). These drugs were given commonly in the popular phen-fen diet plan. Phentermine which is the phen in the phen-fen diet will remain available on the market as it is an old drug that has proven safe through the years. Many people who want to continue on some sort of diet plan may continue to receive phentermine along with some sort of exercise and reduced caloric intake plan which has proven effective. Be sure to check back in the coming months as drug companies will scramble to find a new safer diet pill that will replace Pondimin and Redux in the market place.

New reports show that some antipsychotic drugs can inhibit the in vitro replication of the HIV-1 virus. Test using clozapine and haloperidol have both showed some slow down of the progression of this virus.

The FDA is warning those taking the new asthma pill Accolate (zafirlukast) to look for signs of the Churg-Strauss syndrome. This syndrome is very rare, but can be fatal destroying body organs. The early symptoms of the syndrome are flu-like including fever, muscle aches, and weight loss while the late symptoms include worsening of lung conditions. There is still no evidence to link the syndrome directly to Accolate and the condition occurred only in 6 out of 270,000 patients taking the drug.

Researchers are exploring the possibility that the common housefly may be a carrier of the bacteria Helicobacter pylori, the bacteria responsible for some ulcers and stomach problems.

New generics available NOW include ranitidine (Generic Zantac) and pentoxifylline (Generic Trental) ask your pharmacist about these money saving generics.

Some people are challenging recent reports linking the phen-fen diet to heart valve problems. The argument is focused on the fact that phentermine (the phen in the diet combo) has been around almost 30 years and is not associated with the harsh side effects like pulmonary hypertension or heart disease like Pondimin (fenfluramine) which is known to cause these problems. The summary is that only the fen (Pondimin or Redux) in the phen-fen diet combo is troublesome.

Wyeth Labs the makers of the popular diet pills Pondimin and Redux have developed along with the FDA label changes for these diet pills. The changes to the labels will include a warning about the potentially serious and unusual form of valvular heart disease which has been reported in patients taking Pondimin and phentermine together. These two pills make up the popular diet combination called phen/fen. The symptoms of this disease include difficulty breathing, reduced exercise tolerance and/or swelling of the lower extremities (legs,ankles). The development of this heart problem is not associated with the use of Pondimin or phentermine alone, only when they are used together. The development of valvular heart disease in those using phentermine and Pondimin are inconclusive according to Wyeth although they are now researching this possibility. Redux has not been implicated in the development of this condition when used with phentermine although it will also carry the label warning because Redux and Pondimin are almost identical in chemical structure. Remember Redux has shown to cause primary pulmonary hypertension (PPH) and this condition has very similar symptoms to this valvular heart disease.

A new study conducted in the Netherlands has shown that there is a link between atherosclerosis and Alzheimer's disease. The study showed that people with severe atherosclerosis were three times more likely to have Alzheimer's. The study revealed that subtle changes in the blood vessels of the brain may trigger the nerve degeneration that leads to the development of Alzheimer's disease.

McNeil Consumer Products is soon to begin manufacturing Imodium Advanced. This product will contain loperamide 2mg and simethicone 125 mg. The product is indicated for diarrhea along with bloating, gas, pressure, and cramps.

Stanback Co. is introducing Snap Back Stimulant Powder. One packet of this powder contains as much caffeine as two cups of coffee and the company claims that Snap Back is the fastest-acting alertness aid on the market. Of course caffeine is an addictive drug and all products containing caffeine should be used with caution.

A cardiac monitoring device may soon be available to buy at your local pharmacy. This device called the Personal Heart Device will be available this month for subscribers through Heart Alert, but if everything goes well everyone who desires may be able to get this device soon. The way this device works is during an episode of heart trouble the patient records a 30 second ECG on the device using a rhythm strip and then the patient plays the recording back over the phone to a monitoring center. At this center doctors, nurses, and technicians listen to the rhythm and diagnosis the problem according to the rhythm and the patient's symptoms. The center will, according to the need of the patient, have the ability to contact emergency help and even the patient's physician to help protect the patient's heart from further damage.

There is yet another reason to quit smoking. A study shows that smoking may actually speed up the body's biological clock causing men to go bald and become gray more quickly.

Children suffering from attention deficit hyperactivity disorder (ADHD) are more likely to become addicted to drugs and alcohol. About 15% of all children experiment with drugs and/or alcohol during their teenage years, and of these to experiment those with ADHD are more likely to continue in this abuse. Apparently drugs and alcohol make these children feel more relaxed.

A psychiatrist and professor at the University of California at San Francisco has shown in an open trial that using the herb gingko biloba can reduce sexual dysfunction often experienced with the use of antidepressants. This trial contained six patients in which 5 of 6 were still taking gingko biloba safely and effectively after 2 years. The main side effects seen from taking gingko biloba was GI upset specifically gas, nausea, and diarrhea. The usual dose according to this trial was 60mg twice a day increased slowly to 240mg twice a day. (up to 500mg twice a day has been shown to be safe for those taking antidepressants) Please talk to your prescribing doctor before beginning a new treatment.

If you take a product that contains the herbal stimulant ephedrine you may be in danger. Since 1994 ephedrine products have been linked to over 800 adverse reactions including heart attacks, strokes, and seizures. The FDA is soon expected to put strict limitations on this amphetamine-like compound including a requirement for manufacturers to limit the amount of the stimulant in the products and post warnings of the potential dangers of ephedrine on the products.

You are going to hear a lot about a study that was reported in the Journal of the American Medical Association pertaining to the amino acid homocysteine. The study showed that high blood levels of homocysteine can increase the risk of heart disease as much as cholesterol and smoking. The amino acid homocysteine collects in the blood when the body metabolizes methionine, a protein found in many meats and cheeses. It appears that those at risk to have high homocysteine blood levels are those who are deficient in folic acid. Folic acid, a B vitamin, has shown to help break down homocysteine.

Confide HIV Test has withdrawn from the market due to lack of demand. Shipments of the home test kit ended June 26, but those you still have a test and are seeking results will still be able to obtain the results until August 8. The withdrawal leaves only the Home Access HIV test kits available on the market. This company plans to continue to make their home test kit available.

Prelief is a new dietary supplement that neutralizes the acid in foods. Prelief is added directly to food before ingestion (in a granulate packet) or taken with food as a tablet. Prelief acts instantly and doesn't change the taste of the food. Prelief is tagged as for those who are "food acid intolerant". Prelief is actually calcium glycerphosphate that has been used as a calcium supplement and was recently discovered to be a food-acid neutralizer.

Rogaine (minoxidil topical soln) has now been an OTC product for sometime. But if you are using or are interested in using Rogaine or any generic form (minoxidil) of this drug, there are some things you should know. Minoxidil is for use in patients with hereditary hair loss only. It is not for hair loss do to any other reason such as chemotherapy, nutritional deficiencies, poor hair care techniques, or any medical condition such as thyroid abnormalities which may lead to hair loss. Minoxidil should also not be used if the scalp is red, inflamed, or infected, or if the hair loss is sudden, or during pregnancy, or in children less than 18 years old, or if any other topical product is currently being used on the scalp. Minoxidil doesn't work for everyone and those that it does work for takes time (at least 4 months on the norm) before results are seen. Continued use of minoxidil is necessary to increase and maintain hair regrowth. If you would like more information take to your doctor or pharmacist.

If you are tired of fighting with your child who has ear infection and must take an antibiotic for ten days, a shot of Rocephin may be the fix. A new study shows that a single shot of the antibiotic ceftriaxone (Rocephin) is just as effective as most oral ten day antibiotics for treating an ear infection. Talk to your doctor about this option and remember to ask him about the risks of taking a shot.

Oral inhaled steroids have proven to be the most effective drugs for long-term control of asthma. If you have asthma and are being controlled by oral drugs ask your doctor if an inhaled steroid is right for you. Studies have proven that inhaled steroids cut down on asthmatic emergencies and might even slow the progression of airway scarring and obstruction that is common in asthma. Of course inhaled steroids carry risks as well as all drugs. Inhaled steroids in LARGE doses can cause glaucoma, osteoporosis, and slowed growth in children. Keep in mind this is in large doses. Also you can take measures to reduce the amount of inhaled steroids that is absorbed and leads to these side effects by: 1) using the proper techniques to inhale the drug, ask your pharmacist about these steps 2) using a spacer that can cut down on the amount of drug that goes down the throat 3) having your doctor prescribe a newer drug such as Flovent or Pulmicort that haven proven to cause less systemic absorption 4) using a non-steriodal inhaler such as Serevent to cut down on the use of the steroid inhaler and 5) using the steroid inhaler only as directed. Ask your doctor about taking measures to protect you from systemic absorption from oral inhaled steroids.

Folic acid has shown to reduce the risk of neural tube birth defects such as spina bifida. Thus the US Public Health Service is recommending that women of child bearing years take at least 400 mcg of folic acid per day. If you are pregnant or are considering becoming pregnant be sure to have a proper diet including folic acid to help promote the health of your child.

For those of you who use a MDI or meter dosed inhaler to help with breathing or prevent/treat asthma there is a new device to help. The new device which is called Doser is used to track the number doses (sprays/puffs) left in the inhaler. This can help people who have an emergency inhaler that is not used everyday and thus is hard to keep track with the remaining doses to avoid running out.

Here are some hints to help avoid those summer rashes: Use covering over most of the skin when outdoors (gloves, long sleeves, pants, socks, shoes). Use lotion such as IvyBlock (bentoquatamx) available OTC to block urushiol which is given off from damaged plants and aggravates the skin. Wash all clothing and other things that come in contact with the skin with HOT water and detergent. Be weary of pets that have been in contact with plants as they can pass on the irritant. If you get the rash what can you do? Well nothing really shortens the rash, medicines though can provide some relief from the irritation and itching. Try using oral antihistamines such as Benadryl to help reduce the itching is very effective but remember though that antihistamines cause drowsiness. Topical antihistamines are also available, but are less effective. Topical hydrocortisone is effective in controlling itching, but should not be applied if the area has an open wound. Also consider using oatmeal baths such as Aveeno to sooth the rash.

A new lice egg removal product is now available over the counter. It is called Clear from Care Technologies and works to loosen the grip the lice eggs make on the hair so that the "nits" comb out easier preventing the potential for reinfection. Remember though you must first use a lice killing shampoo and then use Clear Egg Remover to get the eggs. (Clear is available as a combination pack with the lice killing shampoo.)

A study recently published in the Journal of the American Medical Association reports that taking potassium can significantly lower blood pressure. In the study the average drop was 3 points for systolic pressure and 2 points off of diastolic pressure.

New guidelines have been developed by the American Heart Association for protecting those who are at risk for bacterial endocarditis. This is the situation where someone visits the dentist and must take an antibiotic before hand to prevent a bacterial infection that could be detrimental to the heart. The new guidelines call for a single 2 gram dose of amoxicillin which is a change from 3 grams before and 1.5 grams after the appointment. This new single dose is obviously much easier. For those who are allergic to amoxicillin (or penicillins) the new recommendation is the use of Keflex, Duricef, Biaxin, Zithromax, or Cleocin instead of the normal alternative erythromycin which has fallen out of favor because of GI irritation.

There are new reports that the drug Cordarone (amiodarone) which is an antiarrhythmic agent used in patients with ventricular tachycardia and fibrillation may cause eye damage. Optic neuritis and optic neuropathy have been detected to coincide with Cordarone therapy. If you are taking Cordarone and experiencing decreased or blurred vision contact your prescribing doctor for more information.

Zithromax or Z-Pak which is a common antibiotic given mostly for respiratory infections is changing from a capsule to a tablet. This change is to facilitate the ability of the drug to be taken with or without meals, previously the capsules could only be taken on an empty stomach.

The OTC laxative ingredient phenolphthalein has been shown to cause cancer in animal studies and this finding have caused the FDA to change the status of this ingredient from "safe and effective" to "needs more data". Some products will be changing their ingredients because of these findings while other products will be discontinued including Phillips Gelcaps from the Bayer Corporation which is voluntarily discontinuing this product. Ex-Lax which contains phenolphthalein will remain on the shelves. The manufacturer of Ex-Lax (Novartis) says that these findings do not apply to humans.

Lanacane Maximum Strength from Combe Incorporated now contains both an anti-itch component (benzocaine 20%) and an anti-germ component (bezethonium shloride 0.2%). This is goods news for summer time itches because it may help prevent infections.

CigArrest gum and tablets are soon to be available again over the counter. These products will be different from the original CigArrest that was available OTC in the past. CigArrest formerly contained a plaint alkaloid called lobeline sulfate but the new version will contain a herbal mixture that is supposed to reduce the craving for nicotine and decrease the irritability associated with quitting. This product may be a good alternative to using nicotine patches or gum, but is not as effective.

Pregnenolone is the newest and hottest supplement on the market. It is a hormone similar to melatonin and DHEA. Pregnenolone is marketed as a feel good supplement or a brain hormone. The hormone does have an action in the brain that influences alterness, mood, and memory. Pregnenolone like DHEA is converted into the body to other hormones such as pregesterone, testosterone, estrogen among others. There are very few studies proving the effectiveness and safety for pregnenolone so be weary of it. There are thoughts that this hormone along with the other OTC hormones may actually increase one's risk for cancer.

If you suffer from Ulcerative colitis you may benefit from the use of nicotine. Some doctors are turning to nicotine patches and nicotine enemas to treat the irritation and GI inflammation involved in ulcerative colitis.

Many antidepressants especially the SSRI or seritonin specific antidepressants such as Paxil, Prozac, and Zoloft can cause sexual dysfunction which includes decreased sexual drive and/or delayed or inability to achieve a climax. People taking these drugs often keep this quite because of the sensitivity of the subject, but it is simply something that can happen and shouldn't be something of embarrassment. Making your doctor or pharmacist aware of this can help to solve the problem by changing to an alternative drug such as Serzone or Wellbutrin for depression that won't cause this dysfunction. In fact Wellbutrin may actually improve your sexual drive. Other drugs can cause sexual dysfunction while some drugs can actually improve the sexual drive. If you desire more information talk to your doctor or ask a pharmacist. We will be glad to supply you with this information.

If you are taking blood pressure pills and experiencing a consistent nagging cough you may be taking an ACE inhibitor such as Vasotec, Prinivil, Zestril, Altace, Capoten among others. ACE inhibitors work to lower blood pressure by affecting angiotensin II which causes salt and water retention along with constriction of the veins and are very effective, but can sometimes cause this nagging cough. Well now there is an alternative to ACE inhibitors called angiotensin II antagonist such as Cozaar (losartan) and the new Diovan (valsartan). These antagonist are as effective as ACE inhibitors but cause less of the cough side effect. Ask your doctor about Cozaar or Diovan if you are struggling with a cough from your ACE inhibitor.

New help for migraine suffers may be available soon. First the popular migraine drug Imitrex (sumatriptan) from Glaxo-Welcome which is currently available as a pill and an injection may soon be available as a nasal spray also. Also there are three new drugs for the treatment of migraines that are currently under investigation. All these drugs are similar to Imitrex and are showing promising results in current studies. These drugs will offer those who may not respond well to Imitrex another alternative. Look for zolmitriptan (Zomig) from Zeneca to reach the market first. If you would like more information on this new class of drugs called triptans ask your doctor or pharmacist.

New generics that are available now to save you money--Zovirax (acyclovir), Imuran (azathioprine), Ismo (Isosorbide monohydrate). Ask your doctor or pharmacist about how these generics can save you money.

The FDA has ruled against a proposed generic for Premarin (conjugated estrogens) citing that the active ingredients in Premarin which is made from pregnant mares urine can not be clearly defined and thus a synthetic (generic) version will not be approved.

Wyeth Ayerst Laboratories has started a toll free number that people can call to increase their awareness of how depression can impact the family. By calling 1-(888)-222-1213 you can receive educational brochures and other information such as the location of a local support group.

Anti-Inflammatory drugs such as ibuprofen (Advil, Motrin, Nuprin) have shown in a recent study to reduce the risk of Alzheimer's Disease. This is the results of a study released by the National Institute of Aging and John Hopkins University. No guidelines have been set as to the dose or which anti-inflammatory drug should be used to avoid the common side effects from these drugs such as stomach irritation including peptic ulcers. Look for more news about this soon.

Diet Drugs such as Redux and Pondimin may increase your risk for pulmonary hypertension. This is the news from the manufacturer of these drugs Wyeth Laboratories. Pulmonary hypertension is simply high blood pressure in the lungs that may lead to damage of lungs causing difficulty breathing and swelling in the lower parts of the body.

Rejoyn is a new device that can be purchased over the counter to aid those who suffer from impotence. Rejoyn is not a treatment or a cure for impotence, but rather an aid. Impotence can be caused by many things such as fatigue, hypertension, high cholesterol, smoking, and most commonly cardio-vascular problems and diabetes. If you desire information about Rejoyn or would like to make a purchase please email us.

More information on Cholestin the OTC dietary alternative to cholesterol treatment. As mention before on the WEEKLY PHARMACY UPDATE, Cholestin which is produced naturally from a yeast actually contains lovastatin which is an HMG-CoA reducatse inhibitor and is the active ingredient in Merck's cholesterol drug called Mevacor. This supplement is not yet widely available but soon will be, but you need to be cautioned before taking Cholestin. Cholestin has been shown to be effective in lowering cholesterol and is relatively inexpensive (only about a dollar a day), but carries risks as all the cholesterol drugs do. The biggest of these risks is liver toxicity. So if you consume more than 2 drinks a day Cholestin as well as some other drugs may not be good for you to use. Your doctor or pharmacist can give you more insight on this. Another thing to look out for while taking Cholestin is muscle pain or weakness, if you should experience this please contact your doctor. Even though Cholestin is available OTC you should talk to your doctor and/or pharmacist before you start taking it.

Perfect Iron from Sundown Vitamins contains carbonyl iron which is considered to be the most absorbable iron on the market and also has the lowest incidence of side effects. Although the other forms of iron on the market are sufficient enough to supply a normal requirement If you need to take iron because of an anemia or other prescribed need ask your pharmacist about the best iron "Perfect Iron".

Cold Eeze, a lozenge containing zinc, has in one study shown to reduce the duration and severity of the common cold. The ingredients in the product evidently give a boost the body's immune system helping it fight off the cold.

New reports show that vitamin E in high doses slows the mental breakdowns of Alzheimer's disease. Vitamin E which is an antioxidant slowed the rate of disabilitating effects in Alzheimer patients by an average of 7 months according to a study conducted by the National Institute of Health.

More good news about vitamin E. Studies have shown that high doses of vitamin E may actually boost the ability of the elderly to fight off infections.

Beware of children getting into OTC Nicotine Patches. This has been occurring with children thinking that these patches are Band-Aids. Just 20 minutes with this patch on can poison a child leading to vomiting, dizziness, and diarrhea. Used nicotine patches are dangerous also as they may still contain some drug in the patch. Please be careful how you dispose of these patches.

Women taking hormones as replacement therapy are more likely to live longer. Many women fear taking hormones because of the slight risk of increased breast cancer but the results of a new study show that women who take hormones live longer than women who do not and have a higher risk of dying from heart attacks and a higher risk of bone fractures.

VCF Vaginal Contraceptive is a new spermicidal contraceptive alternative. This product contains Nonoxynol-9 which is a proven spermicide and also may help to kill some STD's including HIV. The product turns into a gel upon use and is said to be virtually undetectable by either partner.

New OTC drug testing kits will soon be available. Three kits, Parent's Alert, Dr Brown's Home Drug Testing System, and the Drug Free Family Pak, will be traditional urine test kits. These kits can be used to detect amphetamines, cocaine, marijuana, opiods, among others. The test will require the urine sample to be mailed to a lab for the results to be extracted. Another drug test kit called PDT-90 will test for drugs using a hair test. This kit can test for occasional drug use and can detect drug use within the past 3 months. For more information email us.

Some herbs can interact with your prescriptions. People taking Coumadin should avoid taking ginkgo or feverfew. People taking lithium should avoid taking juniper. And diabetic patients should avoid ginseng because it can have a hypoglycemic effect.

Grapefruit juice could cause a problem when taken with some medications. If you are taking a calcium channel blocker (trade names Norvasc, Plendil, Dynacirc, Cardizem, Calan, Procardia, Adalat, Tiazac among others), Halcion, Seldane, Hismanal, or cyclosporine you may need to watch out. Taking these pills with grapefruit juice and possibly other citrus juices may cause these drugs to become toxic. As your pharmacist or doctor about this problem. Note sometimes your doctor may prescribe you to take your medication like cyclosporine with grapefruit juice.

Many new methods are being tried to treat migraine headaches. Among them are Lidocaine nose drops which if they work and they work in about half the patients that tested them can provide relief in almost 5 minutes. Physicians are also prescribing aspirin and Reglan (metoclopramide) which is a medicine for nausea and stomach disorders. This combination often works as well as Imitrex (sumatriptan) a drug dedicated to treating headaches. The advantage is that this combo costs a lot less and seems to have fewer side effects--stomach irritation and drowsiness the most common from the combination treatment. Also a new study shows that ibuprofen (brands Motrin, Nuprin, Advil) is more effective than Tylenol (acetaminophen) for migraines in children.

The new dietary supplement to lower cholesterol levels is under the gun. The supplement manufactured by Pharmanex called Cholestin reported will lower cholesterol 25 to 40 points. The problem is that the FDA and the Department of Health and Human Services say the supplement is actually a drug that is being sold in violation of the Food, Drug & Cosmetic Act. The supplement contains a natural HMG-CoA reductase inhibitor called mevinolin which is identical to Merck's cholesterol drug called Mevacor. The battle will continue on apparently in the courts. In the mean time if you are using the supplement you should be aware of the potential side effects including liver problems. You probably shouldn't talk Cholestin unless it has been prescribed by your doctor. If you are using the supplement and your doctor is not aware of it, please inform him or her for your own safety.

A victory of some sorts for those who oppose the controversial abortion pill, RU-486. The French pharmaceutical firm Roussel Uclaf has stopped production of the pill because it is apparently unprofitable in Britain, France, and Sweden.

A UTI Home Screening Test Kit is now available to buy over the counter. The new kit simply called UTI is used to test for urinary tract infections. The kit comes with six test strips and six urine collectors. Simply by dabbing the test strip into the urine and comparing it to the color chart included, you can know if you have an urinary tract infection. The test only takes about 60 seconds.

Vagistat-1 (tioconazole 6.5%) is a vaginal ointment that has been approved to OTC status (formerly available only by prescription). Vagistat-1 from Bristol-Myers Squibb is the first single dose treatment for yeast infections. It is to be used by women who have been previously been diagnosed by a doctor with a vaginal yeast infection and have a reoccurrence of the infection with the same symptoms.

As reported earlier on the WEEKLY PHARMACY UPDATE page Luvox, an antidepressant, may help those desiring to quit smoking to succeed. A new study also shows that other antidepressants such as Prozac may also provide some help. Taking high doses of these drugs for 10 weeks raises the odds of both quitting smoking and staying smoke free. Ask your doctor about a program to quit smoking if you desire to become a non-smoker.

Their are new studies suggesting that those who suffer from migraine headaches may have a higher risk of having a stroke in their middle ages. Apparently the same chemical involved in the migraine headaches is also involved in strokes.

Studies now indicate that high sodium intake will certainly increase your blood pressure. Many experts say that a normal daily salt intake should be below the US diet allowance of 2,4000mg.

A new prescription treatment for baldness may soon be available. Merck is currently developing a drug called Propecia (finasteride) which in early testing shows hair growth in 50% of the men in the study. An interesting note is that this drug is actually available now from Merck under the name Proscar which is used to treatment BPH or an enlarged prostate.

New studies show that cholesterol drugs know as the "statins" (trade names Zocor, Pravachol, Mevacor, Lescol, Lipitor) lower the risk of coronary heart disease in women.

Confide HIV Test has now been available to buy OTC since last year. This test allows anyone to safely test themselves for the HIV infection in the privacy of their home. The test is done simply be a finger prick and placing blood on a test card. The card is then mailed to a testing center where the patient can call to get the results of the test anonymously. Because of the privacy desired with this test it can be purchased from us through the mail. Email us for information.

Generic Zantac? Yes generic Zantac will be available soon from Novopharm pharmaceuticals. Zantac which is Histamine 2 blocker is used to reduce acid production in the stomach. Look for this generic ulcer drug to be available in July.

A new study has found that selenium, a mineral that can be bought over the counter and that is found in seafood, can prevent cancer. The study used selenium 200 mcg once daily and found a lower incidence of prostate, colon, rectal and lung cancers. If you are interested in more information on selenium or need to purchase some email us.

Crixivan (indinavir) from Merck will soon be available for disturbution at local pharmacies. Crixivan which is a new powerful protease inhibitor used to treat the HIV infection has shown very promising results when used in combination with other HIV drugs has been available for a while but only through mail order.

Luvox (fluvoxamine), a drug used primarly for depression and is similar to Prozac, Zoloft, and Paxil, has been approved for treatment of the obsessive-complusive disorder (OCD) in both children and adults. Luvox is also sometimes used to treat withdrawl symptoms.

Nasalcrom (cromolyn sodium) is nasal spray for allergic rhinitis. Allergic rhinitis is the sneezing, itching, and runny nose that is brought on by exposure to allergens such as dust or pollen. It was previously only available by prescription only but now can be bought in full prescription strength over the counter. Nasalcrom is a safe drug with no interactions with other medications, but can cause irritation to the nose, a bad taste in the mouth, sneezing, a bloody nose, coughing, and a headache. This medication is not for children under six years of age. As always talk to your doctor or pharmacist before using a new medication. For more information on Nasalcrom Ask a Pharmacist

An FDA advisor committee has confirmed the value of Aspirin in the prevention of heart attacks and strokes. The review showed that this benefit far outweighed the risk of GI irritation. Please talk to your doctor or pharmacist before you begin aspirin therapy.

Over the past months many acid reducing drugs have switched from prescription to OTC (Zantac, Pepcid, Tagamet, and Axid). This drugs are all great at relieving heartburn, acid indigestion, and a sour stomach. They also can be used to prevent these problems when taken before a meal. There is really no true advantage to one of these drugs over another. It is recommended that you stay with the drug that your doctor has chosen for you. If your doctor has not prescribed one of these drugs for you talk to your doctor or pharmacist about which is best for you. Normally the less expensive one is the best except in the case of Tagamet, which has numerous drug interactions and thus probably should not be the first choice. For more information Ask a Pharmacist.

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