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

FDA Approves New Generic HIV Medication

by The GoodRx Pharmacist on January 23, 2018 at 3:35 pm

HIV medications have made some key advancements in recent years, including the use of fewer pills for infected patients and less unwanted side effects.

Many newer combination HIV medications can carry a hefty price tag as they often contain two or three medications in the convenience of one pill. One way patients have been able to reduce the cost of their HIV medication is by filling for a generic, and we have a new one to add to the list.

Most recently, the FDA just approved atazanavir, the generic version of Reyataz, for the treatment of HIV-1 infection.

What is atazanavir indicated for?

Atazanavir is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infections in adults and pediatric patients 6 years and older weighing at least 33 lbs.

Atazanavir is to be taken once-daily, at the same time of the day. Your doctor will determine what dose of atazanavir is right for you as your dose may be based upon your body weight in certain patient populations.

What strength(s) and dosage form(s) will atazanavir be available in?

Atazanavir will be available as an oral capsule in the strengths of 150 mg, 200 mg, and 300 mg.

Brand name Reyataz is available as a capsule as well an oral powder.

What are the most common side effects of atazanavir

The most common side effects associated with atazanavir include yellowing of the skin and whites of eyes, nausea, rash, headache, stomach pain, vomiting, insomnia, dizziness, muscle pain, diarrhea, depression, and fever.

Do I need to take atazanavir with any other antiretroviral medications?

Yes. Atazanavir is to be taken in combination with other antiretroviral medications for HIV-1.

Publix Launches Low-Cost Prescription Drug Program

by GoodRx on January 22, 2018 at 4:07 pm

We have some good news if you have a Publix pharmacy near you.

Publix has launched a new savings program offering 29 common medications at a discounted rate—$7.50 for a 90 day supply. Popular medications on this list include simvastatin, omeprazole, gabapentin, and alendronate. This program is available for both insured and uninsured patients, and there are no membership fees. A full list of included medications and dosages are available here.

Don’t forget that Publix also offers some common medications for conditions like high blood pressure and diabetes at no cost. For a list of drugs covered under their free medication, program see their list here.   

Is there a Publix near me?

If you live in Florida, Georgia, Alabama, South Carolina, Tennessee, North Carolina, or Virginia, you may be near a Publix. Visit Publix’s store locator here to find a store near you.  

Disclaimers: Prices for this program are not yet on the GoodRx site, but they will be available soon. Stay tuned.

We think pharmacy programs that offer discounted generic prescriptions can be another great resource for savings. Please note that GoodRx isn’t connected to Publix and we have not been asked to promote their savings program.

In fact, Publix pharmacies won’t accept GoodRx coupons at all, for their own reasons. But we will continue to show their prices and update people on their programs, in case going to Publix is the best option for you. 

How to Stop Snoring

by Dr. Sharon Orrange on January 22, 2018 at 3:20 pm

Snoring is extremely common and 70% of folks with obstructive sleep apnea (OSA) snore. On the other hand, those who suffer from snoring do not necessarily have OSA. Snoring is caused by the vibration of soft tissues obstructing the throat during sleep.

Patients and their partners often seek help from their doctor with the primary complaint of snoring. Remember, if you have significant obstructive sleep apnea (OSA) wearing a nighttime CPAP device is the solution. However, if snoring in the absence of significant sleep apnea is your problem, treatment may be much easier.

It’s impossible to discuss effective snoring treatment without looking at the role of the nose in snoring. The nose is the first anatomical boundary of the upper airway and stuff congest nasal passages may contribute to snoring.

So, let’s look at the evidence. How do you stop snoring?

Weight loss

…But only in pre-obese or obese snorers. What does that mean? Losing weight does help improve snoring, but only to a certain point. In obese and pre-obese folks, lowering boxy mass index (BMI) to 25 is all it takes, and there is no improvement with extra weight reduction after that. Interestingly, weight reduction is not helpful in adult snorers with a normal BMI. What is your body mass index? Use this to find out.   

Nasal dilators aka “breathe right strips”

Yes, they work and you can buy them over the counter. Both internal (NoZovent, Mute) and external (Breathe Right Strips) nasal dilators improve snoring. When studied, the internal (inside the nose) dilators improved snoring more significantly than the external dilators like Breathe Right, but both do help. Worth a try for sure.

Limiting alcohol and hypnotics at night

What does this mean? Any sleep aid you are using, like Zolpidem, Zaleplon, Eszopiclone, or alcohol will worsen snoring for sure.

Nasal steroid sprays

Nasal steroid sprays have been shown to decrease mouth breathing and increase nasal breathing at night which improves snoring. Using a daily nasal budesonide spray (Rhinocort), fluticasone (Flonase) or triamcinolone (Nasacort), can decrease snoring frequency and increase rapid eye movement sleep (deep sleep).

Avoiding the supine position

Sleeping on your back (supine) shrinks the airway by a third and I’m always impressed when reviewing the sleep studies of my patients to see the difference in snoring and apnea when folks are sleeping on their backs. Train yourself not to do this.

Oral appliances

These take a bit more work to get as you will need to find a specialist who can fit you for these. “Mandibular advancement devices” are effective in reducing snoring and sleep apnea. These oral appliances are made individually by a dental technician and are usually upper and lower devices that work to move the lower jaw forward.

Oropharyngeal (mouth and throat) exercises

This is the current hot topic in snoring treatment, yet it will take getting a referral to someone who knows what they are doing. Studies show that patients attending weekly visits where they were trained to do eight minutes of oropharyngeal exercises three times a day had significant improvement in snoring.  Tongue and mouth/throat exercises have been shown to decrease snoring by 50%. It’s worth asking your primary care doc for a referral for this is you’ve failed other interventions.

Hope this helps.

Dr O.

3 Things You Probably Didn’t Know About Cold and Flu Meds

by Katie Mui on January 19, 2018 at 1:42 pm

By now, you’ve probably heard that this year’s flu season is getting pretty bad (or “moderately severe”, as the CDC puts it), with widespread flu activity all across the U.S. We believe prevention is the best medicine, but certain strains, like this year’s H3N2 virus, are more resistant to the flu shot.   

So if you find yourself feeling feverish and with chills, congestion, runny nose, or body aches (among other common cold and flu symptoms), you might be tempted to head to your local drugstore. But with over 300 products on the shelf in the typical cold and flu aisle (we counted), it’s easy to feel pretty overwhelmed – especially if you’re not feeling quite like yourself. Luckily, we’re here to help you sort through the confusion and pick the best over-the-counter cold and flu meds for you.

1. You’re getting duped by marketing

There are over 300 cold and flu products in the average drugstore, but what you probably don’t know is that they’re really just a handful of combinations of four basic types of ingredients: decongestants, pain and fever reducers, cough suppressants, and expectorants (mucus thinners). There are so many options because each brand (like Robitussin or Vicks) has its own version of almost every combination, plus many combinations come in more than one form (like liquid, dissolving tablets, and ‘liquicaps’). Some of this is good – for example, it’s nice to have a liquid option if you don’t like taking pills – but a lot of it is simply driven by marketing.

2. You’re spending too much on brand names

According to a 2014 study published by the National Bureau of Economic Research, drugstore shoppers spend an extra $44 billion a year on brand-name products, including over-the-counter medications and other health items. Pharmacists, on the other hand, are 90% more likely to buy generics, probably because they know how to hunt them down on store shelves and know that they’re just as effective. But it’s hard for most people to distinguish between pseudoephedrine and phenylephrine or dextromethorphan and doxylamine in order to pick a generic or store brand with the active ingredients they need.

3. You’re probably taking more medicine than necessary

People often take combination-ingredient cold and flu medicines like NyQuil or Tylenol Cold Multi-Symptom. You’ve probably seen TV commercials for these brands so they’re easy to recognize on the shelf, and you know they’ll probably cover whatever your symptoms are. But these combo products often have more ingredients than you need to treat the symptoms you actually have, which puts you at greater risk for side effects, drug interactions, and overdose. Overdose is especially risky with products that contain acetaminophen because going even just a little bit over the daily limit of acetaminophen can put your liver at risk and even cause death. Read our previous post on how to avoid taking too much acetaminophen or Tylenol.

So how do I find what’s right for me?

If you’re looking to treat the symptoms of a developing cold and flu early without having to visit the doctor’s office, our friends at Iodine have just the thing. Their cold & flu tool can help you save time, money, and extra stress on your body. Just select your symptoms, and it’ll narrow down all the options to products that treat the symptoms you actually have. You can compare them side by side and take the list with you to the pharmacy. Get in, get out, go home and rest.

Tamiflu Prescriptions Reveal Shocking Flu Trend

by Tori Marsh on January 18, 2018 at 4:20 pm

A recent report published by the Centers for Disease Control and Prevention (CDC) confirmed what we already knew: this year’s flu is bad. Since October, widespread influenza activity has been reported in 49 states, resulting in 20 pediatric deaths and more than 6,000 influenza-related hospitalizations thus far. These rates surpass last year’s total numbers – and it’s only January.

One more way to see how bad the flu is this season: prescriptions for Tamiflu (oseltamivir), the most popular antiviral medication for treating the flu, are way up. According to a GoodRx analysis based on a significant sample of US pharmacy fills, Tamiflu fills are 640% above this time last year.  

What’s more, it’s only January. As you can see below, fills for Tamiflu peaked in February of last year, indicating that the flu was the most widespread during that time. It’s possible that there is still more to come this year.

This is a stunning illustration of how bad the flu is – and how much worse it may still get.

Why Tamiflu?

If taken within the first 28 hours of getting the flu, Tamiflu can work to block the actions of influenza in your body, and shorten the duration of the virus. You can also take Tamiflu for up to six weeks to prevent you from getting the flu. Not surprisingly, Tamiflu is prescribed more often between the months of October and March, during flu season. Despite the surge of prescriptions, there are some doubts about whether Tamiflu is even effective for treatment or prevention – more on that below.

A shortage in Tamiflu

The high volume of Tamiflu prescriptions at this point in the season has resulted in a shortage of the medication. While the FDA has not yet confirmed this shortage, doctors and pharmacists in both urban and rural areas are reporting difficulty in accessing Tamiflu for their patients.

Those unable to access Tamiflu this year do have other options. Besides Tamiflu, there are two other influenza medications: Relenza and Rapivab. Both are considered just as effective as Tamiflu and may be easier to access this year. For more information on these medications, see our post here.   

Over the counter medications can also help ease symptoms. Read here for more details on over the counter flu medications.

Is it effective?

Tamiflu is sometimes treated as a cure for all cases of the flu, but recent studies call this reputation into question. According to a study-of-studies, or meta-analysis, performed by Cochrane Research of 46 studies involving more than 24,000 people, Tamiflu may provide a much smaller benefit than expected. At best, the analysis found that Tamiflu may only help patients recover one day faster, and may not reduce the number of flu-related complications, like pneumonia. Additionally, it may only reduce the risk of getting sick by 55%. At over $50 per prescription for generic oseltamivir, for some, the benefits may not outweigh the cost.  

While these findings don’t negate the use of Tamiflu, they may indicate that it is less protective than we had previously thought.

Tamiflu side effects

There has been recent concern about Tamiflu’s side effects, especially in younger children. Recently, a 6-year-old girl reportedly attempted to jump out of her bedroom window during a hallucination while taking Tamiflu.  The FDA has warned of similar side effects previously, noting that:

“Children and teenagers with the flu may be at a higher risk for seizures, confusion, or abnormal behavior early during their illness. These serious side effects may happen shortly after beginning Tamiflu of may happen in people when the flu is not treated. These serious side effects are not common but may result in accidental injury to the patient. People who take Tamiflu should be watched for sins of unusual behavior and a healthcare provider should be contacted right away if the patient shows any unusual behavior while taking Tamiflu.”

More common side effects include nausea, vomiting, headache, and pain. Be sure to speak with your doctor if you or a loved one experience any of these side effects for a prolonged period of time.

Why is the flu so bad this year?

This year’s flu is different from past year’s. The reason? Around 80% of flu cases this year involved H3N2, a strain of the influenza A virus that is more dangerous and results in more complications. H3N2 is generally also harder to prevent with the flu vaccine, and this seems to be true this year. Experts say that this year’s flu vaccine may be only 10% effective.

How can you protect yourself?

  • You can still get your flu vaccine. Even though the flu shot may only 10% effective against this year’s flu, you may still want to consider getting it. Even if you get sick, a flu vaccine can also help ease the severity and duration of the virus.
  • Visit your doctor immediately. When true flu symptoms hit, go to the doctor. The sooner you visit, the sooner you can get your prescription for an antiviral medication.
  • Wash your hands. This may go without saying, but washing your hands is your best weapon against the flu virus.
  • Exercising may help. While heavy exercise may predispose you to the flu, a moderate amount may be protective.

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