Drugs and Supplements

Howard LeWine, M.D.

Probiotics may help prevent diarrhea due to antibiotic use

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Probiotic yogurt2

Eating yogurt or taking a so-called probiotic when you have to take antibiotics may help prevent the diarrhea that often accompanies antibiotic treatment. That’s the conclusion of a study just published in the Journal of the American Medical Association. A team of California-based researchers combined the results of 63 randomized trials pitting probiotics versus placebo among almost 12,000 men and women taking antibiotics. Those who took antibiotics plus probiotics were 42% less likely to develop diarrhea as those who got the placebo. About one in three people who take antibiotics develop diarrhea. Antibiotics kill these “good” microbes along with bacteria that are causing an infection. This upsets the balance of the normal flora in the intestines. The result is often loose, watery stools known as antibiotic-associated diarrhea.

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Howard LeWine, M.D.

FDA changes safety information on statin drugs

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

A new ruling from the FDA offers good news and some warnings for people who take a cholesterol-lowering statin. The good news—no more periodic blood tests for liver function. The warnings—taking a statin may increase the odds of developing type 2 diabetes or suffering reversible memory loss or problems thinking. The FDA warned that one statin, lovastatin, shouldn’t be taken with some antibiotics, anti-fungal agents, or medications used to treat AIDS.

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Nancy Ferrari

How drug shortages happen

Nancy Ferrari, Senior editor, Harvard Health
Empty-pill-bottle

Worrisome shortages of important medications—from drugs to manage the symptoms of ADHD to standard cancer drugs—have been in the headlines lately. A shortage can be frightening to the people who need a hard-to-get medication, and frustrating for the clinicians who prescribe it. Manufacturing and quality control issues are among the primary reasons for drug shortages. The FDA can sometimes help ease a drug shortage. What can you do if you are affected? Ask your doctor if another medication might work for you. Be especially wary of Internet or faxed advertisements for alternatives (often highly priced and sometimes counterfeit).

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P.J. Skerrett

The 11 most expensive medications

P.J. Skerrett, Senior editor, Harvard Health
High-cost-medications_border

Some medications can cost as much as $2,000 a year. But according to a post on the Medical Billing and Coding blog, that’s peanuts. The price tag for a year’s worth of Soliris, a drug used to treat a rare blood disease known as paroxysmal nocturnal hemoglobinuria, is $409,500. The blog lists 10 other drugs that cost $200,000 or more a year. All 11 are so-called orphan drugs, developed specifically to treat rare conditions. The post raises questions about how much is too much when it comes to drug costs. If one of these drugs is keeping you or a family member alive, the sky’s the limit. If not, the cost can seem excessive.

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Peter Wehrwein

Switching to generic Lipitor

Peter Wehrwein, Editor, Harvard Health
Generic-drugs

Lipitor, the blockbuster cholesterol-lowering drug, is now being sold as a less-expensive generic. Several other best-selling prescription drugs are set to lose patent protection this year, including Actos, a diabetes drug; Plavix, which helps prevent heart attacks and strokes; and Singulair, an important asthma drug. Although the lower price is great, some people worry that changing from a brand-name drugs to a “no-name” generic one might be risky. Not so, says Dr. Anthony Komaroff, editor in chief of the Harvard Health Letter. In the newsletter’s February 2012 issue, he tackles the brand-versus-generic issue. The FDA is legally required to determine that generic products are “bioequivalent” to brand-name drugs, which means that they produce similar blood concentrations of the same chemical. The vast majority of studies show that generic versions are just as safe and effective as their brand-name counterparts.

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P.J. Skerrett

Resveratrol—the hype continues

P.J. Skerrett, Senior editor, Harvard Health
Grapes-wine

Resveratrol is a compound found in red wine. A new report published in the journal Cell suggesting that resveratrol blocks the action of a muscle enzyme called phosphodiesterase 4 in mice had headline writers in a tizzy, proclaiming that “Scientists May Be Closer to Developing ‘Red Wine’ Drug” and the like. It didn’t merit that kind of hype. Some research, most of it on cell cultures or laboratory experiments with yeast, roundworms, fruit flies, the short-lived turquoise killifish, or mice, suggest that resveratrol may help fight heart disease, some cancers, and other chronic conditions. But there is little evidence about what it can do for humans, and even less about possible side effects.

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P.J. Skerrett

FDA needs stronger rules to ensure the safety of dietary supplements

P.J. Skerrett, Senior editor, Harvard Health
Supplements

Back in 1994, the Dietary Supplement Health and Education Act (DSHEA) allowed companies to sell dietary supplements with established ingredients (meaning those that had been sold in the United States before 1994) without any evidence that they are effective or safe. Manufacturers are supposed to give the FDA evidence that a new ingredient should be safe, but this aspect of the law hasn’t been enforced, writes Harvard Medical School’s Dr. Pieter A. Cohen in a commentary in the New England Journal of Medicine. Compare this hands-off approach with the strict rules and regulations for drugs. Last July, the FDA proposed some rules to help it test new dietary supplements. This is a good first step, but the FDA’s plan doesn’t go far enough, argues Dr. Cohen.

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P.J. Skerrett

Consumers could save as generic Lipitor hits the market

P.J. Skerrett, Senior editor, Harvard Health
Atorvastatin-tall

The patent on Lipitor, the world’s best-selling brand name prescription drug, expired on November 30th. That opens the door for less expensive generic versions of the drug, called atorvastatin, which are now available. In addition to atorvastatin, six other statins are currently available in the United States. Generic drugs are chemical clones of their brand-name counterparts. By law, generic drugs must contain the same active ingredients as the brand-name drug, work the same way in the body, and meet the same standards the FDA has set for the brand-name drug. One big difference is cost. Generic atorvastatin should be less expensive than brand-name Lipitor, although Pfizer, the company that makes Lipitor, is striking deals with insurers and pharmacy benefit managers to price brand-name Lipitor at or under the generic alternatives in order to keep sales of Lipitor as strong as possible for as long as possible.

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P.J. Skerrett

A conversation with Dr. Jerry Avorn about drugs and the drug industry

P.J. Skerrett, Senior editor, Harvard Health

The new fields of pharmacoepidemiology and pharmacoeconomics aim to understand how people use medications and how effective—or ineffective—medications are. A leader in this area is Dr. Jerry Avorn, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School. In a recent issue of the Harvard Health Letter, editor Peter Wehrwein spoke with Avorn about generic drugs, the pharmaceutical industry, the high cost of cancer drugs, and more.

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Howard LeWine, M.D.

Painkillers pose problems for people with heart disease

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications

Millions of people take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin and others), naproxen (Aleve, Naprosyn, and others), and celecoxib (Celebrex) to relieve pain and inflammation. During the last few years, researchers have raised concerns that taking these drugs often may be hard on the heart as well. The latest study, published in the July 2011 issue of the American Journal of Medicine, suggests that regular use of NSAIDs poses a special problem for people who already have heart disease, boosting their chances of having a heart attack or stroke. This research doesn’t mean that people with high blood pressure and heart disease should stop taking NSAIDs, especially if they are used to ease pain from a chronic condition like arthritis. But it may make sense to try an alternative first.

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