Drugs and Supplements

Teens and medicines that cause birth defects: Do doctors drop the ball?

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publications

Doctors may prescribe medicines for teenage girls — for example for acne, depression, or migraines — that are known to cause birth defects. While most parents and doctors hope that these young women avoid pregnancy for many reasons, adults need to help adolescent girls understand the risks of the medications they take and have frank conversations about sex and birth control.

New cures for hepatitis C — but are they affordable?

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

Recently, several new drugs have been developed to treat hepatitis C, a serious viral infection that can cause severe liver damage if allowed to run unchecked. But these new drugs are incredibly expensive, and are unaffordable for many people who need them. Until drugs for hepatitis C (and other high-cost drugs) are priced at affordable levels, many people will be left unable to benefit from modern advances in drug therapy.

Reversing the effects of the new anti-clotting drugs

Samuel Z. Goldhaber, MD
Samuel Z. Goldhaber, MD, Contibuting Editor

Anticoagulants — drugs that reduce the blood’s ability to clot — are used to treat clots in the lungs and legs and to prevent strokes in people with the heart rhythm abnormality called atrial fibrillation. The anticoagulant warfarin has been used for these purposes for many years. But it is difficult and time-consuming to find the optimal warfarin dose, and it carries a risk of difficult-to-control bleeding. Newer anticoagulants offer an easier and equally effective way to control the blood’s clotting ability, but until recently, there was no way to reverse the effects of these drugs if necessary. The approval of new antidotes to these newer anticoagulants will enable doctors to prescribe these drugs with increased confidence.

Do statins interfere with the flu vaccine?

John Ross, MD, FIDSA
John Ross, MD, FIDSA, Contributing Editor

The statin drugs are very effective at reducing LDL (“bad”) cholesterol and may also reduce inflammation throughout the body. Both of these properties can reduce the risk of cardiovascular problems. At the same time, research — some of it conflicting — suggests that statins may also affect the body’s immune system. In particular, they may dampen the response to vaccines.

The very high cost of very low cholesterol

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

The FDA recently approved two new drugs that quickly and effectively lower LDL cholesterol levels. This exciting development is tempered by the very high cost of these drugs. These costs can even trickle down to others on the same insurance plan as people taking these new drugs. Several politicians and institutions have spoken out against these high costs, but it is unlikely that the prices will be lowered anytime soon. For now, these drugs should be reserved only for those whose other efforts to reduce LDL have been unsuccessful.

The placebo effect: Amazing and real

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications

Many people believe that the placebo effect is solely a psychological phenomenon. But for some people, a placebo can have real, measurable therapeutic benefits. The power of the placebo effect is significant enough that it can actually skew study results. Additional research is needed to better understand how to leverage the placebo effect and when doing so might offer real benefits to patients.

The problem with prescription painkillers

Wynne Armand, MD
Wynne Armand, MD, Contributing Editor

Opioids are effective pain relievers. But sometimes people can develop a tolerance to these drugs, requiring increasingly higher doses of medication to achieve the same pain relief. And physical dependence — withdrawal symptoms when the drug is stopped — is also common. The increased availability of these drugs has put many people at risk for addiction, overdose, and even death.

Why many generic drugs are becoming so expensive

Ameet Sarpatwari, JD, PhD
Ameet Sarpatwari, JD, PhD, Contributing Editor

Generic drugs used to be a reliable lower-cost alternative to many brand-name drugs. But thanks to a combination of market forces, the cost of many generics is rising quickly — and steeply. This trend will increase the burden of health care costs for insurers, governments, and individuals. Find out why this is happening, as well as what you can do to help sidestep these costs and advocate for policies that can stem this tide.

Harmful effects of supplements can send you to the emergency department

Susan Farrell, MD
Susan Farrell, MD, Contributing Editor

Many people take vitamins, supplements, and complementary nutritional products in an attempt to optimize health or help prevent disease. Like prescription drugs, these products can have adverse effects, some of which prompt people to seek emergency care. It is important to be a wise consumer if you choose to use these products. An important part of that is making sure your doctors knows exactly what vitamins, supplements, and nutritional products you take.

How well does calcium intake really protect your bones?

Beverly Merz
Beverly Merz, Executive Editor, Harvard Women's Health Watch

How much calcium do you really need for strong, healthy bones? The answer isn’t as clear as we once thought. Recent analyses suggest that neither dietary calcium nor calcium supplements reduce the risk of fractures. In the absence of a clear deficiency, it’s impossible to know how exactly much calcium a person needs. Ideally, you should get most of your calcium through food. Be sure you’re getting adequate vitamin D as well.