| STATISTICS & TRENDS |
| NexgenRx Health
News |
| Issue
1 - July 2005
NexgenRx is pleased to bring you information on selected, new
single source drugs that have received approval by Health Canada
as well as new indications for drugs already on the market.
There are situations when a drug has received a Notice of Compliance
but the drug may not be available in the immediate future. Health
News will also include brief snapshots of information on common
disease states and health related issues from a variety of international
sources. |
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|
New
Drugs
| Brand Name: |
Myfortic |
| Manufacturer: |
Novartis |
Active Ingredient: |
Mycophenolic Acid |
| DIN: |
02264560 Myfortic 180mg enteric coated tablet, 02264560
Myfortic 180mg enteric coated tablet |
| Indication: |
Prevention of renal transplant rejection (in conjunction
with cyclosporine and corticosteroids) |
| Date of NOC: |
February 4 |
| Status: |
Prescription by Law |
Comment: |
Myfortic may replac Cellcept® since it is essentially
the enteric coated version of the molecule, appears to
have fewer adverse effects and is less expensive. |
| Brand Name: |
Niaspan |
| Manufacturer: |
Oryx Pharmaceuticals |
| Active Ingredient: |
Nicotinic Acid |
| DIN: |
02262347 Niaspan sustained release tablet 500mg, 02262355
Niaspan sustained release tablet 750mg, 02262330 Niaspan
sustained release tablet 1000mg |
| Indication: |
Cholesterol Management |
Date of NOC: |
March 3 |
Status: |
Prescription by Law |
| Comment: |
Not interchangeable with Niacin. |
| Brand Name: |
Sativex |
| Manufacturer: |
Bayer |
| Active Ingredient: |
Delta-9-tetrahydrocannabinol, Cannabidiol |
| DIN: |
02266121 Sativex buccal spray 27mg/ml, 25mg/ml |
| Indication: |
Analgesic in Multiple Sclerosis Neuropathic Pain |
Date of NOC: |
April 15 |
| Status: |
Prescription by Law |
| Comment: |
N/A |
| Brand Name: |
Lyrica |
| Manufacturer: |
Pfizer Canada Inc. |
| Active Ingredient: |
Pregabalin |
| DIN: |
02268418 Lyrica 25mg capsule, 02268426, Lyrica 50mg
capsule, 02268434, Lyrica 75mg capsule, 02268442, Lyrica
100mg capsule, 02268450, Lyrica 150mg capsule, 02268469,
Lyrica 200mg capsule, 02268477, Lyrica 225mg capsule,
02268485, Lyrica 300mg capsule |
| Indication: |
Analgesic |
Date of NOC: |
June 3 |
| Status: |
Prescription by Law |
| Comment: |
N/A |
| Brand Name: |
Subutex |
| Manufacturer: |
Schering Canada Inc. |
| Active Ingredient: |
Buprenorphine |
| DIN: |
02242962 Subutex 0.4mg sublingual tablet, 02242963 Subutex
2mg sublingual tablet, 02242964 Subutex 8mg sublingual
tablet |
| Indication: |
Opiate agonist/antagonist: for substitution treatment
in opioid drug dependence in adults through SUBUTEX National
Education Program |
| Date of NOC: |
January 21 |
| Status: |
Prescription by Law |
| Comment: |
N/A |
|
|
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| New
Indications |
Femara
received approval in April 2005 for the extended treatment
of early breast cancer in post menopausal women previously
treated with tamoxifen.
Alertec has a new indication, effective
June 2005, as additional therapy for day time sleepiness due
to sleep apnea. |
|
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| Cardiovascular
Disease Updates |
Statins and Coenzyme
Q10
Statins are widely used to lower cholesterol in patients at
risk of heart attack or stroke, either as primary prevention
or after a cardiovascular event. This class of dugs includes
Lipitor® (atorvastatin), Crestor® (rosuvastatin),
Mevacor® (lovastatin), Lescol® (fluvastatin),Zocor®
(simvastatin) and Pravachol® (pravastatin).
These drugs are effective in lowering Low Density Lipoproteins
(LDL-the “bad†cholesterol)
but a number of patients, particularly on higher doses, find
it hard to be compliant when they suffer from muscle aches
and pains
caused by these drugs. A recent double blind study in the
US indicated that 100mg of coenzyme Q10 taken daily improved
muscle pain associated with taking the statin and was well
tolerated.
Coenzyme Q 10 is not presently eligible on the majority of
drug plans.
Source:
Doctor's Guide August 2005. The complete article can be viewed
by accessing www.docguide.com. |
|
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| High
Dose Statin Therapy |
Clinical trials
have shown that lowering the LDL below the current recommended
guidelines can be beneficial for cardiac patients. Cardiologists
may be prescribing Lipitor® 80mg for some patients.
This will require closer monitoring of enzymes that indicate
if muscle damage is taking place .Since Lipitor®
40mg and 80mg are the same cost, there would be no increased
cost to the patient if the dose doubles. There are no generic
equivalents of Lipitor® available in Canada
Source:
New England Journal of Medicine March 8 2005. |
|
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| Low
Dose ASA |
How low is effective?
Clinical trials have shown that lowering the LDL below the
current recommended guidelines can be beneficial for cardiac
patients. Cardiologists may be prescribing Lipitor®
80mg for some patients. This will require closer monitoring
of enzymes that indicate if muscle damage is taking place.
Since Lipitor® 40mg and 80mg are the same cost,
there would be no increased cost to the patient if the dose
doubles. There are no generic equivalents of Lipitor®
available in Canada. |
|
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| Hypertension |
The ALLHAT (Antihypertensive
and Lipid Lowering Treatment to Prevent Heart Attack Trial)
study indicates that in the US only 1 in 3 patients diagnosed
with hypertension has levels indicated in clinical practice
guidelines to minimize the
risk of future heart attack or stroke. Figures from other countries
are worse. High blood pressure is easily treated with a variety
of safe, well tolerated drugs.
Source:
MedScape 2005. The complete article can be viewed by accessing
www.medscape.com. |
|
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| Policosanol
and Cholesterol Lowering |
| Policosanol is a product
extracted from sugarcane and has been shown to reduce LDL (“badâ€
cholesterol) in a small clinical trial. First steps in cholesterol
lowering would include lifestyle changes in terms of types of
dietary fats consumed, weight reduction and increase in exercise.
If these steps do not achieve acceptable levels of LDL, HDL
and triglycerides then the next step is usually medication with
drugs like statins that are effective in lowering LDL. Policosanol
may be useful for patients with borderline high LDL. The drug
is well tolerated, relatively inexpensive but is not presently
eligible on the majority of drug plans. Normal dosage is 10-20mg
daily.
Source:
MedScape 2005. The complete article can be viewed by accessing
www.medscape.com. |
|
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| Remove
the Salt Shaker |
Randomized controlled
trials studying 737 adults with high blood pressure demonstrated
that reducing daily salt intake by 4.6gram for a period of 4
weeks resulted in decrease in systolic reading of on average
5mmHg and diastolic by 2.7mmHg . Similar studies in adults with
no reported hypertension showed a decrease of 2mmHg and 1mmHg
in systolic/diastolic pressure. People who are motivated can
decrease blood pressure by this simple measure.
Source:
Cochrane Library. |
|
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| Heart
Attacks in Young Men |
Preliminary research
indicates that Chlamydia pneumoniae may increase the risk
of heart attack in young men. This micro organism is related
to the bacterium that causes the better known sexually transmitted
Chlamydia.
C.pneumoniae is not sexually transmitted but can lead to
pneumonia, bronchitis and sinus infection. It is a common
illness and by age 30, half of people have evidence of previous
exposure to this infection.
Source:
Doctor's Guide. The complete article can be viewed by accessing
www.docguide.com |
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| Crestor
for Cholesterol Lowering |
Health Canada issued
a warning to Asian patients using Crestor® that there
may be an increased risk of developing muscle related adverse
effects. The serum levels in Asian-Americans were found to be
twice the level found in Caucasian patients.
Source:
Canadian Pharmaceutical Journal. |
|
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| Antihypertensive
and Quality of Life |
Patients diagnosed
with high blood pressure need to take medication, often for
decades, as preventative treatment. It is important that the
drugs used are well tolerated otherwise the compliance rate
will be further reduced.
Since most people with high blood pressure generally feel
no symptoms there is a higher likelihood of non-compliance.
Often the only way to gauge quality of life is by using subjective
questions to assess symptoms.
The three symptoms that differed most significantly in patients
with high blood
pressure were emotional distress, cardiac symptoms and concern
about effects on sexual function. |
|
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| NSAIDs
and Heart Attack |
Researchers at Nottingham
University, UK compared patients taking NSAIDs in the 3 months
prior to a heart attack with patients who had not taken the
drug for 3 years. The risk increased by 24% in patients taking
Ibuprofen (Advil, Motrin), 55% with Diclofenac(Voltaren),Celebrex
21%, and Vioxx 32%. This group of drugs are widely used in elderly
patients who are also at increased risk of heart attack.
Source:
British Medical Journal. |
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| Guggul
for High Cholesterol |
Guggul is a substance
secreted from the bark of the mukol myrrh tree, native to India,
when the tree is damaged. It has been used in Asia to treat
high cholesterol and is gaining interest in the US as more patients
seek alternative treatment for high cholesterol.
Source:
MedScape 2005. The complete article can be viewed by accessing
www.medscape.com. |
|
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| 10
year Survival after Minor Stroke |
The Lancet reports
that 43% of patients who suffer a minor stroke can expect to
have a second event within 10 years. Secondary stroke prevention
is essential in patients with TIA (transient ischemic attack)
and their risks should be re-evaluated regularly to prevent
cerebrovascular and cardiovascular events in the future.
Source:
Doctor's Guide August 2005. The complete article can be viewed
by accessing www.docguide.com. |
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| Sleep
Therapy may protect against Heart Disease |
Continuous positive
airway pressure, commonly used to treat sleep apnea, may protect
against death related to cardiovascular disease according to
a study from the US. Sleep apnea is associated with some modifiable
risks such as obesity, smoking and alcohol consumption.
Source:
Doctor's Guide August 2005. The complete article can be viewed
by accessing www.docguide.com. |
|
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| H.pylori
and Atrial Fibrillation |
A British study indicates
that Helicobacter pylori. a gastric bacterium commonly found
in patients with stomach ulcers, may also be linked to the development
of atrial fibrillation (irregular heartbeat). H.pylori tests
are available and the bacterial infection treated with a combination
of antibiotics and proton pump inhibitors for a period of 7
days.
Source:
Doctor's Guide August 2005. The complete article can be viewed
by accessing www.docguide.com. |
|
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| Invasive
Treatment after Heart Attack |
Patients who have a
suspected heart attack and do not receive thrombolytic treatment
(clot dissolving drugs)within 12 hours to preserve heart muscle
function may benefit from having a stent, a small device inserted
into the major blood vessels to maximize blood flow to the heart
muscle, implanted . Patients are often seen in emergency rooms
after that critical 12 hour when there is no benefit to be gained
from administration of the clot buster drugs.
Source:
Doctor's Guide August 2005. The complete article can be viewed
by accessing www.docguide.com. |
|
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| Cholesterol
Skin Test |
Prevu Skin Sterol Test
should be available in Canada soon. This test takes 5 minutes,
is non-invasive and does not require 12 hour fasting prior to
the test. It measures the amount of cholesterol in the skin
and is designed to be used in doctor’s offices,
pharmacies or clinics. The test itself is $15 but requires a
spectrophotometer to read the result (cost $2750 to purchase).
This could be an effective screening tool to identify patients
at risk prior to doctors prescribing cholesterol lowering drugs.
Source:
Pharmacist’s Letter 2005. |
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