A healthy lifestyle is the first and most important way to win the battle against cholesterol, but for some it’s just not enough. Many who diet and exercise still find themselves in a fight against cholesterol, and prescription medication may be the way to best combat high cholesterol.
Cholesterol medications help by decreasing your low-density lipoprotein (LDL) aka the “bad” cholesterol that increases the risk of heart disease, decreasing your triglycerides which is the fat in the blood that also increases the risk of heart disease, or by increasing your high-density lipoprotein (HDL) aka the “good” cholesterol that protects from heart disease.
Depending on what your body needs most to lower your cholesterol, your doctor may prescribe one drug or a combination of several different drugs to help lower your cholesterol. Here is a quick overview of some of the drugs you may be prescribed, there benefits and some side effects to look out for.
Statins
Crestor, Lescol, Zocor, Mevacor, Pravachol, and Lipitor, all belong in the class of drugs called statins. Statins slightly increase HDL, and decrease triglycerides as well as LDL. Some possible side effects to look out for are constipation, nausea, diarrhea, stomach pain, cramps, and muscle soreness.
Bile acid binding resins
Colestid, Questran, and Welchol are all considered bile acid binding resins. These drugs only decrease LDL. Some possible side effects are constipation, nausea, and a possible increase triglycerides.
Cholesterol absorption inhibitors
Zetia is known as a cholesterol absorption inhibitor. Zetia decreases LDL, slightly decreases triglycerides, and also slightly increases HDL. Stomach pain and fatigue are the most common side effects associated with Zetia.
Combination cholesterol absorption inhibitor and statin
Vytorin is known as a combination cholesterol absorption inhibitor and statin and decreases both LDL and triglycerides, while increasing HDL. Some common side effects are stomach pain, fatigue, constipation, cramps, muscle soreness.
Fibrates
Fibrates such as Lofibra, Lopid, and TriCor decrease triglycerides and increase HDL. Common side effects include nausea, stomach pain, and gallstones.
Combination statin and niacin
Some drugs like Advicor are combination drugs which combine two or more other types of cholesterol fighting medications. The combination of statin and niacin decreases LDL and triglycerides while increasing HDL. Some common side effects are dizziness, heart palpitations, shortness of breath, sweating, and chills.
Niacin
Niaspan is classified under the drug class of Niacin and is known for decreasing both LDL and triglycerides, and increasing HDL. Some common side effects include nausea, vomiting, diarrhea, gout, high blood sugar, and peptic ulcers.
No matter what cholesterol medicine your doctor determines is right for you, be sure you know what side effects coincide with each drug and the warning signs you should be on the look out for. Be aware that if you are prescribed a statin or a combo drug that includes a statin, you should avoid consuming grapefruit juice.
If you would like to safely buy your cholesterol medication much cheaper than at your corner pharmacy, be sure to use eDrugSearch.com to freely compare all your drug prices so you can start savings upwards to 80% off.
Today in London the FDA decided to postpone approval of a new experimental heart drug, seeking more information about the new product.
The drug called Certriad, combines AstraZeneca’s blockbuster cholesterol pill Crestor with Abbott Laboratories TriLipix.
According to Rueters,
The manufacturers said on Tuesday they had received a so-called “complete response letter” from the U.S. Food and Drug Administration for Certriad, which combines Astra’s blockbuster cholesterol pill Crestor and Abbott’s TriLipix.
Both companies said they were evaluating the letter from the agency and would respond to the request for additional information. An AstraZeneca spokesman declined to give further details.
Combo pills are fairly common for heart drugs, and most thought that FDA approval was a given. Merck merged Zocor and Zetia to form Vytorin, and soon they plan to combine Zetia with Pfizer’s Lipitor.
Combo pills are also fairly common in diabetes drugs. For example Januvia, Avandia,and Actos are all available as combo product with generic versions Glucophage.
In typical big pharma fashion, Astra did not disclose what the FDA has a problem with, but many analysts have voiced concern that Certraid does not have enough backing to pass FDA approval after the results from a clinical study this month showed there was no real benefit from adding TriLipix to Crestor.
Healthcare reform isn’t just about the public option and paying for doctor’s visits — it’s also about equal, affordable access to life-saving medications for all Americans. That’s why many Big Pharma watchdogs are so disappointed with a recent amendment slipped into healthcare legislation that proposes extending patent protection on biologic drugs, delaying for years the public’s access to affordable follow-on versions.
What are biologics? They’re the next big wave in medicine — drugs made not from simple chemical formulations, but from biological components. They’re very expensive, and poised for enormous success:
By 2014, the biggest-selling meds will be biologics, according to an analysis from Evaluate Pharma. Taking the place of Pfizer’s gargantuan drug Lipitor will be Roche’s Avastin, a cancer med expected to account for $9.23 billion in 2014 sales. (Even when you factor in the recent trial disappointments.) The next five top sellers, in order, are expected to be Humira (Abbott Labs), Rituxan (Roche), Enbrel (Wyeth/Amgen), Lantus (Sanofi-Aventis), and Herceptin (also Roche).
Evaluate also predicts that half of the top 100 drugs in 2014 will be biotech meds a huge change from last year’s level of 28 percent and 11 percent in 2000.
Because biologics are so complex, the system we all know, where patented brand names enjoy a period of exclusivity, then eventually make way to cheaper generics doesn’t translate perfectly. Biologic generics are called biosimilars, and they are not seen as generic equivalents. They must be submitted for approvals as new drugs and do their own clinical trials, etc.Â
The Eshoo-Barton amendment, named for sponsoring Representatives Anna Eshoo (D – Calif.) and Joe Barton (R – Texas), would give brand-name biologic drugmakers 12 years of market exclusivity. By comparison, President Obama favors seven years, and Rep. Henry Waxman (D – Calif.) feels that the public should have access to “generic†biologics after just five years. By contrast, says Medical News Today, “The Biotechnology Industry Organization maintains that there should be a minimum 14 years of exclusivity to account for a development process that on average takes 10 years and $1.2 billion for a product to reach market.”
5, 7, 12, or 14 years? As you can see, there is a real difference of opinion on this subject. One person who has written extensively on this is author James Love on the Huffington Post. Here he explains why this amendment is harmful:
The Eshoo/Barton amendment, which has the support of many newly pro-PhRMA democrats, will extend the period of monopolies for biologic medicines, when compared to the original Waxman text. The only question is how long. Part of the harm will be the longer period prohibiting generic suppliers from relying upon evidence that medicines are safe and provide therapeutic benefits. Much of the other harm will come from a number of technical changes in the bill that make it much easier for incumbent firms to block entry through technical issues, extended litigation, and ever-greening of protection from small medically unimportant changes in protected medicines.
This is essentially a case of innovation versus access. Drug companies want protection from the risks and costs borne in the creation and testing of new drugs; patient advocates say that Big Pharma (or Big Biotech, if you like) already make large profits and that the public deserves access to affordable biosimilars in a more timely fashion. Entities that support longer periods of exclusivity, such as universities, biotech companies and venture capitalists are fighting to protect inventors’ rights and ensure more thorough clinical trials. On the other side, consumer groups, labor unions, insurers and generic drug manufacturers ‘see shorter exclusivity as the way to deliver safe, affordable and quality drugs to patients and open the marketplace to increased competition, explains Medical News Today.
The latest high-emotion development is blogger Jane Hamsher’s Are You Or Someone You Know Paying $50,000 A Year For Drugs? It paints an ugly picture of what happens to people who cannot affording life-saving biologics. A few days later, Rep. Eshoo responded to this and other online attention with a blog post on The Hill’s Congress Blog titled Setting the record straight on our health care legislation. If you check in with these two articles, you’ll have the latest from both side of the “biologic generics” debate.
Our mission, as always, at eDrugSearch.com is to improve the American public’s access to safe, quality medications at an affordable cost.
For more information:
- Should We Be OK With The PhRMA Deal With White House?
- US House Panel Backs Exclusivity for Biologic Drugs
- Pay or die: Deadly Pharma amendment in HCR going right under radar
We’re nearing the end of the year, and many people are already in open enrollment for next year’s health coverage, which means it is a great time to plan ahead for your 2010 drug expenditures. No, you can’t know every medication you are going to need, but if you are on a popular, patented maintenance drug such as Lipitor or Cozaar, you’ll be pleased to hear that their patents are expiring in 2010, opening the field for more-affordable U.S. generic versions.
In the meantime, as you do your research, you will see that many are already available as generics, manufactured outside of the U.S. There is usually a considerable cost savings.
Here are all the details of some of the highest-profile drugs that have expiring patents as of the end of 2009, or during 2010 and how and where to get the generic versions.
ARICEPT (donepezil). Pfizer makes the acetylcholinesterase inhibitor Aricept for the treatment of Alzheimer’s disease. Aricept is scheduled to lose patent protection in the U.S. in 2010, but generic versions are already available.
COZAAR (losartan). Merck’s Cozaar is an angiotensin II receptor antagonist, used to treat hypertension. Cozaar‘s patent protection in the U.S. will expire in 2010. In the meantime, generic losartan is available here.
LEVAQUIN (levofloxacin). Johnson & Johnson’s antibiotic drug Levaquin will outlive its patent protection in 2010. However, until that time, you can purchase generic levofloxacin here.
LIPITOR (atorvastatin). Pfizer has the best-selling drug in the world in Lipitor, which treats high cholesterol. In the US, the basic patent for Lipitor expires in March 2010, while the second patent covering the calcium salt of atorvastatin expires in June 2011. It is not yet clear exactly which date will see widespread availability of generic Lipitor in the U.S., but it is coming. In the meantime, generic atorvastatin is available here.
XENICAL (orlistat). Roche’s Xenical is an obesity treatment that prevents the digestive system from absorbing fats. Its patent expires in December of this year. (Note: In some countries, including the U.S., orlistat is available over-the-counter as GlaxoSmithKline’s Alli.)
VALTREX (valacyclovir). GlaxoSmithKline’s Valtrex is a treatment for herpes simplex and herpes zoster (shingles). Valacyclovir was recently approved for generic production, and so generic versions will be on the U.S. market by the end of 2009. As of this writing, generic valacyclovir is available here.
If you’re interested in the business ramifications for the pharmaceutical companies, CNN ran a good article on the topic, and so did Chemistry World.
Enjoy using eDrugSearch.com to knowledgeably plan your medication choices for the coming year.
A diagnosis of high cholesterol can be intimidating, but there is a lot you can do to control this condition. In addition to modifying your diet and upping your exercise, the addition of a HMG-CoA Reductase Inhibitor, a class of drugs commonly called “statins” can safely and effectively lower your cholesterol. (HMG-CoA Reductase helps our liver produce cholesterol; when the chemical is inhibited, the amount of cholesterol is correspondingly reduced.) For people with heart disease, statins can lower the risk of a cardiac event and subsequent death. If you and your doctor have determined that you need a statin, how can you pick the right statin for your needs?
There are six statins on the market: atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin. They differ in their ability to reduce cholesterol, and they also differ in their rates of reducing heart attacks. Their costs are also quite different and since most people take statins for a long time, the costs add up over the years. With all of these variables, choosing the right statin for you can be complex.
All statins are capable of lowering LDL (bad) cholesterol and triglycerides, and raising HDL (good) cholesterol. The statins do differ in how effectively they can do this, and it is highly dose-dependent. Says Drug Digest:
If the needed LDL-C reduction is up to 35-36%, any of the statins should be acceptable choices for therapy. For a desired reduction of LDL-C greater than 42%, simvastatin (Zocor), atorvastatin (Lipitor), or rosuvastatin (Crestor) would be needed.
Indeed, the best-known statins are Crestor, Lipitor, and Zocor (quite probably because they have the greatest effect on cholesterol levels). The latter two are also endorsed by Consumer Reports. Taking evidence for effectiveness, safety, and cost into account, the publication rated both of these statins as Consumer Reports Best Buy Drugs. They recommend:
Generic (simvastatin 20mg or simvastati 40 mg) if you need 30% or greater LDL reduction and/or have heart disease or diabetes, or if you have had a heart attack or have acute coronary syndrome and your LDL level is not highly elevated.
Atorvastatin (Lipitor 40mg or Lipitor 80mg) if you have had a heart attack or have acute coronary syndrome and your LDL is highly elevated; use for two years and then reconfirm need or switch to generic simvastatin.
Charts on Drug Digest have some great comparisons. For instance, they show that Lipitor 10mg – Lipitor 80mg can reduce total cholesterol by 25-45%, while Zocor 5mg – Zocor 80mg can reduce the same numbers by 19-36%, and Crestor 5mg – Crestor 40mg can reduce it by 33-46%. As for lowering HDL, Lipitor can offer reduction of 5-9%, Zocor lessens HDL by 8-16%, and Crestor lowers these numbers by 8-14%. As you can see, choosing the proper statin has a lot to do with which numbers (Total Cholesterol, HDL, LDL, or triglycerides) you are trying to effect.
A final consideration is that last year there was reporting on an observational study done by Pfizer that suggested that there were certain benefits to using Lipitor over Crestor. However, one must keep in mind that Pfizer conducted the study, and they are the manufacturer of Lipitor, and they are defending this drug against Merck’s Zocor product, which is now available in a generic formula. Here is the information as presented by The Wall Street Journal:
An analysis, published in the latest Clinical Therapeutics Journal, mined a large database of health-care records and found that patients taking Lipitor had a 12% lower risk of a cardiovascular event than those on simvastatin, the generic name for Zocor. The patients on Lipitor had a 15% lower risk of having a heart attack.
So-called observational studies like this one that look at data after the fact aren’t as powerful as prospective clinical trials. Jack Tu, a cardiologist who specializes in outcomes research at Canada’s Institute for Clinical Evaluative Sciences, says the latest Pfizer study didn’t take into account factors that could predispose a patient to heart problems, such as smoking and cholesterol levels. Just on this alone, you wouldn’t recommend that everyone should switch onto Lipitor,†he says.
Still, Pfizer hopes that doctors will take notice. We’ve done two rather large observational studies and patients have a lower risk of cardiovascular events on Lipitor [compared with] simvastatin, says Susan Shiff, Pfizer’s team leader for cardiovascular outcomes. Doctors need to factor this into discussions with patients.
You should definitely discuss with your physician which statin is right for you. In general, the best plan is to take the LOWEST dose of a statin that gets you to your target level for cholesterol. Overly large doses can be harmful to your liver and to your muscles. If you experience muscle aches and pains when taking a statin, contact your doctor immediately.
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