Online Purchasing of Medications-Let the Buyer Be Aware

No one knows what the Affordable Care Act will provide in the near future. One thing we know for sure is that the cost of prescription medicine will continue to rise. As a result many Americans are buying their medications online and overseas.

Though technically illegal, millions of Americans buy prescription drugs from overseas pharmacies to save money. But the practice can be a huge gamble.
The National Association of Boards of Pharmacy, a professional group, reviewed over 10,000 Internet drug outlets and found that many sold fake or unapproved drugs. Some that claimed to be Canadian pharmacies actually sold medicines from developing countries where regulations are weak and counterfeit drugs are common.

Only 2 to 3 percent of online pharmacies are legitimate. When buying Canadian look for outlets certified by the Canadian International Pharmacy Association, a trade group of Canadian pharmacies, or those certified by PharmacyChecker.com, a free website that verifies that the foreign sites it approves protect consumer information and meet quality standards.

A study analyzing 372 orders of five popular prescription drugs – Lipitor, Celebrex, Viagra, Nexium and Zoloft – that were purchased from 79 domestic and foreign online drug outlets. Products bought from Canadian or other foreign sites certified by C.I.P.A. or PharmacyChecker.com were of high quality. So were products ordered from American sites verified by either the N.A.B.P. or LegitScript.com, a certification agency founded by a former White House aide on drug policy issues.

But that was not the case for sites that were not certified by any of these four groups. Many of the drugs they sold were fakes, including about a quarter of the Viagra samples, which largely appeared to have originated in China.

You can’t be 100% certain with any sites, frankly, but you are running a much lower risk if you buy from a credentialed site.

Bottom Line: You get what you pay for. If it’s significantly cheaper, there’s probably reason for the decreased cost. I suggest you buy drugs, like heart drugs, blood pressure medication, and medication for treating diabetes, from credible and reliable sources.

This article was excerpted from an article, Is it Safe To Buy Drugs From Online Pharmacies In Canada? by Anhad O’Connor, NYT, November 12, 2013

Mix Grapefruit Juice With Your Cocktails Not With Your Medications

Grapefruit Juice- Careful How You Mix It With Your Medications

Grapefruit juice has many medicinal uses including acidify urine, provide vitamin C which can help prevent colds and flu-like symptoms, and has ingredients that may be beneficial in preventing cancer. However, the juice for all its benefits may have a deleterious interaction with many medications.

Research about the interaction of grapefruit juice with drugs suggests that compounds in grapefruit juice, called furanocoumarins (for example, bergamottin), may be responsible for the effects of grapefruit juice. Researchers believe that furanocoumarins block the enzymes in the intestines that normally break down many drugs. One glass of grapefruit juice could elicit the maximum blocking effect, and the effect may persist for longer than 24 hours. Since the effects can last for such a prolonged period of time, grapefruit juice does not have to be taken at the same time as the medication in order for the interaction to occur. Therefore, unlike similar interactions, where the interaction can be avoided by separating the administration of the two interacting agents by a couple of hours, administration of grapefruit juice with susceptible drugs should be separated by 24 or more hours to avoid the interaction. Since this is not practical for individuals who are taking a medication daily, they should not consume grapefruit juice when taking medications that are affected by grapefruit juice.

The grapefruit juice-drug interaction can lead to unpredictable and hazardous levels of certain important drugs. For example Viagra is of special interest to men. The clinical information is incomplete, but men who take Viagra should be aware that grapefruit juice might boost blood levels of the drug. That could be a good thing for some men with erectile dysfunction, but it could trigger headaches, flushing, or low blood pressure.

Bottom Line: Grapefruit juice can be of benefit to many people who drink it on a regular basis. However, the juice can impair the metabolism of many medications thus placing juice drinkers at risk for developing higher than normal blood levels of their medication. I suggest if you are a frequent grapefruit juice drinker, that you check with your doctor.

When Medicines Make You Sick

Most middle age and older men and women take more than one medication on a regular basis. Unfortunately these medications can interact with each other and produce undesired effects; sometimes the side effects are worse than the disease or condition that the original medication was intended to treat. It is estimated that 4.5 million Americans will return to the doctor’s office or even have to go to the emergency room because of the side effects of medication. There are an estimated 2 million serious drug reactions each year and drug reactions are the fourth leading cause of hospital deaths exceeding only by heart disease, cancer and stroke.

Side effects can produce symptoms ranging from lethargy, insomnia, muscle aches, depression, dizziness, diarrhea, constipation, and even chest paid.

So what can you do to avoid side effects of medications? First be sure your doctor knows what medications you are currently taking. Ask if the drug he is prescribing has any interactions with the drugs you are currently taking. There are computer programs that are available that will alert the doctor of any possible drug interactions. One of the most popular programs is e-Pocrates where the doctor or nurse can write in the drug being prescribed and the drug(s) the patient is currently taking and will list any potential drug interactions. Most electronic medical record programs that are becoming so prevalent among physicians’ practices will notify the doctor of any potential drug interactions.
Also, you can go to the Internet and use one of the search engines such as Google and type in the name of the medication and the phrase “drug interactions” and you will learn what drugs should not be taken together. There are drug interaction checkers available online. One of the best is aarp.org/healthtools.

Next, ask the doctor what are the most common side effects and what is the likelihood of having any of the side effects. If the medical problem is not serious and not incapacitating, you may decide to forgo any new medications.

Also, ask your doctor if there are any lifestyle changes you can make as an alternative to taking medications. For example, if you have newly diagnosed high blood pressure, you can undergo a weight loss program and significantly reduce the salt in your diet, and you may avoid taking blood pressure lowering medications, which have side effects.

If you are taking multiple medications, you can ask your pharmacist to review all of your medications and the pharmacist will let you know which drugs are incompatible. Some pharmacists will charge you a few for this review but it is certainly worth it especially if you are older and if you take multiple medications. Also, if you are in a Medicare Advantage program, you may qualify for its medications therapy management services.

If you begin to experience a change or symptoms shortly after starting a new medication, you should contact the doctor’s office and speak to the doctor or nurse to find out if this is an expected side effect, how long it might last, or if the side effect is more serious and the drug should be discontinued.

It is also important to mention to your doctor any supplements, herbal medications, or vitamins that you routinely take as these may interact with your prescribed medications.

Final advice: Even if you are experiencing side effects due to medications, don’t stop taking the medication without calling your doctor first.

Bottom Line: For the most part drugs properly prescribed can be very helpful and will alleviate symptoms and treat your medical condition. However, all medications have side effects and you can minimize these side effects by being knowledgeable and informed about drugs and drug side effects.

A Grapefruit May Be The New Apple-But Be Careful

For generations we have been encouraged to eat an apple-a-day in order to stay healthy and keep the doctor at bay. Today, the new apple may just be the grapefruit.
Let’s look at the benefits of grapefruit:

Appetite Loss: Grapefruit reduces the feeling of hunger. This is the reason why people include grapefruit in their weight loss programs. High fiber contained by this fruit can satisfy hunger and thus may avoid any overeating temptation. Grapefruit juice, if combined with water, can quench the thirst.

Fatigue: Grapefruit is beneficial in the treatment of fatigue. It helps to dispel fatigue and general tiredness. It can bring about a refreshing feeling in you when you drink equal amount of grapefruit juice and lemon juice.

Acidity: The fresh grapefruit juice has alkaline reaction after digestion. The citric acid increases the effect of the alkalinity reaction after digestion. The juice extracted from the grapefruit is beneficial in preventing the acid formation and many other diseases that arise due to the presence of acidity in the body.

Indigestion: Grapefruit is useful for solving the problem of indigestion. It is very light as compared to other food articles and thus, acts immediately on indigestion by easing the heat and irritation caused in the stomach. It improves the flow of digestive juices, thereby improving the digestive systems.

Insomnia: A simple glass of grapefruit juice, if drunk before going to bed, can promote healthy and sweet sleep and thus, alleviates insomnia.

Constipation: A glass full of fresh squeezed grapefruit in the morning is the best remedy to control the constipation. Grapefruits are high in fiber and they result best in stimulating the colon and other parts of the body.

Urinary Disorders: Grapefruit juice is quite rich in potassium and vitamin C and thus, works as the best medicine in the case of recurrent urinary tract infections.

Lowers Cholesterol: The Journal of Agricultural and Food Chemistry shows that consumption of grapefruit can reduce LDL (“bad”) cholesterol, as well as triglycerides.

Caveats on grapefruit
As with any medication, there are considerations about the use of grapefruit with medications. More than 50 prescription and over-the-counter drugs are affected by grapefruit juice, including some of the most commonly prescribed medications. This list includes a number of medications used to treat high cholesterol, high blood pressure, depression, pain, erectile dysfunction, and allergies.

Grapefruit contains a substance that inhibits the enzyme called CYP3A4. This powerful enzyme breaks down numerous medications such as the cholesterol-lowering drug, Lipitor. Patients who take Lipitor, or some antidepressant medication, and eat grapefruit, can have toxic levels of the medications because the grapefruit inhibits CYP34A.

So what are patients to do? Check with your healthcare provider or pharmacist to find out about your specific drug. All new medications are tested for drug interactions, including grapefruit juice, before they are approved by the U.S. Food and Drug Administration (FDA). When you order medications in the mail or pick them up at your local pharmacy, you should receive a patient information sheet, which will let you know if your drug is affected by grapefruit juice. Some pharmacies may also put a warning label on your medication bottle. If you are not sure, ask the pharmacist.

Bottom Line: Grapefruit juice may be helpful for many conditions and improve overall health. However, there are precautions about using grapefruit because of interactions with certain medications. If you have any questions, check with your doctor or your pharmacist.

How To Become a Better Patient-You Need to Ask the Vital Questions

It is not easy being a patient.  Most patients are nervous and anxious when visiting a doctor and often forget to ask vital questions that will impact their health.  Here are six questions that you should ask your physician when he\she prescribes a new medication:

1.  What does this medication do?  What is the purpose of the medication?

2. How will I know if the medication is working?  Can you tell me about how long I will have to wait before the medication begins to work?

3. What are the side effects of this medication?  What should I do if I experience these side effects?  How common are these side effects?

4. Why is this medication good or effective for my condition?

5. Are there any other non-medication alternatives that I could try that may do the same as the medication?

6. What are the consequences of not taking this medication?

7. Is this a new drug?  Would a less expensive generic drug work just as well?

By asking these questions, you will demonstrate to your doctor that you are actively involved in your medical care.  You now become a part of the “team” and there is no one who should be more interested in your care than you.