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Pepin's Pharmaceutical Prattle for 03-23-2009

 Quote of the day:  It is very difficult to live among people you love and

                       hold back from offering them advice.
                     Anne Tyler (1941 - ), Celestial Navigation, 1974


 Good Morning!

My node id stumpfed ub!

      My sniffling daughter asked for some advice about her allergies. Here goes darlin’,,,

The first, and most obvious, solution is to avoid the source of the allergy… the allergens. This could be pet hair and danders as well as molds, or every sort of pollens (trees to ragweed.) This is much harder to do than to say if you want to continue to have a real life outside of an air quality controlled room.

      I know that you have been using over the counter antihistamines and they are not working all that well for you. You take no solace knowing that Allegra, Claritin and Zyrtec were prescription drugs a few years ago when the FDA decided that patients could self diagnose and treat with relative safety. What else is out there? You could all a decongestant to any of them such as pseudoephedrine (Sudafed) or just buy the “-D” formulation of each. Decongestants are not good if you have trouble with high blood pressure and could stimulate you so much as to cause sleep disorders. Benadryl has always been available OTC but it tendency to cause drowsiness makes it a better sleep aid for some than an antihistamine.

      OTC Afrin nasal spray (or the generic) will relieve nasal symptoms for a few days. If you continue to use it for more than 3 days, your nasal membranes will become dependent upon the spray which means that you will become MORE congested when you stop. Yes, your nose will resemble a potato. Your nose is much to cute to put at risk.

      My suggestion, young lady, is for you to discuss your symptoms with your physician. You may inquire if nasal steroids such as Nasonex (mometasone), Nasacort (triamcinolone), Flonase (fluticasone), Rhinocort (budesonode), or Beconase (beconase) may be right for you. Why is it that your drug plan will pay for one but not another? Because some are available generically and less expensively and some are only available as brand name drugs. Call the number on the back of your “pharmacy card” before you go to the doctor so that a prescription can be written which won’t cost you an arm and a leg. (Ask “what’s on formulary?”) Again, it will be up to the doctor to determine if this is the right approach. If you do go this route, be sure to use the nasal spray every day (as directed) whether or not you are experiencing allergy symptoms that day. The drugs work to protect you from inflammation and are not to be used only when you have symptoms.

       There may be more arrows in the anti-allergy quiver for you down the road but these are a great place to start.

 Have a GREAT week!



ps. Best answer this week to the question "How are you?" was "I'm congested... help!"

pps. Please note that some of the links may not be up for very long and that

     you should capture or print anything that you may wish to keep.

ppps. Happy BD Munch!



1) Top dog of OTC for 2008

Zyrtec converted to OTC status and was the number 1 grosser for 2008. The list also includes Alli as #2.


2) “Sing” to avoid absorbing your supper

Naomi Judd album “Sing” to the first 200,000 people to buy Alli (which blocks the absorption of fat from meals.) This exclusive initial release of an album feels wrong, but I can’t quite put my finger on it. (Seems like too much pressure) They were #2 in otc sales before this stunt. Ps. Mirilax was number 6.


3) FDA warning about insulin pen sharing

Hepatitis C transmitted between patients even though new needles were used for each patient. The FDA is insisting that each pen be used on only for one patient. I think that’s why they are called PERSONEL injector devices.


4) Atypical is atypical

Seroquel has atypical profits for an atypical antidepressant. Lipitor was the biggest Rx winner. All drugs showed a slow rate of growth but it was growth in this crazy world.


5) Reloxin is the name wrinkles may soon be the game.

An alternative to Botox may be just around the corner. Already approved in many other countries for wrinkle removal but the FDA has yet to rule.


6) Alzheimer’s and diabetes link even stronger.

Patients with diabetes are more likely to develop dementia and make it progress faster once it does hit. With diabetes on the rise I can only guess that there will be more demented to care for.


7)Little “Lex”

FDA approves the use of Lexapro for children as probe continues into the marketing of the drug to physicians as appropriate for children. This will be a whale of a head spinner.







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Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARMWORKS, LLC and Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To start or stop any drug without the advice and supervision of your physician would be stupid. So don't do anything based upon what you read here without professional advice.  To be added to or removed from the distribution list please e-mail your request to . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2009 PHARMWORKS,LLC all rights reserved.

Copyright 1998-2009 PHARMWORKS, LLC all rights reserved