Breathe Easier

The most common question in the pharmacy (at least recently) is allergies. Most often nasal congestion. The are two basic routes to go: orally or in the nose. Let's cover the orals first.

Cheapies:

Pseuoephedrine [Sudafed] (OTC): cheap and effective, need an ID to prove you are not turning it into meth.

Phenylephrine [Sudafed PE] (OTC): cheap and not quite as effective, no ID needed.

Diphenhydramine [Benadryl] (OTC): anti-histamine, most effective-most drowsy. About $2 for a box.

Doxylamine [Unisom] (OTC): about the same as diphenhydramine but it lasts longer.

Loratidine [Claratin] (OTC): anti-histamine, less effective but not drowsy not all. Once a day dosing, about $2 a box.

Certrazine [Zyrtec] (OTC): the "middle of the road" anti-histamine, effective and usually not drowsy. Just went generic so not quite as cheap but coming down fast.

Chlorpheniramine [Chlor-Trimeton] (OTC): effective, can be drowsy, and last a long time. I've gotten #100 tablets for $2.19.

Hydroxyzine: the only prescription one in this category. It get prescribed for sleep, bee stings, and pain. Either way it's about $4.

Rip-offs:

Clarinex: $116/month, about $112 more than Claritin per month. A "patent extender" for Claritin. Thankful I probably see a Rx for this once a month. Unfortunately, I see a Rx for this once a month.

Come back next time to see what you can spray up your nose.

The Pain Hurts, Hopefully the Bill Won't Either

People have pain everyday, it just depends on how much. Arthritis, cancer, injuries, diabetes, taco bell, and heart attacks can be causes. If you are not in pain now, just wait a few days and you will be soon.





Cheapest Non-drug treatment:





ICE! It's localized, effective, and safe. [Cost is about 0.001% of your water bill.]





Rip-off Non-drug treatment:





Going to Urgent Care...





Rip-off drug treatments:

Darvocet:

Your dentist may hand this to you, send it back. It's actually cheap, but not very effective and has toxic metabolites that stick around in your body for weeks.

Celebrex:

$100-400/month
This is the "stomach-friendly" NSAID (non-steroidal anti-inflammatory) that is made by Pfizer. But instead it can cause a better chance of stroke or heart attack. Some would say you get what you pay for, I say rip-off.

Expensive, but maybe worth it:

Fentanyl Patch:
probably $100s-1000s
A patch you leave on for a few days at a time. It is the most potent pain-killer around. If you get prescribed this you probably have cancer, so I would hope you have insurance.

Lyrica:
$100-400/month
Better as a last ditch plan. See gabapentin below.

The Triptans (Imitrex, Max-alt, Frova, Zomig):
$100-300/month
The best thing on the planet if you have migraines.

Cheap Meds: There are so many drugs in this category, but many are DEA controlled because they have some addictive potential. You basically have to increase the dose until it works. The prices will depend on what you need but they all are affordable.

Vicoden, Percocet, etc.: Your basic opiate + Tylenol meds. Very common generally work well, prescribed in the millions.

Oxycodone, regular or Oxycontin: A little more potent, a little more expensive, a little less prescribed.

Gabapentin: Went generic (Neurontin) about a year ago, not as addictive and has a wide spectrum of use.

Tramadol: A misunderstood drug, similar to the other opiates. I've seen addicts using this. Very cheap though.





I hope many pain-free days upon you all.

Done with school, back to business...

I'm all done with regular pharmacy school. I'll be doing rotations for the next year at varying locations...I'll have plenty of stories to tell.

1st stop the VA....

Generic Alert: What was good in April

Here is some good new brand names that went off patient and may save you (or your patient) some $$$.

Top Brand to Generics

1. Aricpet (Pfizer/Eisai), one the biggest Alziemer's treatments is finally off. Teva won the aproval for the generic, donepezil. This will save a ton of cash for people on Medicare Part D.
2. Children's (certrizine) Zyrtec Syrup is now on the OTC shelf. Another allergy option for the public can't hurt.
3. Xopenex Solution: this one always seemed like a rip-off, but now at least the price should come down.

One Class of Meds Where You're Really Screwed

<-"Ok sir, that will be $2, 500. Would you like to pay all up front or our financial department can arrange a payment plan."

None of the effective ED meds are cheap. Plus insurance companies do not like to pay for it, so it comes out of pocket for the poor guys. Let's take a look at what it will cost a guy to have sex 3 times a weeks for a whole year:

Viagra: $1,851.05

Cialis: $2,131.85

Levitra: $1,778.31

Hmm...tough decision: sex all year or a brand new LCD TV with a year-long satellite subscription.

Viagra will probably be available generic in a couple of years. In the meantime let's see what on TV.

Wal-Mart offers more cheap meds

Those blue-vested bastards. They've now made a $10/90 day list, and a $9 list. The $9 list has some good women's health meds. Breast cancer, hormone replacement therapy, birth control, osteoperosis prevention (aka Fosamax).

A link to the list.

Financial Disclosure: I'm Broke!

I get tired of thinking about drugs all day and night. Time to bring some diversity here. Just wanted to let everyone know that when I talk positive or negatively about a medication it is not because I have any financial interest in it for the following reasons:

1. Not enough people look at this site to make a dent in any sales. (Maybe someday.)
2. My job performance is not based upon sales in $$$'s.
3. I don't have any significant amount of money to invest in a pharmaceutical company.
4. I don't think any of the big Pharma companies stocks are good investment right now. (Come back for more discussion.)
5. If anything I talk more negatively about big Pharma companies than positive, but it depends on the topic of course.

Bottom line: I'm all about full disclosure. At least from me you don't have to worry about kickbacks from Pfizer.