Cvs Caremark® Maintenance Drug List Effective As of 09/02/2020
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Long-Term Statin Use and Risk of Ductal and Lobular Breast Cancer Among Women 55 to 74 Years of Age
Published OnlineFirst July 5, 2013; DOI: 10.1158/1055-9965.EPI-13-0414 Cancer Epidemiology, Research Article Biomarkers & Prevention Long-Term Statin Use and Risk of Ductal and Lobular Breast Cancer among Women 55 to 74 Years of Age Jean A. McDougall1, Kathleen E. Malone1, Janet R. Daling1, Kara L. Cushing-Haugen1, Peggy L. Porter1,2, and Christopher I. Li1 Abstract Background: Mechanistic studies largely support the chemopreventive potential of statins. However, results of epidemiologic studies investigating statin use and breast cancer risk have been inconsistent and lacked the ability to evaluate long-term statin use. Methods: We used data from a population-based case–control study of breast cancer conducted in the Seattle–Puget Sound region to investigate the relationship between long-term statin use and breast cancer risk. Nine hundred sixteen invasive ductal carcinoma (IDC) and 1,068 invasive lobular carcinoma (ILC) cases in patients 55 to 74 years of age diagnosed between 2000 and 2008 were compared with 902 control women. All participants were interviewed in-person and data on hypercholesterolemia and all episodes of lipid-lowering medication use were collected through a structured questionnaire. We assessed the relationship between statin use and IDC and ILC risk using polytomous logistic regression. Results: Current users of statins for 10 years or longer had a 1.83-fold increased risk of IDC [95% confidence interval (CI): 1.14–2.93] and a 1.97-fold increased risk of ILC (95% CI: 1.25–3.12) compared with never users of statins. Among women diagnosed with hypercholesterolemia, current users of statins for 10 years or longer had more than double the risk of both IDC (OR: 2.04, 95% CI: 1.17–3.57) and ILC (OR: 2.43, 95% CI: 1.40–4.21) compared with never users. -
Appendix A: Potentially Inappropriate Prescriptions (Pips) for Older People (Modified from ‘STOPP/START 2’ O’Mahony Et Al 2014)
Appendix A: Potentially Inappropriate Prescriptions (PIPs) for older people (modified from ‘STOPP/START 2’ O’Mahony et al 2014) Consider holding (or deprescribing - consult with patient): 1. Any drug prescribed without an evidence-based clinical indication 2. Any drug prescribed beyond the recommended duration, where well-defined 3. Any duplicate drug class (optimise monotherapy) Avoid hazardous combinations e.g.: 1. The Triple Whammy: NSAID + ACE/ARB + diuretic in all ≥ 65 year olds (NHS Scotland 2015) 2. Sick Day Rules drugs: Metformin or ACEi/ARB or a diuretic or NSAID in ≥ 65 year olds presenting with dehydration and/or acute kidney injury (AKI) (NHS Scotland 2015) 3. Anticholinergic Burden (ACB): Any additional medicine with anticholinergic properties when already on an Anticholinergic/antimuscarinic (listed overleaf) in > 65 year olds (risk of falls, increased anticholinergic toxicity: confusion, agitation, acute glaucoma, urinary retention, constipation). The following are known to contribute to the ACB: Amantadine Antidepressants, tricyclic: Amitriptyline, Clomipramine, Dosulepin, Doxepin, Imipramine, Nortriptyline, Trimipramine and SSRIs: Fluoxetine, Paroxetine Antihistamines, first generation (sedating): Clemastine, Chlorphenamine, Cyproheptadine, Diphenhydramine/-hydrinate, Hydroxyzine, Promethazine; also Cetirizine, Loratidine Antipsychotics: especially Clozapine, Fluphenazine, Haloperidol, Olanzepine, and phenothiazines e.g. Prochlorperazine, Trifluoperazine Baclofen Carbamazepine Disopyramide Loperamide Oxcarbazepine Pethidine -
What Precautions Should We Use with Statins for Women of Childbearing
CLINICAL INQUIRIES What precautions should we use with statins for women of childbearing age? Chaitany Patel, MD, Lisa Edgerton, PharmD New Hanover Regional Medical Center, Wilmington, North Carolina Donna Flake, MSLS, MSAS Coastal Area Health Education Center, Wilmington, NC EVIDENCE- BASED ANSWER Statins are contraindicated for women who are on its low tissue-penetration properties. pregnant or breastfeeding. Data evaluating statin Cholesterol-lowering with simvastatin 40 mg/d did use for women of childbearing age is limited; how- not disrupt menstrual cycles or effect luteal phase ever, they may be used cautiously with adequate duration (strength of recommendation: C). contraception. Pravastatin may be preferred based CLINICAL COMMENTARY Use statins only as a last resort Before reading this review, I had not been for women of childbearing age ® Dowdenaware Health of the serious Media effects of statin medications I try to follow the USPSTF recommendations and on the developing fetus. In conversations with not screen women aged <45 years without coro- my colleagues, I found that the adverse effects nary artery disease riskCopyright factors for Fhyperlipidemia.or personalof usestatins onlyduring pregnancy are not readily When a woman of any age needs treatment, my known. Such information needs to be more first-line therapy is lifestyle modification. Given the widely disseminated. risks of statin drugs to the developing fetus, Ariel Smits, MD women with childbearing potential should give Department of Family Medicine, Oregon Health & Science fully informed consent and be offered reliable University, Portland contraception before stating statin therapy. I Evidence summary anal, cardiac, tracheal, esophageal, renal, Hydroxymethyl glutaryl coenzyme A and limb deficiency (VACTERL associa- (HMG CoA) reductase inhibitors, com- tion), intrauterine growth retardation monly called statins, have been on the (IUGR), and demise in fetuses exposed market since the late 1980s. -
Medication Dental Watch List Risk for Reflux Risk for Caries
Risk for Stomatitis Risk for Xerostomia Generic and Trade Name Medication Dental Watch List Risk for Reflux Risk for Caries Abilify Celexa Exenatide Itraconazole Naproxen Sinequan Acamprosate Cetirizine Famotidine Ketorolac Neurontin Sporanox Accutane Chantix Feldene Kytril Nexium Strattera Actiq Chlorpromazine Felodipine Lamivudine Nifedipine Subutex Adalat Cholestryramine Fentanyl Lansoprazole Nitro-Bid Sulfamethoxazole Advair Cialis Fentanyl (transmucosal) Levalbuterol Nitro-Dur Sulfasalazine Aldomet Citalopram Flexeril Levbid Nitroglycerin Sulfatrim Alendronate Clarithromycin Flonase Levocarnitine Nitrostat Sumatriptan Alfuzosin Claritin Flovent Levocetirizine Nortriptyline Tacrine Aliskiren Clomipramine Fluoxetine Levodopa Oxybutynin Tadalafil Alprazolam Clonidine Fluticasone Lexapro Pamelor Tegretol Amitriptyline Clozapine Fluvoxamine Lioresal Pentasa Tekturna Anafranil Clozaril Fosamax Lisdexamfetamine Pepcid Tenex Antivert Cognex Fosinopril Lisinopril Periactin Thorazine Aripiprazole Combivir Gabapentin Lithium Piroxicam Tofranil Asacol Copegus Gemfibrozil Locholest Plaquenil Toprol Aspirin Cozaar Granisetron Loperamide Plendil Toradol Atarax Cyclobenzaprine Guanfacine Lopid Prevacid Trexall Atomoxetine Cymbalta Haldol Lopressor Prevalite UroXatral Atrovent Cyproheptadine Haloperidol Loratadine Prinivil Varenicline Azulfidine Cytotec Hydroxychloroquine Losartan ProAmatine Vasotec Baclofen Darifenacin Hydroxyzine Luvox Procardia Versed Biaxin Diflunisal Hyoscyamine Meclizine Propranolol Vistaril Budesonide Ditropan Ibuprofen Mesalamine -
Pharmacogenomics of Endocrine Therapy in Breast Cancer
Journal of Human Genetics (2013) 58, 306–312 & 2013 The Japan Society of Human Genetics All rights reserved 1434-5161/13 OPEN www.nature.com/jhg REVIEW Pharmacogenomics of endocrine therapy in breast cancer James N Ingle The most important modality of treatment in the two-thirds of patients with an estrogen receptor (ER)-positive early breast cancer is endocrine therapy. In postmenopausal women, options include the selective ER modulators (SERMs), tamoxifen and raloxifene, and the ‘third-generation’ aromatase inhibitors (AIs), anastrozole, exemestane and letrozole. Under the auspices of the National Institutes of Health Global Alliance for Pharmacogenomics, Japan, the Mayo Clinic Pharmacogenomics Research Network Center and the RIKEN Center for Genomic Medicine have worked collaboratively to perform genome-wide association studies (GWAS) in women treated with both SERMs and AIs. On the basis of the results of the GWAS, scientists at the Mayo Clinic have proceeded with functional genomic laboratory studies. As will be seen in this review, this has led to new knowledge relating to endocrine biology that has provided a clear focus for further research to move toward truly personalized medicine for women with breast cancer. Journal of Human Genetics (2013) 58, 306–312; doi:10.1038/jhg.2013.35; published online 2 May 2013 Keywords: aromatase inhibitors; breast cancer; pharmacogenomics; tamoxifen INTRODUCTION trials were the double-blind, placebo-controlled NSABP P-1 trial of Breast cancer is the most common form of cancer in women both in tamoxifen8, and the double-blind NSABP P-2 trial that compared the United States1 and Japan.2 Endocrine therapy is the most raloxifene with tamoxifen.9,10 Combined, these two studies involved important modality in the two-thirds of patients with an estrogen over 33 000 women, which constituted about 59% of the world’s receptor (ER)-positive early breast cancer. -
Aromatase Inhibitors
FACTS FOR LIFE Aromatase Inhibitors What are aromatase inhibitors? Aromatase Inhibitors vs. Tamoxifen Aromatase inhibitors (AIs) are a type of hormone therapy used to treat some breast cancers. They AIs and tamoxifen are both hormone therapies, are taken in pill form and can be started after but they act in different ways: surgery or radiation therapy. They are only given • AIs lower the amount of estrogen in the body to postmenopausal women who have a hormone by stopping certain hormones from turning receptor-positive tumor, a tumor that needs estrogen into estrogen. If estrogen levels are low to grow. enough, the tumor cannot grow. AIs are used to stop certain hormones from turning • Tamoxifen blocks estrogen receptors on breast into estrogen. In doing so, these drugs lower the cancer cells. Estrogen is still present in normal amount of estrogen in the body. levels, but the breast cancer cells cannot get enough of it to grow. Generic/Brand names of AI’s As part of their treatment plan, some post- Generic name Brand name menopausal women will use AIs alone. Others anastrozole Arimidex will use tamoxifen for 1-5 years and then begin exemestane Aromasin using AIs. letrozole Femara Who can use aromatase inhibitors? Postmenopausal women with early stage and metastatic breast cancer are often treated with AIs. After menopause, the ovaries produce only a small amount of estrogen. AIs stop the body from making estrogen, and as a result hormone receptor-positive tumors do not get fed by estrogen and die. AIs are not given to premenopausal women because their ovaries still produce estrogen. -
Department of Health
DEPARTMENT OF HEALTH National Drug Policy - Pharmaceutical Management Unit 50 National Formulary Committee Philippine National Drug Formulary EssentialEssential MedicinesMedicines ListList Volume I, 7th Edition ( 2008 ) Published by: The National Formulary Committee National Drug Policy ‐ Pharmaceutical Management Unit 50 DEPARTMENT OF HEALTH Manila, Philippines All rights reserved 2008 The National Formulary Committee National Drug Policy‐Pharmaceutical Management Unit 50 (NDP‐PMU 50) Department of Health San Lazaro Cmpd., Rizal Ave., Sta. Cruz, Manila, Philippines 1003 ISBN 978‐971‐91620‐7‐0 Any part or the whole book may be reproduced or transmitted without any alteration, in any form or by any means, with permission from DOH provided it is not sold commercially. ii PHILIPPINE NATIONAL DRUG FORMULARY Volume I, 7th Edition 2 0 0 8 Francisco T. Duque III, MD, MSc Secretary of Health Alexander A. Padilla Undersecretary of Health, Office for External Affairs Robert Louie P. So, MD Program Manager, NDP-PMU 50 Dennis S. Quiambao, MD Proj. Mgmt. Operating Officer & Coordinator (PMOOC) NDP-PMU 50 NATIONAL FORMULARY COMMITTEE Estrella B. Paje-Villar, MD, DTM & H Chairperson Jose M. Acuin, MD, MSc Alma L. Jimenez, MD Alejandro C. Baroque II, MD Marieta B. de Luna, MD Bu C. Castro, MD Nelia P. Cortes-Maramba, MD Dina V. Diaz, MD Yolanda R. Robles, PhD Pharm Mario R. Festin, MD, MS, MHPEd Isidro C. Sia, MD BFAD Representative SECRETARIAT Luzviminda O. Marquez, RPh, RMT Mary Love C. Victoria, RPh Michael D. Junsay, RPh Ermalyn M. Magturo iii Republic of the Philippines DEPARTMENT OF HEALTH OFFICE OF THE SECRETARY 2/F Bldg. 1, San Lazaro Cmpd., Rizal Avenue, Sta. -
New Zealand Data Sheet 1. Product Name
NEW ZEALAND DATA SHEET 1. PRODUCT NAME Norvir 100 mg tablets. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains 100 mg ritonavir. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM White film-coated oval tablets debossed with the corporate Abbott "A" logo and the Abbott-Code “NK”. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications NORVIR is indicated for use in combination with appropriate antiretroviral agents or as monotherapy if combination therapy is inappropriate, for the treatment of HIV-1 infection in adults and children aged 12 years and older. For persons with advanced HIV disease, the indication for ritonavir is based on the results for one study that showed a reduction in both mortality and AIDS defining clinical events for patients who received ritonavir. Median duration of follow-up in this study was 6 months. The clinical benefit from ritonavir for longer periods of treatment is unknown. For persons with less advanced disease, the indication is based on changes in surrogate markers in controlled trials of up to 16 weeks duration (see section 5.1 Pharmacodynamic properties). 4.2 Dose and method of administration General Dosing Guidelines Prescribers should consult the full product information and clinical study information of protease inhibitors if they are co-administered with a reduced dose of ritonavir. The recommended dose of NORVIR is 600 mg (six tablets) twice daily by mouth, and should be given with food. NORVIR tablets should be swallowed whole and not chewed, broken or crushed. NORVIR DS 29 April 2020 Page 1 of 37 Version 35 Paediatric population Ritonavir has not been studied in patients below the age of 12 years; hence the safety and efficacy of ritonavir in children below the age of 12 have not been established. -
Effect of Tamoxifen Or Anastrozole on Steroid Sulfatase Activity and Serum Androgen Concentrations in Postmenopausal Women with Breast Cancer
ANTICANCER RESEARCH 31: 1367-1372 (2011) Effect of Tamoxifen or Anastrozole on Steroid Sulfatase Activity and Serum Androgen Concentrations in Postmenopausal Women with Breast Cancer S.J. STANWAY1, C. PALMIERI2, F.Z. STANCZYK3, E.J. FOLKERD4, M. DOWSETT4, R. WARD2, R.C. COOMBES2, M.J. REED1† and A. PUROHIT1 1Oncology Drug Discovery Group, Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, U.K.; 2Cancer Research UK Laboratories, Department of Oncology, Hammersmith Hospital, London W12 0NN, U.K.; 3Reproductive Endocrine Research Laboratory, University of Southern California, Keck School of Medicine, Women’s and Children’s Hospital, Los Angeles, CA, U.S.A.; 4Department of Biochemistry, Royal Marsden Hospital, London, SW3 6JJ, U.K. Abstract. Background: In postmenopausal women sulfate and dehydroepiandrosterone levels. Results: Neither estrogens can be formed by the aromatase pathway, which anastrozole nor tamoxifen had any significant effect on STS gives rise to estrone, and the steroid sulfatase (STS) route activity as measured in PBLs. Anastrozole did not affect which can result in the formation of estrogens and serum androstenediol concentrations. Conclusion: androstenediol, a steroid with potent estrogenic properties. Anastrozole and tamoxifen did not inhibit STS activity and Aromatase inhibitors, such as anastrozole, are now in serum androstenediol concentrations were not reduced by clinical use whereas STS inhibitors, such as STX64, are still aromatase inhibition. As androstenediol has estrogenic undergoing clinical evaluation. STX64 was recently shown properties, it is possible that the combination of an to block STS activity and reduce serum androstenediol aromatase inhibitor and STS inhibitor may give a therapeutic concentrations in postmenopausal women with breast cancer. -
Aromatase Inhibitors and Their Use in the Sequential Setting
Endocrine-Related Cancer (1999) 6 259-263 Aromatase inhibitors and their use in the sequential setting R C Coombes, C Harper-Wynne1 and M Dowsett1 Cancer Research Campaign, Department of Cancer Medicine, Division of Medicine, Imperial College School of Medicine, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK 1Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK (Requests for offprints should be addressed to R C Coombes) Abstract Over the past decade several novel aromatase inhibitors have been introduced into clinical practice. The discovery of these drugs followed on from the observation that the main mechanism of action of aminogluthemide was via inhibition of the enzyme aromatase thereby reducing peripheral levels of oestradiol in postmenopausal patients. The second-generation drug, 4-hydroxyandrostenedione (formestane), was introduced in 1990 and although its use was limited by its need to be given parenterally it was found to be a well-tolerated form of endocrine therapy. Third-generation inhibitors include vorozole, letrozole, anastrozole and exemestane, the former three being non-steroidal inhibitors, the latter being a steroidal inhibitor. All are capable of inhibiting aromatase action by >95% compared with 80% in the case of 4-hydroxyandrostenedione. The sequential use of different generations of aromatase inhibitors in the same patients is discussed. Studies suggest that an optimal sequence of these compounds may well result in longer remission in patients with hormone receptor positive tumours. Endocrine-Related Cancer (1999) 6 259-263 Introduction reduced, although formal trials comparing different dose regimens and using sufficient numbers of patients to The aromatase enzyme is a cytochrome P450-mediated provide the necessary statistical power have not been enzyme complex responsible for the conversion of the adequately carried out. -
Guideline for Preoperative Medication Management
Guideline: Preoperative Medication Management Guideline for Preoperative Medication Management Purpose of Guideline: To provide guidance to physicians, advanced practice providers (APPs), pharmacists, and nurses regarding medication management in the preoperative setting. Background: Appropriate perioperative medication management is essential to ensure positive surgical outcomes and prevent medication misadventures.1 Results from a prospective analysis of 1,025 patients admitted to a general surgical unit concluded that patients on at least one medication for a chronic disease are 2.7 times more likely to experience surgical complications compared with those not taking any medications. As the aging population requires more medication use and the availability of various nonprescription medications continues to increase, so does the risk of polypharmacy and the need for perioperative medication guidance.2 There are no well-designed trials to support evidence-based recommendations for perioperative medication management; however, general principles and best practice approaches are available. General considerations for perioperative medication management include a thorough medication history, understanding of the medication pharmacokinetics and potential for withdrawal symptoms, understanding the risks associated with the surgical procedure and the risks of medication discontinuation based on the intended indication. Clinical judgement must be exercised, especially if medication pharmacokinetics are not predictable or there are significant risks associated with inappropriate medication withdrawal (eg, tolerance) or continuation (eg, postsurgical infection).2 Clinical Assessment: Prior to instructing the patient on preoperative medication management, completion of a thorough medication history is recommended – including all information on prescription medications, over-the-counter medications, “as needed” medications, vitamins, supplements, and herbal medications. Allergies should also be verified and documented. -
First Dose Efficacy of Alfuzosin Once Daily in Men with Symptomatic Benign Prostatic Hyperplasia
ADULT UROLOGY FIRST DOSE EFFICACY OF ALFUZOSIN ONCE DAILY IN MEN WITH SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA LEONARD S. MARKS, CLAUS G. ROEHRBORN, MARC GITTELMAN, DANIEL KIM, JOHN FORREST, AND SHARON JACOBS ABSTRACT Objectives. To evaluate the onset of action of alfuzosin once daily (OD) as determined by uroflowmetry early after initial dosing. Alfuzosin OD is an extended-release formulation of a uroselective, alpha1-adrenorecep- tor-blocking agent (alpha-blocker) used in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Methods. This was a randomized, placebo-controlled, two-way Latin square crossover study. Forty-nine patients were selected for this study on the basis of their symptomatic improvement during previous treatment with alpha-blockers and significant decreases in urinary flow rate when that treatment was withdrawn. Results. Our analysis showed that significant increases in the maximal urinary flow rate (Qmax) in 34 assessable patients occurred as soon as 8 hours after the initial dose of medication and persisted for at least 4 days. The ⌬Qmax for alfuzosin 10 mg OD was 3.2 mL/s and for placebo it was 1.1 mL/s. The difference of means for the assessable population was 2.1 (95% confidence interval 0.8 to 3.4, P ϭ 0.002). The overall incidence of adverse events was low. Only dizziness, experienced by 3 patients treated with alfuzosin compared with 1 patient treated with placebo, appeared to be related to the study drug. Conclusions. Together, our findings suggest that alfuzosin OD exhibits a urodynamically measurable effect on bladder outlet obstruction due to benign prostatic hyperplasia in men with lower urinary tract symptoms within hours of the first administration.