Home | Login | Subscribe Today!Aug. 1, 2010
 Pharmacist's Practice Pearl from Pharmacist's Letter

Dear KPhA Member,

Pharmacist's Letter and Kansas Pharmacists Association are pleased to offer KPhA members the Pharmacist's Practice Pearl. This monthly resource gives you some of the valuable recommendations and information available in the full Pharmacist's Letter service. Read on for the Pharmacist's Practice Pearl or...

Subscribe to the full Pharmacist's Letter service

You'll get a valuable service that saves your time and keeps you abreast of significant developments in drug therapy...PLUS, as a KPhA member, you'll get a year of CE credits and PL CE & Training OrganizerTM included free with your subscription.

Practice Pearl - August 2010

     Now that Avandia will not be used, what should patients use instead?
     Both Avandia (rosiglitazone) and Actos (pioglitazone) increase the risk of heart failure, fractures, and macular edema.
     But Avandia and Actos have different cardiovascular risks.
     Avandia is linked to a higher risk of heart attacks and strokes...but Actos is not.
     There seems to be one additional case of heart attack, stroke, heart failure, or death for every 60 patients taking Avandia for one year compared to Actos.
     Avandia also seems to cause one heart attack for every 37 to 52 patients who take it for 5 years.
     Avandia has a less favorable effect on lipids than Actos.
     Avandia INCREASES LDL and triglycerides. Actos tends to LOWER triglycerides, raise HDL more, and not raise LDL as much.
     Avandia is also a more potent PPAR-gamma agonist which might increase the risk of adverse effects compared to Actos.
     The company is being criticized for hiding negative studies...and some experts say their RECORD trial is biased.
     Warn patients not to just stop Avandia on their own.
     Recommend switching to Actos or another diabetes med.
     Suggest starting with Actos 15 mg/day for patients on Avandia 4 mg/day...and Actos 30 mg/day for Avandia 8 mg/day.
     Keep in mind that Actos and Avandia are NOT first-line options for type 2 diabetes. Recommend optimizing metformin first then picking a second drug based on A1C lowering, side effects, and cost.
     For help, see our Diabetes Treatment Algorithms plus Drugs for Type 2 Diabetes chart. Also get our Avandia Patient Handout to save time answering questions and explaining the reasons for a switch.

View Detail-Document #260801
 What's a Detail Document?
 Learn more about Pharmacist's Letter
 Subscribe to the entire Pharmacist's Letter service
Copyright © 2010 Pharmacist's Letter. Illegal to reproduce and/or forward.
PharmacistsLetter.com

Click here to Subscribe Today!
Return to top
Pharmacist's Letter: August 2010; Vol: 26, No. 8
Return to top
Click here to Subscribe Today!

Pharmacist's Letter is an independent service, providing unbiased information to subscribers, who are its sole means of support. No advertising of any kind is accepted.

Users of this document are cautioned to use their own professional judgment and consult any other necessary or appropriate sources prior to making clinical judgments.

Our editors have thoroughly researched the information with input from experts, government agencies, and national organizations.

Information and Internet links in this article were current as of the date of publication.

© 1997-2010 by Therapeutic Research Center. All rights reserved. No part of Pharmacist's Letter or its associated Detail-Documents presented either on paper or in electronic form may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval system without written permission from Therapeutic Research Center.

Reprint exceptions:
1. A single copy for personal use by subscriber is permitted.
2. Documents that are Patient Handouts may be reproduced by a subscriber and handed to patients without written permission.
More for KPhA Members
Useful Links
  
Home | Search or Browse | Index of Topics | Privacy Policy | Email Us
Therapeutic Research Center
3120 W. March Lane, PO Box 8190, Stockton, CA 95208, Tel:(209) 472-2240 Fax:(209) 472-2249
Copyright © 1995-2010, All rights reserved.