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- Spring 2008 -

Seasonal Allergies

RI Dept Health Info on Tuberculosis

Common Cold from Mayo Clinic

Nasal Irrigation Video Mayo Clinic

Stomach Flu (Viral Gastroenteritis) and Rehydration

Charts for Blood Sugar & Blood Pressure

Brisk Daily Walk Improves Metabolic Profile

Aquatic Exercise Mayo Clinic Link

Diabetes Center Mayo Clinic Link

more...
New Patient FormFollow Up Visit
WebMD Health Headlines
Panel: New Tools Help Smokers Quit
Body Contouring Surgery Improves
Ginseng May Help Treat Schizophrenia
Few Aware of Stroke Warning Symptoms
Gamma Knife Snips OCD in Bud
CDC: 52% With Diabetes Have Arthritis
To Avoid Dementia, Watch Your Weight
Withdrawal Symptoms From Smoking Pot?
New Guidelines for Osteoporosis in Men
Antipsychotics in Kids May Add Weight
Computers May Play Role in Some School Shootings
Safest Spot for Baby's Car Seat?

In The News...

 

Suicide Warning for Antismoking Drug

FDA Says Patients Taking Chantix Should Be on the Lookout for Mood or Behavior Changes
By Todd Zwillich
WebMD Medical News

Feb. 1, 2008 -- Federal officials warned Friday that a popular antismoking drug may be linked to suicides in some patients.

The drug, called Chantix, has been used by more than 5 million patients as a smoking cessation aid, according to manufacturer Pfizer Inc. The drug will now carry new labels warning doctors and consumers of reports of suicidal thoughts and behaviors.

FDA officials said they had received nearly 500 reports of suicidal thoughts, behaviors, and completed suicides, 420 of which were in U.S. patients. Thirty-four cases of completed suicide were recorded in the U.S., along with five cases overseas.

The reports don't prove that Chantix was the cause of the suicide. But FDA officials say their investigation showed several suicide cases in patients with no history of psychiatric problems.

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Varenicline (marketed as Chantix)
http://www.fda.gov/cder/drug/advisory/varenicline.htm
Audience: Neuropsychiatric and other healthcare professionals, consumers
[Posted 02/01/2008] FDA informed healthcare professionals and consumers of important revisions to the WARNINGS and PRECAUTIONS sections of the prescribing information for Chantix regarding serious neuropsychiatric symptoms experienced in patients taking Chantix. These symptoms include changes in behavior, agitation, depressed mood, suicidal ideation, and attempted and completed suicide. While some patients may have experienced these types of symptoms and events as a result of nicotine withdrawal, some patients taking Chantix who experienced serious neuropsychiatric symptoms and events had not yet discontinued smoking. In most cases, neuropsychiatric symptoms developed during Chantix treatment, but in others, symptoms developed following withdrawal of Chantix therapy. See the FDA Information for Healthcare Professionals Sheet for recommendations and considerations for healthcare professionals on using Chantix therapy for patients.

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Ezetimibe/Simvastatin (marketed as Vytorin), Ezetimibe (marketed as Zetia), and Simvastatin (marketed as Zocor): Early Communication about an Ongoing Data Review
Audience: Cardiovascular healthcare professionals and patients
[Posted 01/25/2008] FDA provided healthcare professionals with an early communication about an ongoing data review for Ezetimibe/Simvastatin (marketed as Vytorin), Ezetimibe (marketed as Zetia), and Simvastatin (marketed as Zocor). This early communication is in keeping with FDA’s commitment to inform the public about ongoing postmarketing drug issues.

Merck/Schering Plough Pharmaceuticals reported preliminary results from the Effect of Combination Ezetimibe and High-Dose Simvastatin vs. Simvastatin Alone on the Atherosclerotic Process in Patients with Heterozygous Familial Hypercholesterolemia (ENHANCE) trial. This trial was designed to evaluate the amount of atherosclerotic plaque in blood vessels located in the neck based on images obtained through ultrasound in patients treated with Vytorin (ezetimibe plus simvastatin) or simvastatin alone.  Merck/Schering Plough stated that there was no significant difference between Vytorin and simvastatin in the amount of atherosclerotic plaque in the inner walls of the carotid (neck) arteries despite greater lowering of LDL-cholesterol (bad cholesterol) with Vytorin compared to simvastatin. Once Merck/Schering Plough completes the analysis of the unblinded data from ENHANCE, it will submit a final study report to FDA. Once FDA receives the final study report, FDA estimates it will take approximately 6 months to fully evaluate the data. After reviewing the data from the ENHANCE study, and considering all other available information about the link between LDL lowering and reduction of cardiovascular events, FDA will determine whether any further regulatory action is warranted with regard to Zetia and Vytorin and also whether any changes to FDA’s current approach to drugs that lower LDL cholesterol are warranted.

Patients should talk to their doctors if they have any questions about the information from the ENHANCE trial.

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[January 25, 2008 - Early Communication about an Ongoing Data Review - FDA]
Ortho Evra Contraceptive Transdermal Patch
Audience: Reproductive healthcare professionals, patients
[Posted 01/19/2008] FDA modified the prescribing information for the Ortho Evra Contraceptive Transdermal (Skin) Patch to include the results of a new epidemiology study that found that users of the birth control patch were at higher risk of developing serious blood clots, also known as venous thromboembolism (VTE), than women using birth control pills. VTE can lead to pulmonary embolism. The label changes are based on a study conducted by the Boston Collaborative Drug Surveillance Program on behalf of Johnson and Johnson. The patch was studied in women aged 15-44. These findings support an earlier study that also said women in this group were at higher risk for VTE.

FDA believes that Ortho Evra is a safe and effective method of contraception when used according to the labeling, which recommends that women with concerns or risk factors for serious blood clots talk with their health care provider about using Ortho Evra versus other contraceptive options.

[January 18, 2008 - News Release - FDA]
[January 18, 2008 - Questions and Answers - FDA]

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Cough and Cold Medications in Children Less Than Two Years of Age
Audience: Consumers, pediatric and primary care healthcare professionals
[Posted 01/17/2008] FDA informed consumers and healthcare professionals that the Agency has completed its review of information regarding the safety of over-the-counter (OTC) cough and cold medicines in children under 2 years of age and recommends that these drugs not be used to treat children in this age group because serious and potentially life-threatening side effects can occur. FDA's recommendation is based on both the review of the information the Agency received about serious side effects in children in the referenced age group and the discussion and recommendations made at the October 18 -19, 2007, public advisory committee meeting at which this issue was discussed. FDA has not completed its review of information about the safety of OTC cough and cold medicines in children 2 through 11 years of age. See the FDA Public Health Advisory for Agency recommendations regarding this issue.

[January 17, 2008 - Public Health Advisory - FDA]

Previous MedWatch alert:
[Jan 12, 2007]

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Bisphosphonates (marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa)
Audience: Orthopedic Surgeons, other healthcare providers, patients
[Posted 01/07/2008] FDA informed healthcare professionals and patients of the possibility of severe and sometimes incapacitating bone, joint, and/or muscle (musculoskeletal) pain in patients taking bisphosphonates. Although severe musculoskeletal pain is included in the prescribing information for all bisphosphonates, the association between bisphosphonates and severe musculoskeletal pain may be overlooked by healthcare professionals, delaying diagnosis, prolonging pain and/or impairment, and necessitating the use of analgesics. The severe musculoskeletal pain may occur within days, months, or years after starting a bisphosphonates. Some patients have reported complete relief of symptoms after discontinuing the bisphosphonate, whereas others have reported slow or incomplete resolution. The risk factors for and incidence of severe musculoskeletal pain associated with bisphosphonates are unknown.

Healthcare professionals should consider whether bisphosphonate use might be responsible for severe musculoskeletal pain in patients who present with these symptoms and consider temporary or permanent discontinuation of the drug.

[January 07, 2008 - Drug Information page - FDA]

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FDA Issues Safety Alert on Avandia

http://www.fda.gov/bbs/topics/NEWS/2007/NEW01636.html

The U.S. Food and Drug Administration (FDA) is aware of a potential safety issue related to Avandia (rosiglitazone), a drug approved to treat type 2 diabetes. Safety data from controlled clinical trials have shown that there is a potentially significant increase in the risk of heart attack and heart-related deaths in patients taking Avandia. However, other published and unpublished data from long-term clinical trials of Avandia, including an interim analysis of data from the RECORD trial (a large, ongoing, randomized open label trial) and unpublished reanalyses of data from DREAM (a previously conducted placebo-controlled, randomized trial) provide contradictory evidence about the risks in patients treated with Avandia.

Patients who are taking Avandia, especially those who are known to have underlying heart disease or who are at high risk of heart attack should talk to their doctor about this new information as they evaluate the available treatment options for their type 2 diabetes.

FDA's analyses of all available data are ongoing. FDA has not confirmed the clinical significance of the reported increased risk in the context of other studies. Pending questions include whether the other approved treatment from the same class of drugs, pioglitazone, has less, the same or greater risks. Furthermore, there is inherent risk associated with switching patients with diabetes from one treatment to another even in the absence of specific risks associated with particular treatments. For these reasons, FDA is not asking GlaxoSmithKline, the drug's sponsor, to take any specific action at this time. FDA is providing this emerging information to prescribers so that they, and their patients, can make individualized treatment decisions.