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Tadalafil

By ProfJameson · Comments (0)
Wednesday, March 2nd, 2011

Brand Names:

Cialis, Adcirca

What is it?

Cialis helps erections by helping the body open the arteries that provide blood to the penis. The better the blood supply, the better the erection.

What’s In It For Me?

This drug helps you get an erection that is good enough to make intercourse possible. In studies, up to 77% of patients reported getting erections that led to a good sexual experience. Of course, the amount of benefit depends on the reason for the erection problem

The Good

Cialis has the advantage that it is a tablet. It can be taken once and will continue to work for up to 36 hours so that you can choose when to have intercourse, and it also allows for intercourse more than one time. An additional convenience factor is that Cialis does not have to be taken on an empty stomach.



The Bad

First of all, you should check with your doctor to be sure your heart is strong enough to have intercourse. There are some mild side effects that are possible while using Cialis. During studies, 10% of patients experienced headache, 9% got heartburn, and 7% felt back or muscle pain. It is also important to know about the less common, but serious side effects. If an erection is experienced for longer than 6 hours then you should go to the emergency room. If there is any blurry vision or hearing loss then you should stop taking Cialis and contact your doctor. Finally, you SHOULD NOT USE Cialis if you take any nitrate type drug such as Imdur, Ismo, Nitrobid, nitroglycerin, or isosorbide. If you have any question about whether you can take Cialis, ask your doctor or pharmacist.

The Controversial

Everyone has different expectations. Cialis may or may not do everything you hope it will do. It will certainly not make you 21 years old again. Also sexual function is greatly affected by your relationship to your partner and other life stresses.

For The Cynic

It may not work the first time you use it. Don’t give up on the drug until you have tried it a few different times (on different days), maybe even up to 8 times. Even after 8 different tries, there is a 30% to 40% chance that the drug will work.


The Cost

The cost of Cialis is very similar to the cost of other drugs that can help with erectile dysfunction. These drugs are still only sold as brand name drugs and are more expensive than many drugs. Some insurance companies still do not cover this type of medication. Only you can decide if it is worth the cost.

Cialis is a costly drug, but is quite effective for a majority of patients.

Written by Kevin Oppenneer, Edited by Profjameson

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Categories : Sex Specific Drugs
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Metoprolol

By ProfJameson · Comments (0)
Wednesday, March 2nd, 2011

Brand Names:

Lopressor® (metoprolol tartrate), Toprol XL® (metoprolol succinate)

What is it?

Metoprolol is a medication to help lower blood pressure along with diet and exercise changes. It can also be used for the treatment of heart failure.

What’s In It For Me?

Blood pressure control can lower the risk of problems associated with elevated blood pressure. These problems include stroke, heart attack, and kidney failure.

The Good

Metoprolol is a good medication for lowering blood pressure. There are less side effects with this medication when compared to other similar medications. Toprol XL (metoprolol succinate) is the longer acting form of metoprolol and only needs to be taken one time daily.



The Bad

Metoprolol like other similar medications may cause some side effects. There may be more side effects associated with metoprolol tartrate (Lopressor) and may include low blood pressure in about 27.4% of patients and slow heart rate in about 15.9% of patients. The most common side effects of metoprolol succinate (Toprol XL) may include dizziness in about 1.8% of patients and slow heart rate in about 1.5%. Slow heart rate may cause dizziness, lightheadedness, tiredness, confusion, trouble concentrating, and shortness of breath.

The Controversial

There are two kinds of this medication, one is long acting and the other is short acting. Both are useful for high blood pressure, but only the long acting one is useful for heart failure. Metoprolol tartrate (Lopressor®) is the short acting medication, and metoprolol succinate (Toprol XL®) is the long acting medication.

For The Cynic

Although metoprolol succinate (Toprol) can decrease the chances of dying from heart failure, you still have an 85% chance of NOT dying within 18 months if you have heart failure that is not treated with metoprolol. Metoprolol succinate (Toprol XL®) may increase your chance of not dying to 90.5% for the same 18 month period. Of course the benefits continue beyond 18 months, but we don’t have statistics for that.


The Cost

Metoprolol tartrate is very cheap and can be found on four dollar list in some pharmacies. Metoprolol succinate is a little more expensive, but still affordable.

Metoprolol is a good drug and is better and has less side effects than other similar medications. If you have heart failure we suggest you take the longer acting metoprolol succinate.

Written by Caleb Bryant, edited by ProfJameson

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Categories : Blood Pressure Drugs
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Fluticasone-Salmeterol

By ProfJameson · Comments (0)
Friday, March 18th, 2011

Brand Names:

Advair Diskus, Advair HFA

What is it?

Fluticasone-Salmeterol is a two in one drug given to people with breathing problems like asthma and COPD, to help them breathe easier. It is treats inflammation and it has a long acting drug that opens airways.

What’s In It For Me?

If you need both medications this is an easy and convenient way to get them into your lungs. It is a dry powder inhaler which is very easy to use.

The Good

Using this drug daily the way your doctor prescribes it, will help stop or reduce how often you get serious breathing problems. You should not need to use the albuterol “rescue” inhaler more than once or twice per week.

The Bad

This drug does not work immediately, so do not use it if you should experience an attack from sudden serious breathing problems. It only works when taken regularly, not as needed.  There are some drugs, like albuterol, used just for attacks because they work quicker.  Some side effects may occur, but generally less than 5 per cent of people get them. These include throat irritation, headache and mouth infections (you should rinse with water and spit out after use).

The Controversial

The salmeterol half of this combination has been associated with more deaths in asthma patients. Some people think it is because people tried to use it like a rescue inhaler and did not get help in time. Perhaps a bigger concern is that many people with asthma do not need the salmeterol half of the combination and so you are getting risks without any benefit. Also many people with chronic lung disase called COPD or emphysema (usually smoking related) , don’t need the fluticasone part of the combination. Again, risks without benefits. 

Fact Box

The main benefit in chronic lung disease (not asthma) is to decrease the number of exacerbations or “bad spells”

For The Cynic

This drug is marketed like it is the only drug for lung problems. It is much better to start with single drugs rather than combinations and use the combination only in people who have proven they need both meds.

The Cost

This drug or any other ones like it are not available in generic form, so patients usually pay brand name copays. Those that pay cash, it is well over $100 per month (as of Spring 2011)

This is a very good combination medication, but it should only be used in people who are not controlled on a single drug product.

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Categories : Lung Drugs

Insulin Glargine

By ProfJameson · Comments (0)
Friday, March 18th, 2011

Brand Names:

Lantus

What is it?

Lantus lowers high blood sugar in diabetic patients. Lantus is a slow release product similar to the insulin that is found in your body. Insulin is made by your pancreas to control the sugar levels in your blood. This long acting medication provides a steady level of insulin for a full 24 hour period.

What’s In It For Me?

Well controlled blood sugar can prevent long term problems related to diabetes. These problems can include heart disease, vision problems, foot and nerve problems,and kidney failure.

The Good

Lantus is very good at lowering blood sugar over a 24 hour time period. Because this is a longer acting form of insulin it only needs to be injected once daily. This long acting form of insulin has a lower risk of low blood sugar compared to shorter acting forms of insulin.

The Bad

Lantus is only available as an injection. Lantus is so good at lowering blood sugar that it may lower it to much at times. When your blood sugar is to low this is called hypoglycemia, and can cause increased sweating, dizziness, and confusion. Some people may have a mild burining or stinging feeling after injection.  If you eat badly and try to correct it by taking more Lantus, you will gain weight.

The Controversial

Recent reports suggest that Lantus may raise the risk of cancer. This has not been proven and should not be a reason to stop Lantus.

Fact Boxes

 

For The Cynic

 Even we cynics can’t find much to criticize with insulin glargine.  Generally it should be combined with short acting insulin at each meal.  Some doctors tend to feel safer increasing the Lantus dose instead of giving adequate meal insulin.

The Cost

Lantus is not available as a generic. Lantus is no longer on patent, but it is not being produced generically. Until another manufacurer produces a generic version of Lantus the price will remain high.

Lantus is a great drug to help control blood sugar. However, it is important to keep a healthy diet and exercise. We suggest Lantus if your blood sugar is not controlled using other blood sugar medications.

Written by Nicholas Andersona and Caleb Bryant.   Edited by ProfJameson

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Categories : Diabetes Drugs

Ezetimibe

By ProfJameson · Comments (0)
Friday, April 8th, 2011

Brand Names:

Zetia   Vytorin (combination)

What is it?

Ezetimibe works in the intestines to block cholesterol that comes from food.

What’s In It For Me?

There are different types of cholesterol, HDLs are the good kind (think “H” for healthy) and LDLs are the bad kind (think “L” for lethal).  High LDL can increase your chance of getting heart disease, ezetimibe alone or with other medications helps reduce the LDL.
>

The Good

Unlike other drugs for cholesterol (statins), which work in the liver, ezetimibe works differently and has very little side effects.  

The Bad

Actually, side effects of this drug are very rare; they include diarrhea, nausea and gallstones. All these have a less than 10% chance of happening.  The important bad news is under the “Controversial” section below.

The Controversial

We know that having an LDL that is low is good.  We DO NOT KNOW that lowering LDL with drugs is always helpful.  We know ezetimibe will lower your LDL, but there is no reason to think it will actually decrease heart attacks.  In facts studies so far suggest it will not. 

For The Cynic

 So let’s see.  Would you take a drug that costs money and changes a lab test, but probably has not effect on heart attacks and strokes?    We wouldn’t.

The Cost

This drug is not available in generic form; most patients would have to pay brand name copays.  It will be expensive for some time to come.

Although Ezetimibe lowers LDL moderately, there is not enough evidence of real benefit (heart attacks and strokes) to add it to things that we know work (like simvastatin)

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Categories : Cholesterol Drugs, Drugs by Category

Diltiazem

By ProfJameson · Comments (0)
Wednesday, April 27th, 2011

Brand Names:

Cardizem, Cardizem CD, Cardizem LA, Cardizem SR, Cartia XT, Dilacor XR, Dilt-CD, Dilt SR, Diltia XT, Taztia XT, Tiamate, Tiazac

What is it?

Diltiazem is a calcium channel blocker. Like a traffic light to your smooth muscles, diltiazem slows down calcium flow into the muscle. It relaxes your blood vessels and your heart.

What’s In It For Me?

Diltiazem is commonly used with other medications to reduce your blood pressure and your heart rate. As well, diltiazem also increases blood flow to your heart and reduces the workload of your heart. This is helpful for people with chest pain caused by their heart.

The Good

Dlitazem can reduce your risk of heart attacks and strokes by decreasing your blood pressure. It also helps with symptoms of heart pain (also called angina).

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The Bad

Blocking calcium flow into your muscle can sometimes have negative as well as beneficial effects. Studies have shown that people on diltiazem might feel lack of energy, headache, dizziness, and lower heart rate, but these side effects only happened in about 1 out of 20 people. Another possible side effect is fluid build-up in your knees and ankles. If this happens, it is not an emergency, but you should let your doctor know.

Diltiazem should usually be avoided in patients with a weak heart pump. Caution should be used when combining Diltiazem with other drugs that slow heart rate.

The Controversial

 This drug does not have as many studies proving it’s benefit on reducing strokes and heart attacks as some other drugs for hypertension.

The Cost

Diltiazem is inexpensive. Diltiazem is covered by all major health plans. Short acting diltiazem (requires more than once daily dosing) are on some pharmacies’ 4-dollar plan.

Diltiazem is useful as an extra or alternative medication for blood pressure or angina (heart pain). Normally, diltiazem is not the first drug to use for blood pressure or heart problems.

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Categories : Blood Pressure Drugs
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Levothyroxine

By ProfJameson · Comments (0)
Thursday, April 28th, 2011

Brand Names:

Levothroid, Levoxyl, Synthroid, Unithroid
To find out if you have one of these problems your doctor will do lab work. If you have one of these problems your thyroid hormone (T4) will be low. On the other hand your thyroid stimulating hormone (TSH) will be high because this hormone tells your body that T4 levels are low.

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What’s In It For Me?

Replacing thyroid hormone will prevent the bad things caused by low thyroid.  The most common problems from low thyroid are constipation, dry skin,  tiredness, hair loss, heavy and irregular periods, feeling cold all the time, weight gain, and joint stiffness.
If left untreated you may develop difficulty thinking, pain and loss of feeling in your arms and legs, and even coma.

The Good

Levothyroxine works very well in most patients to increase thyroid levels. This will usuallly eliminate your symptoms.

“

The Bad

Levothyroxine has minimal side effects once the ideal dose is found. Some signs of too much thyroid are include feeling warm all the time, nervousness, increased heart rate, headache, and diarrhea. These side effects could be a sign that you are getting to much thyroid medication. The dose of your medication may need to be lowered.

This medication should be taken first thing in the morning an hour before eating. Calcium products (milk, yogurt, cheese, ect.) should not be taken within 4 hours of levothyroxine. This is because calcium containing foods can make Levothyroxine not work as well.
You will have to take this drug for the rest of your life.
You will need to get yearly lab values.

The Controversial

Some patients may get even more benefit from supplementing levothyroxine with cytomel. Cytomel is another thyroid replacing medication (T3). Taking cytomel with levothyroxine may make patients feel better and is an option for some patients.

For The Cynic

Levothyroxine should not be used for weight loss or to increase energy. Using Levothyroxine for these purposes can be very risky and have little benefit.

The Cost

Levothyroxine is available as a generic and is cheap. It is on the $4 list for those pharmacies that have a $4 list.

 Levothyroxine his highly effective for the large majority of patients and is inexpensive

Written by:Kala Bieniek and edited by ProfJameson

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Categories : Thyroid Drugs

Lisinopril

By ProfJameson · Comments (0)
Tuesday, May 3rd, 2011

Brand Names: Prinivil, lisinopril-hydrocholorthiazide(combination)

What is it?
Lisinopril is an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor). Its primary use is to lower blood pressure.

What’s In It For Me?

The class of ACE inhibitors lowers the risk of  heart attacks, strokes and death by about 30%.  So, for example, if your risk an event  is 10% in the next 10 years, treating your blood pressure would lower it to 7%.   Ace inhibitors are the preferred first line drugs for people with Diabetes and high blood pressure.

The Good
Lisinopril is one of the most effective drugs for lowering the risk of heart attack and stroke. It is the preferred first line drug for people with Diabetes and high blood pressure.

The Bad
Lisinopril can cause in increase in the postassium in your blood. It can also worsen kidney function, but kidney problems only happens in people at risk, like those who are dehydrated or have very weak hearts. For patients at risk, lower doses can sometimes be used safely. An allergic type of reaction causing swelling of the tongue, neck, and jaw can occur. It is not common but it can still happen in 1 out of 100 people who take this drug.
The Controversial
Some scientists believe any drug that lowers blood pressure will protect the kidney, and some believe ACE inhibitors are better than other blood pressure drugs.

For The Cynic
It is hard to be cynical about an inexpensive drug that works great.

For The Cost
This drug is very inexpensive and yet one of the best blood pressure drugs we have.

Lisinopril is a great drug is inexpensive. It is one of our top recommended drugs for high blood pressure .

Written and edited by ProfJameson

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Categories : Blood Pressure Drugs

Hydrochlorothiazide

By ProfJameson · Comments (0)
Monday, May 9th, 2011

Brand Names: Hydrodiuril   Hydrochlorothiazide is included in combination pills with many different blood pressure medicines.   Do a search for hydrochlorothiazide to find them all. 

What is it?
This drug, often called HCTZ is a water pill. It is helpful for lowering blood pressure and also for getting rid of excess water, such as in swollen ankles.

What’s In It For Me?

Lowering High Blood Pressure helps prevent strokes and heart attacks. Also HCTZ can get rid of excess salt and water that leads to swelling or to fluid in lungs.

The Good
Like all drugs, HCTZ has side effects. Your doctor will need to do lab tests for low potassium and to check you kidneys. It also causes a mild increase in blood sugar for some people and can also raise the uric acid, which is a concern for people with gout. Most drugs that lower blood pressure can have an effect on sexual function in men.

The Bad
Like all drugs, HCTZ has side effects. Your doctor will need to do lab tests for low potassium and to check you kidneys. It also causes a mild increase in blood sugar for some people and can also raise the uric acid, which is a concern for people with gout. Most drugs that lower blood pressure can have an effect on sexual function in men.

The Controversial
It is often assumed that all water pills in the class called “thiazides” are the same. However, the drug chlorthalidone was the drug that was used for almost all the big studies showing improvement in strokes and heart attacks. We actually prefer chlorthalidone for this reason.

For The Cynic
If your risk of strokes and heart attacks are fairly low, 30% is a pretty small decrease (example: a 7% risk in 10 years would be reduced to a 5% risk in 10 years.  The higher your risk, the bigger the benefit.  See our section on High Blood Pressure.

The Cost
Hydrochlothiazide is very inexpensive and is on the $4 list at many pharmacies.

The Bottom Line
Hydrochlorothiazide inexpensive and a great drug. We do prefer to use chlorthalidone because most of the studies were done with that drug.

written by ProfJameson and edited by ProfJameson

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Categories : Blood Pressure Drugs

Enalapril

By ProfJameson · Comments (0)
Tuesday, May 10th, 2011

Brand Names: Vasotec, enalapril-hydrocholorthiazide(combination)
What is it?
Enalapril is an Angiotensin Converting Enzyme Inhibitor (ACE Inhibitor). Its primary use is to lower blood pressure.

What’s In It For Me?
Decreasing high blood pressure is helps reduce your risk for stroke and heart attack. Also, Enalapril has a protective effect from kidney damage that leads to protein in the urine, which is significant problem for patients with Type 2 Diabetes.
The Good

The class of ACE inhibitors lowers the risk of  heart attacks, strokes and death by about 30%.  So, for example, if your risk an event  is 10% in the next 10 years, treating your blood pressure would lower it to 7%.   Ace inhibitors are the preferred first line drugs for people with Diabetes and high blood pressure.


The Bad
Enalapril can cause in increase in the postassium in your blood. It can also worsen kidney function, but kidney problems only happens in people at risk, like those who are dehydrated or have very weak hearts. For patients at risk, lower doses can sometimes be used safely. An allergic type of reaction causing swelling of the tongue, neck, and jaw can occur. It is not common but it can still happen in 1 out of 100 people who take this drug.
The Controversial
Some scientists believe any drug that lowers blood pressure will protect the kidney, and some believe ACE inhibitors like enalapril are better than other blood pressure drugs.
For The Cynic
It is hard to be cynical about an inexpensive drug that works great.

The Cost
This drug is very inexpensive and yet one of the best blood pressure drugs we have.

Enalapril is a great drug is inexpensive. It is one of our top recommended drugs for high blood pressure .

Written and edited by ProfJameson

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Categories : Blood Pressure Drugs
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