Pharmacies accused of paying kickbacks to drug addicts

From the Globe and Mail:
Pharmacies that offer cash incentives to drug addicts for their daily methadone prescriptions are under investigation by the B.C. College of Pharmacists and PharmaCare, the provincial government's drug-insurance plan.

“I can confirm that we have an active investigation … but I am not in a position to reveal any details,” Lori DeCou, a college spokesperson, said yesterday in an interview.

Bernadette Murphy, a spokesperson for PharmaCare, said the provincial agency was working with other authorities. “The investigation has been going on for some months,” she said.

Helen Weiss, who has been working at the Native Health Society Medical Centre for six years, said yesterday five or six pharmacies in Vancouver's Downtown Eastside have posed problems for years.

Methadone is prescribed to addicts as a substitute for heroin. To ensure that the addicts consume the drug and do not resell it on the street, the pharmacists are expected to watch the addicts as they drink the methadone. ...more

Watch out for drug names that look, sound alike

I thought this was worth posting even though some of the drug names are not used in Canada. The message is still relevent. For example, Reminyl's name was unchanged in Canada. Also, Klonopin was named Rivotril in Canada.

From the Associated Press:
Take the generic drug clonidine for high blood pressure? Double-check that you didn't leave the drugstore with Klonopin for seizures, or the gout medicine colchicine.

Mixing up drug names because they look or sound alike — like this trio — is among the most common types of medical mistakes, and it can be deadly. Now new efforts are aiming to stem the confusion, and make patients more aware of the risk.

Nearly 1,500 commonly used drugs have names so similar to at least one other medication that they've already caused mix-ups, says a major study by the U.S. Pharmacopeia, which helps set drug standards and promote patient safety.

Last week the influential group opened a Web-based tool to let consumers and doctors easily check if they're using or prescribing any of these error-prone drugs, and what they might confuse it with. Try to spell or pronounce a few on the site — http://www.usp.org — and it's easy to see how mistakes can happen. Did you mean the painkiller Celebrex or the antidepressant Celexa? ...more

Prices of patented drugs set to decline

I was under the impression that most prescription medications were relatively cheaper in South Africa. However, this does not appear to be the case as their government is mandating lower prices based on comparisons with four other countries, one of which is Canada.

From the Business Report (South Africa):
Half of the originator medicines available in South Africa should be cheaper by February, which is the deadline for complying with interim international benchmarking prices.

Anban Pillay, the head of pricing at the department of health, said yesterday that half of these drugs were more expensive locally than in Spain, New Zealand, Australia and Canada, the four countries against which South Africa is being benchmarked.

Pillay said the four countries had been chosen because they had pricing systems that ensured the viability of pharmaceutical companies while offering their citizens affordable medicines.

"They also have respect for intellectual property, which is important," he said.

Pillay said the differences in price ranged between 10 percent and 50 percent. The sums consumers could save would be known in about a month.

The government has published a notice detailing the methodology to be used when benchmarking patented medicines. Interested parties have 30 days to comment.

Pillay said not all drug prices would come down. "About half of the drugs sold in our market are more expensive than in those countries, so about half will be [affected]." ...more

Security rules rile physicians, pharmacists

From the Pittsburgh Tribune Review:
Many pharmacists and doctors see new regulations to make prescriptions more tamper-resistant as one more burden being placed on them for others' problems.

Jim Lynn of the Smithfield Pharmacy in Fayette County said the prescription changes that will take effect later this year are an example of "more legislation, more scrutiny (on the medical professionals), as if it's our problem."

Starting Oct. 1, the federal government is requiring that prescription pads have three safety features to reduce the chances of patients forging prescriptions and to save the government money. The features are designed to make it more difficult to copy, erase or modify the prescription. ...more

National plan for exotic drugs unlikely: minister

From the Calgary Herald:
Canadians who suffer from rare diseases are calling for a long-awaited national orphan drug strategy as provincial health ministers gather in Quebec City this week, but Alberta's minister is not optimistic they will reach a deal.

Groups like the Canadian Association of Pompe, which represents patients with an unusual neuromuscular condition, said Tuesday the ministers must come to an agreement because patients can't afford the pricey medications for their diseases.

"When you're looking at a rare disease, time is life . . . they go downhill without the treatment," said Linda Pare, the Innisfail-based secretary of the association, whose son suffers from the condition.

Orphan drugs are pharmaceuticals for unusual conditions that often come with enormous price tags, costing as much as $1 million a year.

Alberta Health Minister Ron Liepert agreed a national strategy for drugs to treat rare diseases is important, particularly as the province moves ahead with developing a new pharmaceutical policy. ...more

Shoppers’ beauty stores raise eyebrows

After a really successful run, could this be a misstep by Shoppers Drug Mart? I'm not a financial expert, but I don't really see these stores catching on. If you want to buy cosmetics from Shoppers Drug Mart, why wouldn't you just go to the nearest existing Shoppers location? They seem to be everywhere already.

From the Financial Post:
Beauty has a new name at Shoppers Drug Mart Corp. - "Murale."

The largest drug store chain in Canada has unveiled the name of its newest store concept, whose first stores will open in Ottawa and Montreal in November.

"Murale is a beauty masterpiece that will give access to the most innovative and leading beauty products, services, consultation, and advice," said Jurgen Schreiber, chief executive of Shoppers.

The company said in a statement that the name Murale "is distinctive, expressive and highly suggestive of art and beauty". Shoppers first announced that it would open stand-alone cosmetic boutiques at the annual general meeting of shareholders this year.

The stores, which will compete with standalone specialty beauty chains such as Sephora, will carry dermatological skin care and luxury beauty items and fragrances. ...more

Newer Blood Pressure Drug Better for Some Heart Patients, Diabetics

From the Washington Post:
A new study offers a possible alternative to heart patients and diabetics who need to keep their blood pressure under control but who cannot tolerate the standard treatment of ACE inhibitors.

Reporting at the European Society of Cardiology in Munich on Sunday, Canadian researchers said they found that the angiogenesis-receptor blocker (ARB) known as telmisartan worked well for the 20 percent of patients with vascular disease and high-risk diabetes who can't take ACE inhibitors. The study was released in the Aug. 31 online issue of The Lancet to coincide with the meeting presentation.

In the randomized, controlled trial, almost 6,000 patients with vascular disease or high-risk diabetes took either telmisartan or a placebo, and were followed for almost five years. Rates of death, heart attack, stroke or hospitalization for heart failure were tracked as primary outcome measures during the study period.
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Mean blood pressure was lower in the telmisartan group by 4.0/2.2 mm/Hg, and there was a relative risk reduction of 13.3 percent for those taking telmisartan. Fewer patients on the medication wound up in the hospital for cardiovascular problems (30.3 percent), compared to those on placebo (33 percent). ...more

Study says direct-to-consumer drug advertising not that effective

From the Canadian Press:
Drug advertisements aimed at consumers may not be having the effect on sales that opponents and proponents of the practice assume they do, a new study suggests.

The analysis, by researchers from Harvard Medical School and the University of Alberta, looked at Canadian sales data for three drugs that were heavily advertised in the United States, ads which Canadians watching U.S. television would have seen.

The researchers found no evidence of a spike in sales for two of the drugs after the TV ads started to run. There was a marked increase in sales for a third drug but the effect was short-lived.

"I think that we've shown that the effects are pretty unimpressive for the three drugs we've looked at," said Harvard professor Stephen Soumerai, the senior author.

"Two out of three there isn't an ounce of effect."

The study was published Tuesday in the British Medical Journal's online edition. The authors say it is the first to actually test for evidence of an impact of drug ads by using what's called a control group. ...more

HPV vaccine shows higher rate of anaphylaxis: study

From CTV News:
The human papilomavirus (HPV) vaccine is up to 20 times more likely than other school-based vaccines to cause anaphylaxis, according to a study released Monday.

Anaphylaxis is a severe allergic reaction. Symptoms include difficulty breathing, nausea and rashes, but can be treated easily if identified early.

Last year Ontario, Nova Scotia, Prince Edward Island and Newfoundland launched HPV vaccination programs in schools, and more provinces are slated to begin programs in September. The massive campaign has had some parents asking questions about the safety of the vaccine.

The Australian rate of anaphylaxis in women following HPV vaccination is 2.6 per 100,000 doses. For most other vaccines the rate is 1 per million.

Dr. Julia Brotherton, lead author of the study, published in the Canadian Medical Association Journal, said some women may be allergic to the vaccine components. So far researchers haven't found which parts of the vaccine are causing the reactions. ...more

Doc Q scrubs website

I am not surprised that the Ontario College of Physicians have some problems with MPP/MD Shafiq Qaadri's website. It seemed to be one shameless name drop of a drug after another. In the article below, it's revealed that the good doctor is on the payroll of several drug companies, but he seems to be a bit uncertain about how much they pay him.

I went back to the DoctorQ.ca website, and they have made a few small changes. I notice that the "Micardis" tab has been renamed "Telmisartan" (its generic name, but the page still has a URL of http://www.doctorq.ca/Micardis.html.

If I hear another physician ever complain to me about pharmacists' potential lack of ethics when it comes to prescribing, I think I'll refer them to this site.

From the Toronto Sun:
Unplug the drug plugs, Dr. Qaadri.

That's the message Liberal MPP Dr. Shafiq Qaadri got from the province's medical authorities after a Toronto Sun story pointed out much of the content on his medical clinic website violated doctor advertising rules.

Qaadri has been scrubbing the website of nearly 60 separate plugs for brand name pharmaceuticals ever since.

"As soon as concerns were raised, I contacted the College of Physicians and Surgeons of Ontario and they gave me advice that I should remove them, and I did," said Qaadri, a family physician and Liberal MPP for Etobicoke North.

College rules prohibit doctors from mentioning drugs by name, using any superlatives to describe them or from associating themselves with any products or services. ...more

Prescriptions to go electronic

From Stuff.co.nz:
Scribbled doctors' prescriptions look to be on the way out with the Health Ministry set to pilot electronic prescribing next year.

Electronic prescribing will let GPs send prescriptions to pharmacies online, in a move the ministry says will help reduce medical errors.

Nelson woman Hilda Sixtus died in 2006 after she was allegedly prescribed a powerful anti-cancer drug with incorrect dosage instructions.

Pharmacists have said patients are at risk from errors in some existing software used to manage prescriptions, which could lead to incorrect doses being prescribed.

Alan Hesketh, deputy director of the ministry's information directorate, says electronic prescribing will reduce the risk of incorrect drugs being prescribed through the use of a common medications list – which will contain standardised doses, forms, strengths and instructions for medicines.

Health practitioners and patients will be able to access a complete electronic pharmaceutical history, showing what drugs people have taken and when. ...more

Prescriptions can be difficult to fill around storms

From WWLTV.com (LA):
As people stock up on hurricane supplies, they are finding it may cost more money than they budgeted for.

That's because when it comes to one necessity – medications -- health insurance companies haven't built in a plan for hurricanes.

In Metairie, people crowded a local drug store getting prepared for Gustav.

"People coming in like crazy buying water. We sold 4 pallets of water yesterday and I thought it was going to slow up, but it's moving out as much as we can and batteries," says Greg Ciolino, C's Store Manager

And along with water and batteries, there is another necessity they are hurrying to buy.

"We're here for our medicine and it is the first thing we thought about when the storm was coming," says shopper Paul Clement, Sr. ...more

New meds aren't always 'safe and effective'

From the Globe and Mail:
If you want to avoid potential adverse reactions from prescription drugs you should shy away from new medications that have been on the market for less than two years, a health-systems expert warns.

"It is assumed by the general public that new drugs ... have been put through exhaustive trials and found to be safe and effective," said Donald Light, a sociology professor at the University of Medicine and Dentistry of New Jersey. But, he added, new products are not necessarily better or safer than drugs already available.

In fact, reviews of the medical literature reveal that only one in seven new drugs is superior to existing medications. What's more, two out of every seven new drugs result in side effects serious enough to eventually warrant special warnings or even withdrawal from the market.

And a big problem is that many of these adverse reactions don't become apparent until a drug has been used by millions of patients for several years. ...more

The hardest working pill on the market

From Canada.com:
For the past decade, erectile dysfunction drugs such as Viagra and Cialis have sent men marching into bedrooms all over the world with renewed confidence and vigour.

Now, there seems to be another good reason to appreciate them -- they may help to save some of the planet's endangered animal species.

Evidence is mounting that men who used to rely on concoctions such as tiger penis soup and powdered rhinoceros horn are finding the convenient and fast-acting pills a good alternative.

One landmark study, done in 2004 by Australian researchers led by William von Hippel, involved 256 Chinese men, aged 50 to 76 years. All were receiving treatment at a traditional Chinese medicine clinic in Hong Kong.

The scientists found these consumers reported selectively switching to Western medicines to treat erectile dysfunction or ED, but not to treat other health ailments, such as gout and arthritis. ...more

Iraq moves to curb sales of fake drugs

From the Los Angeles Times:
Amid the cacophony of Baghdad's Bab Sharaji market, Yasir Mazen peddles counterfeit Viagra and other pills, gels and creams promising cures for everything from sexual dysfunction to bad skin.

It's a thriving business. "They always come back to buy more," the 20-year-old said of his customers.

But Mazen, as well as sellers of legitimate medications, may find it harder to get hold of goods to hawk come Monday. That's the deadline the Ministry of Health has set for enforcing drug laws that have been largely ignored since the ouster of Saddam Hussein in 2003.

Though the laws remained in effect, the invasion and its aftermath led to a vacuum in enforcement while the newly opened borders sent counterfeit goods flooding into the country.

The government says the deadline is part of a sweeping effort to bring Iraq in line with international norms and clean up the burgeoning trade in fake drugs. There are only two state-run pharmaceutical factories in Iraq, so 90% of the medications used here are imported. Nearly all are made by companies not registered in Iraq and sold without being tested for efficacy. ...more

Drug May Lower Blood Pressure in Adolescents With Hypertension

I've never heard of anyone trying to lower uric acid levels to control hypertension before this article. I find this to be a fascinating new approach. This reminds me of the then-radical theory that ulcers can be caused by bacteria and can be treated with antibiotics - a totally new approach. Credit to Corey Nahman for finding this one.

From the Washington Post:
The drug allopurinol -- a drug used to lower uric acid levels -- may lower blood pressure in adolescents with high blood pressure, a new study shows.

Because high blood pressure is commonly associated with high uric acid levels, some studies suggest that elevated uric acid may be one cause of high blood pressure. But since elevated uric acid levels in high blood pressure could be the result of several factors, high uric acid levels are not currently considered a true risk factor for hypertension.

The current study, published in the Aug. 27 issue of the Journal of the American Medical Association, tested whether treatment with allopurinol would reduce blood pressure in 30 11- to 17-year-olds who had high uric acid levels and newly diagnosed high blood pressure. ...more

Warfarin underused by patients at risk for stroke

This study comes as no surprise to anyone who has worked in an anticoagulation clinic. There are far too many people in the community not being properly managed on their warfarin, or aren't taking it when they should be.

From Reuters:
New research indicates that most patients with atrial fibrillation -- the most common type of heart arrhythmia -- who suffered a stroke and were eligible for anticoagulation treatment, were not taking any warfarin or were not taking enough.

"These are missed opportunities for stroke prevention," lead author Dr. David J. Gladstone, from the University of Toronto, said in a statement. "Sadly, we frequently see patients admitted to a hospital with a devastating stroke who are known to have atrial fibrillation, yet were either not taking warfarin or were taking a dose that is not therapeutic."

Warfarin, also known by the trade name Coumadin, can reduce the risk of stroke by preventing the formation of blood clots, which often occur in patients with atrial fibrillation. The clot may detach from the wall of the blood vessel and become lodged in the brain, blocking the flow of blood and causing a stroke. Atrial fibrillation doesn't always cause symptoms, but the condition can be quite dangerous.

As they reported in the current online issue of Stroke, the researchers analyzed data for 597 patients with known atrial fibrillation and potentially preventable strokes who were entered in the Registry of the Canadian Stroke Network from 2003 to 2007....more

N.S. man sues over drug Avandia

From the Halifax Chronicle Herald:
A Nova Scotian man has launched a class action lawsuit against the federal government and the company responsible for the popular drug Avandia, most commonly used to treat Type 2 diabetes.

Counsel for Ronald Finck of Shinimicas Village, Cumberland County, filed the statement of claim in Nova Scotia Supreme Court in Halifax on Wednesday.

Named as defendants are Glaxosmithkline Inc., Glaxosmithkline PLC, Glaxosmithkline Services Unlimited, Smithkline Beecham Corporation and the Attorney General of Canada.

In the court document, lawyer Wei Wu of the Merchant Law Group in Saskatchewan claims that Avandia, also known as rosiglitazone, raises the risk of heart attack, heart failure and death in older patients.

He alleges that Glaxosmithkline knew or should have known that its product, approved by Health Canada on March 21, 2000, was unsafe for patients. ...more

Keep taking statins after heart attack: study

From Reuters:
People who are tempted to quit taking their statin medication because it failed to prevent a heart attack should think twice, Canadian researchers said on Wednesday.

They said heart attack survivors who stopped taking the cholesterol-lowering drugs were more likely to die during the following year than those who had never been on the drugs.

The findings, published in the European Heart Journal, underscore the effectiveness of the drugs, which not only reduce levels of low-density lipoprotein or LDL, the so-called bad cholesterol, but may also reduce inflammation.

Dr. Stella Daskalopoulou and colleagues at McGill University studied data on British patients who had survived a heart attack and were still alive three months later.

"Patients who used statins before an AMI (heart attack) and continued to take them after were 16 percent less likely to die over the next year than those who never used them," Daskalopoulou said in a statement. ...more

Wrong meds blamed for crash

From Surrey (BC) Now:
Nesta DeRoy, 81, was parking her car in front of a Nissan dealership in South Surrey when she stepped on the gas instead of the brake and plowed into the window, sending people inside scurrying for cover.

DeRoy believes the wrong medication made her drowsy.

She's grateful a cement barricade stopped the car from going further, "otherwise it would have been a big disaster because there were people looking in the showroom."

"I could have killed somebody, I could have killed myself."

Moments before the accident, her friend Julie Mahler, remarked that she looked tired and had asked her if she was feeling all right. Mahler even offered to take over the wheel.

Two days after the accident, DeRoy said she called the pharmacy at Save-On-Foods in Scottsdale Mall to renew her prescription for "hydrochlorothiazide," which helps treat her high blood pressure, and that's when she found out she was given Clonazepam, a sedative.

DeRoy said when she gave the pharmacist the number code on her prescription bottle, he went "kind of quiet" and asked her to repeat it. ...more

Dementia drugs still prescribed, despite warnings

From the Globe and Mail:
Prescription rates of certain antipsychotic drugs given to seniors with dementia have increased significantly despite safety warnings in recent years, according to a new study that questions the effectiveness of the warning mechanisms used by drug makers and Health Canada.

The findings, published today in the Canadian Medical Association Journal, reveal that overall prescriptions of atypical antipsychotic drugs to elderly people suffering from dementia - many of whom live in nursing homes - jumped 20 per cent between 2002 and 2007. Three major safety warnings were issued during that period. "The point is the warnings had a limited impact," said Geoffrey Anderson, professor in the department of health policy, management and evaluation at the University of Toronto and an author of the study. "These are human beings ... It's our duty to protect the care for them."

Atypical antipsychotic drugs are a relatively new class of "second generation" antipsychotic drugs used to treat schizophrenia and other serious psychological problems.

Health Canada issued the first warning about the atypical antipsychotic drug risperidone, sold under the brand name Risperdal, in 2002 after studies showed it was associated with an increased risk of stroke in older dementia patients. Another warning was issued in 2004 about the atypical antipsychotic olanzapine, sold under the name Zyprexa, amid fears of increased risk of stroke and other health issues. ...more

Teva Says Parkinson's Drug Is First to Slow Disease

From Bloomberg:
Teva Pharmaceutical Industries Ltd. said its Azilect pill is the first to slow the progression of Parkinson's disease in new findings that may increase sales of the medicine to more than $1 billion.

Patients who took the 1-milligram dose of Azilect at the outset of an 18-month trial showed ``significant improvement'' over patients who started nine months later, Petah Tikvah, Israel-based Teva said in a statement today. The test results were presented at a medical conference in Madrid today.

Azilect, Teva's second original product, was introduced in 2005 to treat the symptoms of Parkinson's, an incurable disease that destroys patients' nerve functions. Teva needs to replace revenue from its first original drug, Copaxone for multiple sclerosis, before it loses patent protection in 2014. Peak sales of the pill may now surpass $1 billion, instead of an estimated $250 million a year, said Ronny Gal, who follows Teva at Sanford C. Bernstein in New York, in a June 16 interview. ...more

Canada OKs vaccine to prevent painful shingles in seniors

From CBC News:
Health Canada has approved a vaccine to help prevent painful singles in people 60 or older who had chickenpox earlier in life.

Zostavax, made by Merck Frosst Canada, should be available through doctors and pharmacies starting sometime next year, the company announced Tuesday.

Shingles occurs when the chickenpox virus reactivates after lying dormant in nerve cells, sometimes for decades, and starts reproducing again. In other cases, the virus may stay dormant indefinitely.

Shingles, also called herpes zoster, causes a painful red rash and sensations of tingling, itching and burning. The rash can lead to scarring and the pain can persist in some people for months or years. Up to 20 per cent of adults who have had chickenpox will get shingles later in life. ...more

FDA to Revise Rules For Cold Medications Meant for Children

From the Washington Post:
The Food and Drug Administration yesterday announced plans to revise standards for over-the-counter cough and cold medications for children, a step that could lead to removing the popular products from the market.

In response to rising concerns that the products are ineffective and could be unsafe, the agency said that, for the first time in decades, it will revamp the criteria that have allowed the products to remain on drugstore shelves.

"Modern science has advanced since, and this is an opportunity to apply modern science to evaluate these products," said Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research.

As the first step in that process, the agency will hold a special hearing Oct. 2 to begin to consider a series of questions, including: What types of studies should be done to evaluate the products? Should the products remain available without a prescription? How should the doses be determined? Should products that combine different ingredients remain available? ...more

MD wants codeine banned at hospital

From the Globe and Mail:
Canada's obstetricians say a study showing how a popular pain reliever can turn a mother's milk into a toxic brew for newborns has raised warning bells, with one doctor asking the country's busiest maternity hospital to yank the product off its shelves.

"My suggestion is that all obstetric units across this country remove T3s [Tylenol 3] from their obstetric formulary," said perinatologist Peter von Dadelszen, associate professor of obstetrics and gynecology at the University of British Columbia.

"... I've actually contacted the hospital leadership [at BC Women's Hospital] asking that it be yanked completely so we no longer have it available."

Also yesterday, the Society of Obstetricians and Gynaecologists of Canada said it will meet next week with the Canadian Pediatric Society to discuss the best and safest pain relief for nursing mothers - with an eye to having a guideline on the subject by 2009, said its executive vice-president, André Lalonde.

"We don't want to panic people here. There's kind of a warning bell going out there, but we need a lot more studies to see it," Dr. Lalonde said in an interview from Ottawa. "The general advice is to take the smallest dose possible." ...more

Pharmacists’ fury at having to turn their patients away

From the Belfast Telegraph:
A Northern Ireland pharmacist last night told how he has had to turn patients away because of a row between chemists and the Government over cash for a vital health care service.

Yesterday, the Belfast Telegraph revealed that nearly 500 community pharmacists across the province had withdrawn a service for minor ailments after they claimed that a new “enhanced” version was being hoisted on them by the Department of Health.

Under the former scheme, community pharmacies were able to consult and treat customers with coughs and colds, sore throats, and hayfever, as well as providing medical advice and GP referrals.

However, the Department’s plans to increase the permitted treatment range means that pharmacists themselves will have a price to pay for this service.

With the Government cap on remunerated treatment of minor ailments placed at 1,300, pharmacists who wish to continue treating customers’ coughs and colds beyond this will have to do so without funding.

The Pharmaceutical Contractors Committee (PCC) is leading the battle against the proposed scheme, seeking terms which take into account the views of community pharmacists. ...more

Pharmacist's jars worth thousands of pounds are discovered in a cupboard

From the Daily Mail (UK):
A pharmacist who spent decades devoting her life to her business never realised she had a ready-made fortune on her shelves - her mixing jars.

Unbeknown to Ann Seedhouse, the coarse-looking earthenware pots that held her elderflower and red poppy were more than three centuries old and worth thousands of pounds.

Friends described Miss Seedhouse, who never married and channelled all of her efforts into her work, as a businesswoman ahead of her time.

But now it has emerged her meticulous attitude to achieving success overlooked two little things - the jars.

They sat amid the jumble of dozens of other containers in her traditional shop in Brownhills, Staffs, until she finally retired in the 1970s.

After that they ended up in a cupboard at her home, where they were finally uncovered by astonished experts during a clearance of her estate. ...more

Epilepsy drug reverses rat obesity

From the Globe and Mail:
An epilepsy drug being tested for use in treating addiction can help obese rats shed weight, U.S. government researchers said on Wednesday.

Their findings point not only to an easy treatment for obesity, but show it to be similar to drug addiction, they said.

Even rats bred to be obese lost up to 19 per cent of their weight, and normal rats lost 12 to 20 per cent of their weight after 40 days of injections of the drug, called vigabatrin or GVG, the team at the U.S. Department of Energy's Brookhaven National Laboratory found.

"When we gave GVG, they would steadily lose weight, and when we took them off GVG, they would steadily gain weight," Amy DeMarco, who worked on the study, said in a telephone interview.

"It was like a roller coaster. It was also dose-dependent. Rats given higher doses would lose more weight." She added that her team saw no side effects in the rats.

Vigabatrin, sold as Sabril in Canada, Mexico and Britain by Sanofi Aventis, is being tested in people now for cocaine and methamphetamine addiction. ...more

Codeine bad for some breast-fed babies: study

From the Globe and Mail:
Nearly one-quarter of babies whose mothers took codeine while breastfeeding showed signs of central nervous system depression, according to a new study, suggesting the drug can transform mother's milk into a troubling brew.

Specifically, 17 of 72 babies became sedated or experienced abnormal breathing, including one who narrowly avoided a tragic reaction, according to Hospital for Sick Children researchers in collaboration with the University of Western Ontario.

“You cannot continue to give it [codeine] like candies,” Gideon Koren, lead author of the study published in the journal Clinical Pharmacology & Therapeutics, said in a telephone interview. “… In some cases, this can be life-threatening.”

Codeine is extremely prevalent: Dr. Koren estimated as many as 120,000 Canadian women a year receive the drug after childbirth. And although it has been known that some mothers carry multiple copies of a gene capable of converting the common pain reliever into strong concentrations of morphine, he said the study suggests the pharmacological phenomenon is broader than initially thought. ...more

Medicare not universal without coverage of prescriptions, new CMA head says

From the Globe and Mail:
Canada's medicare system cannot truly be considered universal until it starts providing access to prescription drugs regardless of a patient's ability to pay, the new president of the Canadian Medical Association says.

"If access to diagnosis is universal, why isn't access to drugs?" Robert Ouellet asked yesterday in his inaugural address.

"The current health system is universal only in half-measures. If we were diagnosing the problem, we would say it suffers from hemianopsia" - blindness in half the visual field.

At least 600,000 Canadians - nearly all of them in Atlantic Canada - have no drug coverage at all. Another six million people have inadequate drug coverage - meaning basic treatments for common conditions such as diabetes pose a serious financial hardship.

Canadians spent $20.6-billion on prescription drugs last year, according to the Canadian Institute for Health Information.

Dr. Ouellet noted that Quebec is the only province with a universal prescription drug plan and urged other provinces to follow suit. ...more

Taking pills? Avoid the juice

From the Calgary Herald:
A leading Canadian researcher is warning people about taking their daily dose of prescription pills with orange or apple juice - nearly 20 years after his earlier caution about grapefruit juice prompted sticker warnings on drug vials.

David Bailey and colleagues announced to a startled - and skeptical - medical world in 1991 that grapefruit juice can boost the amount of certain drugs absorbed into the bloodstream two- to threefold, turning normal doses into potentially toxic overdoses. Today, nearly 50 drugs carry labels warning about the so-called Grapefruit Juice Effect.

Now, in another surprise discovery, Bailey is reporting that grapefruit juice - as well as orange and apple juice - also appears to do the opposite by substantially lowering the absorption of certain other drugs, including certain antibiotics and drugs used to treat high blood pressure and heart disease.

Chemicals in the fruit juices appear to turn off a pump that normally helps get drugs out of the gut and into the body. The concern is that drugs essential for treating serious medical conditions might lose their benefit. ...more

Many Canadians stigmatize mentally ill, poll finds

From CTV News:
Many Canadians hold negative attitudes towards people with mental health issues, says a new poll released Monday by the Canadian Medical Association.

The CMA says those attitudes have not changed in decades. The federal government has announced $75 million in funding to de-stigmatize mental health in Canada, but results could take years.

The poll, which was part of the CMA's 2008 National Report Card, showed 46 per cent of Canadians think people use the term "mental illness" as an excuse for bad behaviour.

One of four Canadians in the survey said they were scared to be around someone with a mental illness - something that doesn't surprise Tammy Lambert. ...more

Doc going too far on website: Kormos

You can check the mentioned website at www.doctorq.ca. I am not familiar with the Ontario College of Physicians and Surgeons rules regarding advertising, but I`m quite surprised that he is willing to make some pretty specific recommendations. I`m also quite sure that most physicians do not have a special tab and page on their website for one specific drug. He must really like Micardis.

From the Toronto Sun:
Liberal MPP Dr. Shafiq Qaadri has crossed the line by pushing a wide range of brand-name pharmaceuticals, a book and other services on his medical clinic website, the New Democrats' Peter Kormos says.

"Mr. Qaadri calls it patient education," Kormos said. "Most observers would call it crass and commercial self-promotion.

"For a guy who's as smart as he says he is, you'd think he'd know better. This is incredible."

Kormos says his reading of advertising guidelines issued by both the Ontario College of Physicians and Surgeons and the Canadian Medical Association would put much of the content on doctorq.ca outside of the rules, which say drugs should not be mentioned by name and that doctors should not promote products or services.

Qaadri did not respond to calls requesting comment.

His website mentions nearly 60 drugs by brand name, many with his personal recommendation, and rarely with any mention of side effects, contraindications or cost. A link to buy his 2006 book The Testosterone Factor is also prominent on the site. ...more

Mental illness 'final frontier' of accepted discrimination

From the Calgary Herald:
Nearly one in two Canadians believes mental illness isn't always "real," but a cop-out for bad behaviour and personal weakness, and attitudes toward people with addictions border almost on religious judgment, a new national survey shows.

One in four is afraid to be around someone with a serious mental illness, and about half of the 2,024 Canadians surveyed online said they would avoid socializing with or marrying someone with a mental illness.

The Ipsos Reid survey, commissioned by the Canadian Medical Association and to be released today at its annual meeting in Montreal, "shines a harsh, and frankly unflattering light on the attitudes we Canadians have concerning mental health," CMA president Dr. Brian Day said in a release. ...more

F.D.A. Weighs Training to Dispense Narcotics

I can`t imagine this ever happening, but it`s an interesting idea...

From the New York Times:
Should doctors be required to undergo special education in order to prescribe powerful narcotics? The Food and Drug Administration may soon recommend that they do so, though such a move would most likely prove controversial.

“I think it is a good idea, and it is something we are considering,” said Dr. Bob Rappaport, the director of the division of Anesthesia, Analgesia and Rheumatology Products at the F.D.A. But the agency itself does not have the authority to take such a step, Dr. Rappaport said.

Typically, state medical boards, rather than the federal government, impose licensing requirements on doctors, including the type of continuing education they must receive. A few states, including California, now provide doctors with education about the treatment of pain patients. But nationally, state medical boards have shown little interest in mandating added training in the use of potent pain medications or in screening patients for those prone to drug abuse.

Pain experts say they support increased education for doctors, but some fear that mandatory training may harm pain patients by limiting the number of doctors prescribing such drugs. ...more

NBA star Nash challenges Ontario gov't

From the Windsor (ON) Star:
Canadian basketball superstar Steve Nash is appealing to the Ontario government to fund expensive treatment for Hunter syndrome, a rare genetic disorder that's debilitating a 12-year-old Tecumseh boy.

Nash, a Victoria, B.C., native who plays in the National Basketball Association for the Phoenix Suns and was twice named the NBA's Most Valuable Player, has recorded a YouTube video urging Queen's Park to fund enzyme replacement therapy for those suffering from Hunter syndrome, or MPS II.

"I hope all Canadians will join me in asking their politicians to fund enzyme replacement therapy for Hunter syndrome in Ontario and across Canada," Nash says in the video, clad in a green T-shirt that reads "Got Hope." ...more

Narace wants pharmacists to take on greater role

From Trinidad and Tobago's Newsday:
Health Minister Jerry Narace wants pharmacists to take on a greater role as caregivers, decision makers, communicators, managers — in short he wants them to become “seven- star” pharmacists.

According to Narace, the annual Caribbean Association of Pharmacists convention, currently taking place in Trinidad, would give pharmacists time to reflect on the idea of “seven-star” pharmacists, exchange ideas and set the tone for the Caribbean pharmacist of the future who will become partners in the health care reform.

Narace was speaking at the opening ceremony of the 28th annual CAP convention at the Hyatt Regency ballroom on Tuesday.

Attending the convention are pharmacists from Antigua, Barbados, Bahamas, Cayman Islands, Canada, Dominica, Guyana, Jamaica, Spain, St Kitts/Nevis, St Lucia, St Vincent and the Grenadines, Turks and Caicos, USA, UK and Trinidad and Tobago. ...more

Anemia caused by chemotherapy, dialysis or heart disease may actually help heal the body

From the Ottawa Citizen:
Anemia caused by chemotherapy, dialysis or heart disease may actually help heal the body rather than harm it, says a new study that challenges the need for a $9-billion-a-year drug.

The study, published in the Canadian Medical Association Journal, suggests millions of patients with anemia due to chronic disease are being dangerously overtreated. In many cases, the treatments could increase risk of death, said Dr. Ryan Zarychanski, the study's co-author and a scientist at the Ottawa Health Research Institute.

"Doctors have been taught for generations that anemia is bad and they want to help their patients by treating it," said Dr. Zarychanski, who's also a hematologist at The Ottawa Hospital. "But we failed to consider this response may be adaptive and may be exactly the response that the body needs at that time." ...more

Drugs, angioplasty give similar life quality: study

From Reuters:
Using drugs alone may take longer than angioplasty or stent surgery to help restore blood flow in patients with clogged arteries but in the long run patients do just about as well, researchers reported on Wednesday.

The surgery, known as PCI for percutaneous coronary intervention, may provide more short-term relief for some patients with severe or more frequent chest pain but the benefits tend to fade over the years, the international team of researchers reported in the New England Journal of Medicine.

They assessed 2,287 volunteers in 50 U.S. and Canadian medical centers as part of a study called COURAGE, for Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation.

They reported last year that patients getting drugs alone for chest pain known as angina and for heart disease are no more likely to die or have a heart attack during the follow-up period of 30 to 84 months than people who also received PCI. ...more

City prepares new regulations for methadone dispensaries

From Surrey (BC) Now:
Surrey is set to adopt tougher rules to regulate pharmacies that dispense methadone.

Modeled on similar bylaws in Vancouver, council has given preliminary approval to new regulations aimed at preventing the concentration of these pharmacies in the Whalley downtown core.

Pharmacies dispensing methadone, a synthetic drug used to treat drug addiction, will have to be at least 400 metres away from another one.

Councillor Linda Hepner said the purpose of the stringent rules is to prevent small pharmacies from getting around being classed as a methadone dispensary simply by stocking "a few hair products and an aspirin."

"It is something we want to get a better control of," Hepner said.

The city centre has 16 full-service drugstores that dispense methadone and five methadone dispensaries. The dispensaries are all in the Whalley core within a few steps or blocks of each other. ...more

Some people taking cholesterol-fighting statins splitting pills, saving money

From the Canadian Press:
A small but growing percentage of British Columbians who take statins to lower their cholesterol have twigged to the fact that they can save on their medication bills by pill splitting, a new study suggests.

While the researchers only looked at records for statin prescriptions filled in British Columbia, they suggest substantial savings could be made by individuals who pay for their own drugs, by private or government-run drug plans or a combination of the two if the technique were more widely used.

"There are a lot of patients out there who are taking statins who ... could save a lot of money by splitting a larger tablet, or perhaps even moving to a lower cost statin and splitting a larger tablet of that statin and save even more money," said Colin Dormuth, an analyst in the University of British Columbia's Therapeutics Initiative and lead author of the study.

"There's a lot more potential for splitting to occur." ...more

Heartburn drugs boost hip-fracture risk over long term: study

From CBC News:
Popular heartburn medications may significantly increase the risk of suffering a disabling broken hip when taken over the long term, Canadian doctors say, and the drugs may be being prescribed inappropriately.

Proton pump inhibitors, or PPIs, such as Prilosec, Nexium and Prevacid, constitute class of drugs commonly prescribed for peptic ulcers and reflux, and they are often taken for years. In 2004, 12.4 million prescriptions were written for the drugs in Canada, according to the Canadian Agency for Drugs and Technologies in Health.

In Tuesday's issue of the Canadian Medical Association Journal, Dr. William Leslie, director of Manitoba's bone density program, and his colleagues find that taking PPIs for seven years or more nearly doubles the risk of an osteoporosis-related fracture.

Hip fractures can be severe, leading to death in about 20 per cent of cases. The number of Canadians who suffer the injury is predicted to increase to more than 88,000 in 2041, up from 23,375 in 1993-1994, an earlier study suggested. ...more

Website again pitching untested cancer drug

From the Edmonton Sun:
A controversial website marketing a promising yet untested treatment for cancer is once again running after U.S. officials shut it down last year.

"We ship internationally, everywhere in the world, except the United States and its territories," reads the site's home page, www.buyDCA.com.

The U.S. Food and Drug Administration ordered the California-based operation closed last summer after its owners began selling the drug, dichloroacetate, or DCA, as a cancer treatment.

The marketing efforts followed developments here in Edmonton by University of Alberta researcher Evangelos Michelakis that showed DCA -- a common and cheap drug -- shrinks tumours in rats. ...more

Vacations put extra strain on pharmacist shortage

From CBC News:
A drop in new pharmacy graduates has exacerbated a shortage of professionals staffing pharmacies across Newfoundland and Labrador, with some forced to close during normal operating hours to accommodate vacation requests.

"Most of us are working extra hours all the time," said Rod Forsey, president of the Pharmacists' Association of Newfoundland and Labrador.

"This summer, with the number of vacations that have to be covered and the shortage of pharmacists, a lot of pharmacies are reducing their hours during slower periods, like on weekends, just to get by, basically," Forsey told CBC News Monday. ...more

Health Canada draws blank on tainted herbal sleep medicine

From Canada.com:
Health Canada does not know how powerful prescription tranquilizers ended up in herbal sleep-aid products, and on Canadian shelves.

Nearly two years after 55-year-old Michael Berggren died in a single-vehicle rollover after unwittingly taking prescription estazolam in a herbal sleep medicine, the government has learned little about who tainted the herbal remedies, where they did it, or how.

"While some of the raw materials in four of the products were imported by the same supplier, Health Canada cannot confirm at which point in the manufacturing process the products became adulterated with this controlled substance," spokesman Alastair Sinclair wrote in an e-mail to the Edmonton Journal.

"These products may have been imported into Canada or they may have been manufactured in Canada with imported raw materials."

Sinclair did not say what the government has done to identify the source of the illegal drugs, nor what inspectors have done to figure out who is adding them to herbal remedies. ...more

Chlamydia drug over-the-counter

From BBC News:
For the first time an antibiotic for chlamydia is to be made available from pharmacists, without a prescription.

People aged over 16 will be able to buy Clamelle after testing positive for the infection, or having sex with someone who tests positive.

The medicines regulator has decided the drug will be made available over-the-counter later this year.

If untreated, chlamydia can cause serious problems, including infertility and possibly cancer in later life.

Experts are alarmed that rates of infection have soared in recent years, particularly among the young.

The drug, also called azithromycin, will still be available via the traditional route - either from a GP or a genito-urinary medicine clinic. ...more

Codeine-laden painkillers stay on sale

Note: Nurofen Plus is a combination of ibuprofen and codeine.

From News.com.au:
Heavy-duty painkillers containing codeine will remain available over the counter but pack sizes could be reduced to stop drug abuse, a government committee has ruled.

Doctors and pharmacists have welcomed a decision not to reclassify codeine combination medicines such as Nurofen Plus as prescription-only.

The drug class was under investigation due to mounting claims of serious medical complications among addicted Australians, with one online forum suggesting 7000 people were hooked.

A report released last month linked high use to serious side-effects, like perforated stomach ulcers and renal failure, and death. ...more

Association of ceftriaxone with fatal outcome when administered intravenously with calcium-containing solutions

From Health Canada:
There is a risk of precipitation when ceftriaxone and calcium are administered concurrently via intravenous route.

Cases of fatal reactions with ceftriaxone-calcium precipitates in lung and kidneys have been described in neonates and infants (ref 1-4). In some cases the infusion lines and the times of administration of ceftriaxone and calcium-containing solutions differed.

Although there are no reports to date of intravascular precipitations in patients, other than neonates, treated with ceftriaxone and calcium-containing solutions, the theoretical possibility exists for an interaction between ceftriaxone and calcium-containing solutions in patients other than neonates. ...more

Pharmacists working with patients, doctors on medication reviews

From the Cape Breton (NS) Post:
The goal of the medication review program is to help patients achieve the best outcomes with their medications while minimizing risk.

Designed by the Pharmacy Association of Nova Scotia, the program can now be offered by community pharmacies throughout Nova Scotia.

Tanya Howley, the pharmacist/owner of North Sydney’s Shoppers Drug Mart, has a pharmacist dedicated to the program, but the reviews will be done on a demand basis.

“The program works in conjunction with the physician,” she said. “The key is to provide patients with the opportunity to gain a better understanding of their medications and identify and resolve potential barriers to medication delivery.”

In order to quality, you have to be a senior and on the Pharmacare program, be taking at least four medications or taking medication that potentially puts you at risk of adverse effects and have at least one of the following; diabetes, asthma, arthritis, congestive heart failure, chronic obstructive lung disease, hyperlipidemia or hypertension. ...more

Drugs increase life expectancy of HIV patients by 13 years: study

From CBC News:
B.C. researcher Robert Hogg knew that a frequently used cocktail of drugs was helping people with HIV live longer than expected. He was also well aware of studies, regional in focus, that showed drugs taken in combination were keeping AIDS at bay.

Although treatment had to be for life, evidence was growing that people with HIV could live many years with the right mix of medication. Prospects for a longer life were improving.

But Hogg did not know how much better. So in the late 1990s, he undertook, along with researchers from Western Europe, the U.S. and Canada, to find out the impact of AIDS drugs on life expectancy.

Hogg and others published their findings in the July 26 issue of the medical journal Lancet. Their study found that a combination of antiretroviral drugs increases the life expectancy of HIV patients in high income countries by more than 13 years.

That means a patient who began drug treatment at age 20 could expect, on average, to live about 49 years longer to reach 69. ...more

Rexall testing e-prescription system

From CBC News:
Pharmacy company Rexall said Tuesday that it is testing an "e-prescription" program at selected stores in five Canadian communities.

E-prescribing is a way for doctors to send prescriptions to a drugstore using a computer or a handheld device like a BlackBerry.

"There are proven benefits to the patient from e-prescribing, including the potential to reduce the incidence of medication and dispensing errors due to illegible prescriptions," Dr. Arif Bhimji, president of Alberta's Medicentres, said in a release issued by Rexall.

E-prescribing can cut prescribing errors, dosing errors and harm to patients, Rexall said, citing a study published in the Health Services Research Journal in June 2007. ...more

Prescription for self-service

From Self Service World:
When Don Waugh, co-founder and chief executive of PCA Services in Oakville, Ontario, started his company two years ago, he envisioned an integrated self-service dispensing and medication-management system designed for pharmacies, hospitals, medical clinics and physicians’ offices.

About six weeks ago, PCA, which provides hardware and software for drug-therapy dispensing and management, developed PharmaTrust, Canada's first point-of-care dispensing. ...more

Critics question use of antidepressants to treat PMS

From Canada.com:
Doctors are testing women taking antidepressants at the first symptom of premenstrual irritability, a move critics worry could lead to even more prescribing of "psychotropic" drugs to women.

A small new study shows antidepressants work within hours to dampen premenstrual anger and irritability. It usually takes several weeks for the drugs to start working in depression, and months before a maximum effect is achieved.

But studies suggest a popular class of drugs called SRIs, or serotonin reuptake inhibitors, work more rapidly to reduce symptoms such as irritability and anger.

Some women are already taking antidepressants continuously for severe PMS, or for part of their menstrual cycle - from ovulation to menstruation.

But the new study asked, how fast do the drugs really work?

"Do you need to take it a few days before the irritability starts, or would it be like taking an Aspirin - take it the same day when the symptoms first surface," said Dr. Mikael Landen, a psychiatrist at the Karolinska Institute in Stockholm, Sweden. ...more

Coverage could soar under new guidelines

From the Globe and Mail:
The number of people with HIV-AIDS eligible for treatment with powerful drug cocktails could more than double under new guidelines being published today.

In wealthy countries such as Canada, that means virtually everyone who is infected with the AIDS virus could soon be on a drug regimen.

But the number of people in the developing world getting optimal treatment is unlikely to grow because of the cost, creating an ever-widening care gap.

"Our coverage is sub-optimal everywhere," Julio Montaner, president of the International AIDS Society, said yesterday. "We want these guidelines to be a motivation for the expansion of treatment."

Currently, people with HIV-AIDS are deemed to be eligible for treatment with antiretroviral drugs (ARVs) when their CD4 count falls below 200. (CD4 cells control the body's immune response against infections and are a key measure of how the disease is progressing.) Under the new guidelines, published in the Journal of the American Medical Association, it is recommended that anyone with a CD4 count of 350 or lower begin treatment with ARVs. ...more

Company asks pharmacists, hospitals to return drug

So far, there has been no news that any of these products were distributed in Canada.

From the Seattle Post Intelligencer:
A New Jersey company is asking pharmacists and hospitals to return all prescription drug products made at one of its facilities because it did not pass health authorities' standards.

A Food and Drug Administration inspection at the Little Falls, N.J., facility of Actavis Totowa LLC "revealed operations which did not meet the FDA's or Actavis' standards for good manufacturing practices," according to a company statement issued Friday. ...more

Syndicate to crack down on doctors selling medication in clinics

From Daily News Egypt:
Head of the Doctors’ Syndicate, Dr Hamdy El-Sayyed, sent a stern warning to any doctors found selling medication in their private clinics, saying they will be referred to a disciplinary court.

The announcement came in response to a complaint filed by Dr Ahmed Gebril, head of Alexandria’s Pharmacists’ Syndicate, regarding doctors and medical centers that sell medication without a permit, which is in violation of the law and the industry’s code of ethics.

El-Sayyed replied with a letter to Gebril, assuring him that any doctor accused of doing so would be referred to a disciplinary court.

He also said that the syndicate is “willing to start an investigation right away into every case mentioned in the complaint.”

El-Sayyed told Daily News Egypt that doctors who violate this law will be interrogated before being referred to a disciplinary court, which will then decide on the appropriate punitive measure — be it a warning, a fine or suspension that can range from one week to several months or even years.

Members of the Doctors’ Syndicate clarified that El-Sayyed’s announcement is nothing new because it is prohibited by law for doctors to sell medication. ...more

Drug store buries plastic

From the Barrie (Ont.) Examiner:
Sandy Frape's pharmacy is going green on Monday, but her customers might not notice the change. That is, until they ask for a bag to carry home their purchases.

"Starting on Monday, we're turfing all our plastic bags for new biodegradable ones," said Frape, store manager of Pharmasave on Blake Street. "It's a going green thing and it's really big in the United States right now. In Canada, it hasn't quite caught on yet."

Frape's store is one of three in Barrie switching to the more environmentally- friendly bags and all 400 Pharmasave locations across the country are making the change.

"We're the first Canadian-owned pharmacy to be doing this," Frape said. "These bags look just like the plastic ones, but they will break down in landfill much faster." ...more

Important information regarding ratio-Metformin 500mg lot 638812

From Health Canada:
ratiopharm, following discussions with Health Canada, would like to inform you that there is a possibility that bottles of ratio-Metformin 500mg lot 638812 may contain stray tablets of ratio-Lovastatin 40mg. This situation arises from a product complaint. ...more

Pharmacy Guild urges looser rules on repeat prescriptions - ABC News (Australian Broadcasting Corporation)

From the Australian Broadcasting Corporation:
The Pharmacy Guild is recommending changes which would allow patients to buy repeat prescriptions from chemists for certain drugs for up to two years, without permission from their doctor.

The change is being proposed by the Pharmacy Guild to cut the number of unnecessary visits people pay their GPs.

Under the plan, there would need to be a record of a patient being prescribed the drug previously, before it could be dispensed again.

Guild president Kos Sclavos says the system would cover a range of common drugs.

"Simple products like the contraceptive pill, once a doctor has initiated therapy," he said. ...more

McKesson move for Uniprix could affect Shoppers more that Jean Coutu

From the Financial Post:
The newspaper La Presse has cited rumours that McKesson Corp., a distributor to Canadian and U.S. pharmacies, is buying Uniprix Inc., a banner group for 400 independent pharmacies in Quebec. Should McKesson buy Uniprix, says BMO Nesbitt Burns analyst David Hartley in a note to clients, it may have a bigger impact on Shoppers Drug Mart Corp. than The Jean Coutu Group Inc., given it could remove potential independent acquisition opportunities for an aggressively expanding Shoppers network of stores.

Mr. Hartley believes that McKesson - which recently bought Proxim, a 250-store banner group - may be motivated to buy the Uniprix banner in an effort to protect against losing distribution business to an expanding Shoppers and Jean Coutu Group. Quebec is a highly coveted market given the high number of scrips (prescriptions) dispensed versus the rest of the country, he says - approximately 90,000 per drug store annually, on average, versus approximately 40,000. ...more

Antibiotic ignorance leads to drug-resistant superbugs: Report

From the Vancouver Sun:
People who self-medicate with leftover antibiotics are helping to spread drug-resistant superbugs, according to a report based on a survey that found widespread ignorance about antibiotic use among Canadians.

"A large proportion of the general public is uninformed about antibiotics, and are therefore susceptible to misinformation," says a June report by Les Etudes de Marche Createc, which conducted the survey for the Public Health Agency of Canada.

It found almost one in three Canadians either wrongly believed antibiotics are effective against colds or didn't know if they are. Only 44 per cent knew antibiotics kill bacteria but not viruses.

Close to half incorrectly thought recent use of an antibiotic protects against re-infection or didn't know whether it does. In fact, recent antibiotic use increases the risk of infection by resistant bacteria. ...more

Nasal bed-wetting drug may cause side-effects

From CTV News:
Health Canada is warning consumers that the nasal form of the drug desmopressin should not be used to treat bed-wetting because of the risk of potentially fatal side-effects.

Desmopressin can cause water retention that could lead to a low blood sodium level, also known as hyponatremia. Although rare, hyponatremia can lead to seizures and even death, Health Canada said Friday in an advisory.

The warning, issued in conjunction with manufacturer Ferring Pharmaceuticals, said bed-wetting must not be treated with any nasal form of desmopressin, including DDAVP Spray or DDAVP Rhinyle Solution. The condition must be treated only with desmopressin taken by mouth (DDAVP Melt).

"If you or your child is currently taking a nasal form of desmopressin ... for bed-wetting, you should talk to your doctor to see if you need to continue on desmopressin treatment," Health Canada said. "If continued treatment is necessary, you should be changed over to an oral form." ...more

Pharmacists urged to 'tell the truth' about homeopathic remedies

From the Guardian (UK):
Britain's leading pharmacists' organisation is being urged to crack down on high street chemists that sell homeopathic remedies, amid accusations that they are in breach of their own ethical guidelines.

The Royal Pharmaceutical Society has been asked to take action following allegations that pharmacists are failing to give customers proper information about the shortcomings of homeopathic treatments before they buy them.

In an open letter to the society, Edzard Ernst, the country's only professor of complementary medicine, criticises high street pharmacists for selling homeopathic remedies without informing customers that they contain no biologically active agents and are no more effective than sugar pills.

The ethical code states that pharmacists who sell homeopathic remedies, herbal medicines or other complementary therapies, "must assist patients in making informed decisions" by providing them with "necessary and relevant information".

According to the letter, "customers are frequently misinformed ... by promotional material available in UK pharmacies and verbal advice given by pharmacists. Thus pharmacists breach their own mandatory ethical code on a daily basis." ...more

Morning-after pill expected to soon be available over the counter

From the Grand Falls-Windsor (NL) Advertiser:
When the province's health minister signs off on legislation for the morning-after pill, Newfoundlanders will join the ranks of countries with some of the easiest access to emergency contraception.

Known as Plan B, the drug was only available at first with a doctor's prescription.

Ottawa allowed the pill to be sold without a prescription as of 2005, but a consumer could only obtain it after talking first to a pharmacist.

Sandra Carey, a pharmacist in Grand Falls-Windsor and president of the National Association of Pharmacy Regulatory Authorities (NAPRA), said the executive of her group agreed the drug, called Plan B (Levon-orgestrel) by its manufacturer, is safe.

"The executive of my group had the option to accept or reject the recommendation from the recommendations that have come down from NDSAC (National Drug Scheduling Advisory Committee), and they have decided to accept it," she said. ...more

Roche to suspend HIV research, seeing no advances

From the National Post:
Swiss pharmaceutical company Roche Holding AG will suspend its HIV research because none of its pending medicines represent significant improvement over existing drugs, a company spokeswoman said on Friday.

"Research scientists currently working in HIV will be reassigned to other activities," Linda Dyson, a spokeswoman in Roche's U.S. office in New Jersey, said in an e-mail.

Dyson confirmed an e-mail sent on Wednesday to some activists informing them of the decision. In that e-mail, the company said it "decided to refocus our resources within virology on diseases in which we can deliver substantial improvements over existing medications." ...more

Health Canada asking makers of some antibiotics to put tendon warning on label

From the Canadian Press:
Health Canada announced Thursday that it will ask makers of a class of antibiotics to include a prominent warning on the label that the drugs can lead to tendon ruptures.

The announcement follows on the heels of a similar policy decision from the U.S. Food and Drug Administration. That agency revealed Tuesday that it was asking manufacturers of fluoroquinolone drugs to put a "black box" warning - the FDA's most stringent safety labelling requirement - on their products.

In an emailed response to questions posed Tuesday, Health Canada said it will ask manufacturers of fluoroquinolones to include a "box warning" on the product monographs alerting people who take the drugs of the fact they may be at higher risk of tendon ruptures.

Drugs in the fluoroquinolone class include ciprofloxacin (Cipro), levofloxacin, norfloxacin, ofloxacin, gemifloxacin and moxifloxacin. ..more

DDAVP Spray (desmopressin acetate nasal spray) and DDAVP Rhinyle (desmopressin acetate nasal solution)

From Health Canada:

Ferring Pharmaceuticals, in cooperation with Health Canada, wishes to inform Canadians about new safety information regarding desmopressin when it is used nasally for the treatment of bedwetting (also called Primary Nocturnal Enuresis or PNE). Because of increased risk of serious side effect with all nasal formulations, they are no longer indicated for use in patients with bedwetting.

Desmopressin can cause water retention that could lead to a low blood sodium level (hyponatremia). Hyponatremia is rare but serious and if unrecognized, can lead to seizures and even death.
For Health Professionals
For the Public

Recall of Sandoz Timolol Ophthalmic Solution 0.25% and Sandoz Timolol Ophthalmic Solution 0.5% due to potential health risk

From Health Canada:
Health Canada is warning consumers not to use the prescription drug Sandoz Timolol Ophthalmic Solution in 0.25% and 0.5% strengths, because some bottles may contain more of the active ingredient (timolol maleate) than indicated on the label, exposing patients to an increased risk of adverse events.

Sandoz Timolol Ophthalmic Solution 0.25% and 0.5% are eye drops taken for treatment of increased intraocular pressure (high fluid pressure inside the eye) and glaucoma.

Potential adverse events may include red eye, eye irritation, inflammation of the eyelids and/or cornea, drooping of the upper eyelid, double vision, dizziness, headache, abnormally slow heartbeat, abnormally low blood pressure, shortness of breath, difficulty breathing, and cardiac failure.

Patients taking either Sandoz Timolol Ophthalmic Solution 0.25% or 0.5% eye drops should discontinue use and consult their health care practitioner immediately to ensure that treatment of the original condition (intraocular pressure) is not interrupted. Consumers should return the product to their pharmacist for safe disposal. ...mote

Pharmacist-turned-entrepreneur has the right medicine

From the Arizona Republic:
The Apothecary Shops was on financial thin ice three years ago. The specialty pharmacy had opened too many retail stores, was losing money, and its chief supplier threatened to cut it off.

At the time, founder and CEO John D. Musil realized that he couldn't accomplish every strategic and operational task on his own. He needed help.

"It was kind of the slap in the face," said Musil, a pharmacist turned businessman. "It was a point where you need to figure out what you're going to do or you're going to go broke."

Musil hired a trio of executives to oversee the company's pharmacy operations, sales and finances, and he took on the role of chief strategist for the small Phoenix company that he founded a dozen years ago.

The strategy has paid off. The privately-owned company expects to increase revenue 30 percent this year to about $83 million. It has nearly tripled its sales over the past six years, and the company was recognized by Inc. magazine as one of the nation's 5,000 fastest-growing private companies. ...more

Postal union stages Day of Action

From the Timmins (Ont.) Daily Press:
The Canadian Union of Postal Workers held a day of action on Friday to express its dissatisfaction over services being mailed out to a popular drug store.

More and more of the work is getting shipped to Shoppers Drug Mart stores, said Donald Lafleur, national vice president of the union.

The gathering was held outside the Canada Post office in the heart of downtown, with a barbecue for those passing by.

"We're here to raise awareness about the government moving the public postal service into the private realm," Lafleur said.

"The concern we have is the services will deteriorate."

He said postal workers receive a level of training unmatched by staff in the drug stores, who he believes are underpaid and won't receive a pension or benefits. ...more

Shoppers Drug Mart Rises After Profit Beats Estimates

From Bloomberg:
Shoppers Drug Mart Corp., Canada's biggest drugstore chain, rose the most in six years in Toronto trading after second-quarter profit climbed more than analysts estimated on higher sales of medicine and store-brand products.

Net income increased 14 percent to C$128.3 million ($127.8 million), or 59 cents a share, for the 17th straight gain in quarterly profit. Revenue in the three months that ended June 14 rose 9.4 percent, Shoppers Drug Mart said today in a statement.

The chain boosted sales of generic drugs and introduced more profitable merchandise such as a new Nativa organic food line and higher-priced cosmetics. Chief Executive Officer Jurgen Schreiber, 46, added more store-brand lines to gain market share since taking the helm last year. ...more

Drug helps anorexia patients gain weight, feel happy

From CTV News:
A drug used to treat schizophrenia may be a new tool to help patients with anorexia gain weight and control their obsessive thoughts about food.

New Canadian research has found that when anorexia patients take olanzapine, they gain weight, feel calmer and do not have the obsessive thoughts about weight and food that characterize the debilitating condition.

The research was led by Dr. Hany Bissada, a psychiatrist at and director of The Ottawa Hospital Regional Centre for the Treatment of Eating Disorders. The study included 34 women with anorexia who were enrolled in the centre's day program for anorexia treatment. ..more

Uneven enforcement of ban on drug ads creates double standard: medical journal

From the Canadian Press:
Health Canada's uneven enforcement of its ban on direct-to-consumer drug advertising may strengthen the hand of media companies fighting in court to have it overturned, the Canadian Medical Association Journal said Monday in an editorial.

Signed by editor-in-chief Dr. Paul Hebert, the editorial said the current situation amounts to a double standard, with Canadian media outlets barred from selling drug ads, even though Canadians watching American TV networks or reading American magazines are being "bombarded" with drug advertisements.

"We get contamination from the U.S. We get direct-to-consumer advertising, because we get it from them," Hebert said in an interview.

"So I guess my question is: Why is that allowed to happen?"

CanWest Global Communications is challenging the direct-to-consumer advertising ban, saying it violates the right to free expression enshrined in the Charter of Rights and Freedoms.

Health Canada spokesman Alastair Sinclair said the federal department is defending the case and preparing its response, but noted it would "not be appropriate for Health Canada to comment further on a matter before the courts."

The United States and New Zealand are the only jurisdictions in the world that allow drug companies to advertise prescription drugs directly to consumers. Where they are permitted to advertise, drug companies spend hundreds of millions of dollars trying to get consumers to ask for their brand of cholesterol-lowering medication or their version of acid reflux pills. ...more

Doctors hopeful easier blood thinners are nearing

From the Associated Press:
A trio of experimental drugs has doctors hopeful that for the first time in decades, millions of people at risk of lethal blood clots may soon get easier treatment.

The first goal is a pill option for people who now need daily blood-thinning shots for weeks after knee or hip replacement surgery.

But the ultimate goal is an alternative to that old standby warfarin, also called Coumadin, the nation's most troublesome lifesaver because of side effects and restrictions its 2 million users face.

Now in late-stage testing in thousands of Americans are three pills that work to prevent blood clots in ways that promise to be less burdensome. One of the trio, Boehringer Ingelheim's Pradaxa, just began selling in Europe.

The drug research comes as Medicare is considering withholding payment from hospitals when at-risk patients develop clots in their veins, usually the legs — a common preventable cause of hospital deaths. The National Quality Forum has estimated that only about a third of patients who need protective blood thinners while hospitalized get them.

Known medically as a "deep vein thrombosis" or DVT, such a clot can kill quickly if it moves up to the lungs. There aren't good counts, but recent estimates suggest that about 900,000 people a year suffer a vein clot, and nearly 300,000 die. Being immobile for long periods, such as during hospitalizations or even long airplane flights, can trigger a clot. Vice President Cheney suffered one after a long trip last year. NBC correspondent David Bloom died of one in 2003 after spending days in a cramped military vehicle while covering the invasion of Iraq. ...more

Reported malfunctions with Twinject auto-injector pose potential health risks

From Health Canada:
Health Canada is advising Canadians of reported malfunctions with the Twinject 0.3 milligram (mg) auto-injector and the Twinject 0.15 mg auto-injector that may pose serious health risks to users.

Twinject is a pre-filled, single-use automatic injector containing an epinephrine solution that is used for the emergency treatment of severe allergic reactions, including anaphylaxis. The product is available in two dosing strengths, 0.3 mg and 0.15 mg. The injector is designed to administer one automatic injection, followed by a second dose by manual injection if necessary.

Since Twinject was first marketed in Canada on August 1, 2005, Health Canada has received 30 reports of malfunctions associated with the use of either the 0.3 mg or the 0.15 mg dosage strength. Most cases were reported to be life threatening and required either emergency room visitation or hospitalization. Twenty eight patients recovered without any major complications, and the outcome of the other two patients remains unknown. ...more

Ratio-Morphine Tablets Recalled in Canada due to Risk of Accidental Overdose

From Health Canada:
Health Canada is warning consumers not to use the prescription drug ratio-Morphine SR in 15 milligram (mg), 30 mg, and 60 mg formats. Some tablets may contain more morphine than the label indicates, exposing patients to the potential risk of accidental overdose. Oversized tablets that are noticeably thicker than the regular tablets, and which may contain more morphine than the strength indicated, have been found on the Canadian market. Ratio-Morphine SR tablets are taken orally for the relief of severe pain.

Symptoms of an overdose include abnormal breathing, dizziness, confusion or extreme drowsiness, cold or clammy skin, and abnormally low blood pressure and heart rate. A severe overdose may result in coma, cardiac arrest and death.

The Canadian distributor, ratiopharm, has initiated a recall of the affected lots after two separate complaints were received by the U.S. manufacturer, KV Pharmaceutical.

Health Canada advises consumers currently using ratio-Morphine SR at the 15 mg, 30 mg or 60 mg strength not to take these products and to contact their treating physician immediately to obtain a suitable alternative product for their medical condition. Consumers should return the product to their pharmacist for safe disposal. ...more

Some kids should be on cholesterol drugs: study

From CTV News:
Children eight years of age or older should be treated with cholesterol medication if they are found to have high levels of low-density lipoprotein (LDL), or so-called bad cholesterol, a new report says.

The new recommendation from the American Academy of Pediatrics is a drastic step toward preventing cardiovascular disease among at-risk children, including those with high cholesterol.

CTV medical consultant Dr. Marla Shapiro said the recommendation to medicate kids with cholesterol drugs should not come as a surprise, given the dramatic rise in obesity among children.

"We're at the point where a large, respected pediatric society, which happens to be the American Pediatric Society, is taking a stand and really saying that with the rising epidemic of obesity, we know that in youth and young children this will translate into premature heart disease and stroke in the years to come," Shapiro told CTV Newsnet. ...more

Jean Coutu Group Rises; Retailer Expects Sales Growth

From Bloomberg:
Jean Coutu Group Inc., the Canadian pharmacy chain that became Rite Aid Corp.'s biggest shareholder in 2007, rose 2 percent in Toronto trading after the retailer said sales growth should improve later this year.

Jean Coutu said today the first-quarter net loss widened to C$20.2 million ($19.8 million), or 8 cents a share, in the three months through May 31, mostly from its 30 percent Rite Aid stake that must be reported under Canadian accounting rules. The U.S. chain posted four straight quarters without profit.

The company sees earnings growth coming from new outlets in Quebec and the Rite Aid stake as the third-largest U.S. drugstore chain finishes integrating Eckerd and Brooks stores obtained from Jean Coutu. Sales gains from renovated sites will kick in later this year, Chief Executive Officer Francois Coutu said today.

``They're very well positioned for growth here,'' Airan Friedman, an analyst with Accountability Research Corp., said in a telephone interview. ``It's a defensive name, and it's where you want to be in the economic climate that we're in.'' ...more

Ontario to cover cost of expensive cancer treatment

From the Toronto Sun:
Ontario will spend an additional $50 million to cover three of the most expensive cancer drugs over the next three years, Health Minister David Caplan announced Wednesday.

The province is earmarking $30 million to fund Avastin for colorectal cancer and $20 million to pay for both Sprycel, used to treat leukemia, and Alimta, for lung cancer, Caplan said.

But it’s not clear whether everyone who requests the drugs will be able to get the medication.

About 3,000 patients are looking for Avastin, which costs $40,000 for one treatment, according to Cancer Care Ontario. That could add as much as $120 million to the province’s drug budget.

Many cancer patients say they’ve been forced to pay tens of thousands of dollars for drugs that were recommended by their doctors but not covered under the provincial health insurance plan. Some sought donations and organized fundraisers to help defray the huge cost of the potentially life-saving treatment. ..more

Lilly Loses Appeal to Limit Damages in Canadian Suit

From Bloomberg:
Eli Lilly & Co. lost an appeal to limit potential damages in a lawsuit filed by Canadian patients who claimed they developed diabetes after using its Zyprexa schizophrenia drug.

An Ontario appeal court today affirmed a lower court's decision that plaintiffs in a class-action, or group, suit may try to recover money the Indianapolis-based company made from sales rather than get damages. The plaintiffs sought C$900 million in damages in their initial claim.

Lilly, the world's biggest maker of psychiatric medicines, is accused of failing to warn the Zyprexa schizophrenia treatment may cause diabetes. Opting to go after a company's sales is unprecedented in court, said Toronto class-action lawyer Paul Bates, who isn't involved in the Zyprexa suit. ...more

Children's suicide attempts raise concerns about ADHD medication

From the Globe and Mail:
New questions are being raised about the safety of a drug used to treat attention-deficit hyperactivity disorder amid reports that more than 40 Canadian children have attempted suicide after taking it.

The issue highlights a long-brewing debate over the decision to prescribe powerful drugs to treat complex psychiatric problems among children.

"It does raise some concerns," said Roger McIntyre, head of the Mood Disorders Psychopharmacology Unit at Toronto's University Health Network.

"Childhood psychiatric disorders, I think, are an area [that] in and of itself remain a controversial topic."

Health Canada said it received 189 reports of adverse reactions associated with atomoxetine, sold under the name Strattera, from the time it was put on the market in February, 2005, to the end of last year.

The reports included 55 suicide attempts - 41 of which were among children aged 6 to 17, and 12 that were adults between 18 and 45. Ages were unavailable in two reports, according to information published by Health Canada in its quarterly publication on adverse drug reactions. ...more

Shoppers' move into specialty pharmacy market

From the Financial Post:
Shoppers Drug Mart Corp.'s decision to move into the specialty pharmacy market this week was well received by analysts.

The acquisition of Calea HealthAccess, which distributes and administers drugs to patients with complex medical conditions such as cancer and HIV, provides Shoppers with better knowledge of a fast-growing specialty pharmacy segment," Scotia Capital analyst Ryan Balgopal said in a note to clients. With growth rates in the mid-teens, entering the sector "is complementary to [Shoppers'] existing businesses and allows it to leverage its scale." Mr. Balgopal reiterated his rating of sector outperform on the shares and his one year price target of $67.50.

While the acquisition is not material from a financial reporting perspective, Shoppers' entry into the $3-billion a year specialty pharmacy business in Canada seems to follow a trend occurring among U.S. counterparts such as CVS and Walgreens, said Desjardins Securities analyst Keith Howlett. "Both drug retailers and wholesalers in the U.S. appear to want to move to a new business paradigm with higher margins, based upon services which make more healthcare more efficient for patients and players," he wrote in a note to clients. He reiterated his buy recommendation and his $60 price target on the shares. "In a sea of retailing despair, Shoppers is one of a select few that will grow earnings per share in the second quarter of 2008." ...more

Sex and the Stampede

From the Vancouver Sun:
Sex and Stetsons -- it's enough to get some partygoers at the Calgary Stampede saying yee-haw.

The annual summer festival is renowned for getting folks in the saddle, so to speak.

Just ask Darcy Chalifoux, who said he has seen "some porta-potties rocking" over the years.

There's a lot more than roping going on at the Calgary Stampede. Many of the spectators are hot to trot, too.

"Things get a little wonky," said the sales and marketing director for the Wildhorse Saloon, a Stampede party tent.

"It's a part of people having fun."

But just how promiscuous are Stampede revellers? With the wanton behaviour of participants now a part of the folklore of Stampede parties, it's sometimes difficult to separate fact from the urban myth.

Calgary Health Region officials say their STD clinic is busier with visits the week following Stampede, and there's a slight increase in the number of people picking up the morning-after pill -- also known as Plan B -- at the sexual and reproductive health clinics. ...more

B.C. court clears path for cancer survivors to sue over hormone replacement

From the Canadian Press:
An international maker of a hormone replacement drug has lost its bid to block a B.C. lawsuit, clearing the way for a possible class-action suit on behalf of breast cancer survivors.

Hundreds of B.C. women who claim they got breast cancer after taking the drugs Premarin and Premplus have contacted the law firm involvined in the B.C. Supreme Court lawsuit.

David Klein, the lawyer for the women, said it means if the company is found at fault, the international firm would be held accountable in a Canadian court.

"Now we can put the case back on track toward getting it certified as a class action," he said.

Officially, the lawsuit has one plaintiff so far. Dianna Stanway is the representative plaintiff in the court action that first must be certified by the court as a class action, allowing the other women to join. ...more