Transdermal Metformin bypasses the gastrointestinal system, which benefits people who experience gastrointestinal side-effects from the oral version of the drug…

Metformin (Glucophage®, Glumetza®, Fortamet® Riomet®), which traditionally comes in tablet form, is a very beneficial medication commonly used for treating Type 2 diabetes and polycystic ovaries. However, some patients cannot tolerate the oral dose due to nausea, vomiting, gas, bloating, diarrhea and loss of appetite, which are common side effects of oral Metformin. Indeed, one in 20 patients have oral Metformin therapy discontinued due to the severity of their side effects. Besides, some patients may have difficulty swallowing the large tablets, which increases the risk that they will discontinue their medication prematurely. Metformin also interacts with other medications that patients might be taking.

Although oral Metformin is the first line of treatment for patients, for those who cannot tolerate it, Compounding pharmacies such as NewSpring offer a solution – change the route from oral to transdermal.

With a doctor’s prescription, a compounding pharmacy will formulate Metformin into a gel or cream to be applied on the skin. Transdermal application of Metformin bypasses the gastrointestinal system, which benefits people who experience gastrointestinal side-effects from oral metformin.

Since Metformin is so effectively absorbed through the skin, the dosage for transdermal application is significantly lower than the oral dose. Research has shown the transdermal route to be effective. Each patient is carefully monitored to ensure that the formulation works for them

For more information on Transdermal Metformin come into the pharmacy or give us a call on 623-932-9800.

Source: The above article is based on an article published in the Feb 2014 PCCA Apothagram

Why popular antacids may increase chance of bone fractures

CAMBRIDGE, Mass., March 26, 2015 – Newly published research from the Forsyth Institute details a discovery explaining why the 100 million Americans estimated to be taking prescription and over-the-counter antacid and heartburn medications may be at an increased risk of bone fractures.

The new report from Forsyth, published in the March issue of the prestigious medical research journal PLOS Genetics, explains that stomach acid in the gastrointestinal tract plays an important role in helping the intestines absorb and transfer calcium to the skeletal system. While the introduction of proton pump inhibitor-based antacids reduces the level of acidity in the stomach to bring relief to patients, the reduction also interrupts and even stops the gut from absorbing much needed calcium.

The connection between proton pump inhibitors and bone fractures has been well established, with the Food and Drug Administration in 2010 requiring a warning label placed on all product packaging. Other research has indicated these medications may block the absorption of important nutrients, but until this study it was not known how or why this was happening in the body.

“The regulation of bone mass by the gastrointestinal tract represents a remarkable example of an unexpected and important relationship between these two systems that is only now becoming fully appreciated,” said Dr. Ricardo Battaglino of the Forsyth Institute. “It could help us better understand and find new ways to treat common clinical conditions that currently require medications which have been linked to weakened bones, such as popular antacids.”

Over-the-counter and prescription antacids are used by 100 million Americans to treat heartburn and related conditions. It is the third highest selling drug category with $14 billion in annual sales according to the American Academy of Family Physicians. Fractures at the hip, wrist, arm, ribs and even vertebrae – especially in individuals aged 50 and older – can permanently impair quality of life and result in an expensive drain on the American healthcare system.

The above article is based on materials provided by Forsyth Institute. It may be edited for content and length.

Is it Dementia, or Just Normal Aging? New Tool May Help Triage

ROCHESTER, Minn – Researchers at Mayo Clinic developed a new scoring system to help determine which elderly people may be at a higher risk of developing the memory and thinking problems that can lead to dementia. The study is published in the March 18, 2015, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Our goal is to identify people who are at the highest risk for dementia as early as possible” said study author Ronald Petersen, M.D., Ph.D., Chester and Debbie Cadieux Director of the Mayo Clinic Alzheimer’s Disease Research Center, Cora Kanow Professor of Alzheimer’s Disease Research and a member of the American Academy of Neurology.

“Early detection of individuals at high risk of developing memory and thinking problems that we call mild cognitive impairment (MCI) is crucial because people with MCI are at a greater risk of developing dementia. This allows for a wider window of opportunity to initiate preventative measures.”

The study involved 1,449 randomly selected people from Olmsted County, Minnesota between the ages of 70 and 89 who did not have memory and thinking problems. At the start of the study and at visits every 15 months for an average of 4.8 years, participants were given memory and thinking tests. During the study, 401 people — nearly a third — developed MCI.

The scoring system took into account factors that could be easily obtained from medical records, such as years of education, number of medications, history of stroke or diabetes, and smoking. Researchers also factored in information obtained at the clinic visit, such as a test of thinking abilities, symptoms of depression and anxiety, and slow gait. Factors were assigned a score based on how much they contributed to the risk of developing thinking problems. For example, being diagnosed with diabetes before age 75 increased the risk score by 14 points, while having 12 or fewer years of education increased the risk by two points.

Many predictive factors were different for men and women. While the risk of MCI increases with age overall, younger men were at a higher risk of developing MCI than younger women. Conversely, older women have a somewhat higher risk than older men.
Variables such as age, diabetes, heart health risk factors, slow gait, depression and anxiety disorders, stand out as contributing most to the risk score. The APOE gene, which has been linked to a higher risk of dementia, was determined in the study to be only a moderate risk factor.

“This risk scale provides an inexpensive and easy way for doctors to identify people who should be referred to more advanced testing for memory issues or may be better candidates for clinical trials,” said Petersen.

This article is based on material provided by Mayo Clinic. It may be edited for content and length

Ten percent of heart patients may be inappropriately prescribed aspirin: Over the counter use may increase numbers

WASHINGTON (Jan. 12, 2015) — More than 10 percent of patients treated with aspirin therapy for primary cardiovascular disease prevention were likely inappropriately prescribed medication, according to a new study in the Journal of the American College of Cardiology that examined practice variations in aspirin therapy. Accessing data from the National Cardiovascular Disease Registry Practice Innovation and Clinical Excellence (PINNACLE) Registry, researchers examined a nationwide sample of 68,808 patients receiving aspirin for primary cardiovascular disease prevention. By evaluating aspirin guidelines by the American Heart Association, the U.S. Preventative Services Task Force, and other organizations, researchers determined aspirin use to be inappropriate in patients with a 10 year cardiovascular disease risk of less than 6 percent. Researchers identified patients from 119 practices who were prescribed aspirin between January 2008 and June 2013, excluding patients receiving aspirin as a secondary prevention due to history of cardiovascular disease such as myocardial infarction, prior stroke, and atrial fibrillation. The study found nearly 12 percent of the patients receiving aspirin for primary prevention were receiving it inappropriately. The frequency of inappropriate aspirin use was higher among women, at nearly 17 percent compared to men at 5 percent. Patients inappropriately receiving aspirin were, on average, 16 years younger than those receiving aspirin appropriately. Inappropriate aspirin use decreased from 14 percent in 2008 to 9 percent in 2013. In practices with more than 30 patients receiving aspirin for primary prevention, researchers found a median practice-level frequency of inappropriate use of 10 percent and varied significantly across practices at a range of 0 to 72 percent. Researchers used median rate ratio to suggest that between two “identical” patients treated at two random practices, one patient was 63 percent more likely to be prescribed aspirin inappropriately than a similar patients due to the practice where they receive care. Aspirin therapy is not shown to reduce adverse cardiovascular events in patients without cardiovascular disease and a low risk of developing disease. However, it is associated with an increased risk of gastrointestinal bleeding and hemorrhagic strokes which often outweighs any potential benefits. The U.S. Food and Drug Administration recently denied a request to allow the marketing of aspirin for primary prevention, following that decision the FDA also issued a public advisory against the general use of aspirin for primary prevention. As aspirin is available over the counter, it is also possible inappropriate aspirin use is higher if patients are taking it by their own choosing. “Medical providers must consider whether the potential for bleeding outweighing the potential benefits of aspirin therapy in patients who don’t yet meet the guidelines for prescribing aspirin therapy,” said the study’s lead and senior author, Ravi S. Hira, M.D. and Salim S. Virani, M.D., Ph.D., of the Baylor College of Medicine in Houston. “Since aspirin is available over the counter, patient and public education against using aspirin without a medical provider’s recommendation will also play a key role in avoiding inappropriate use.” In an accompanying editorial, Freek W.A. Verheugt, M.D., of Onza Lieve Vrouwe Gasthuis Radboud University Nijmegen Medical Centre in Amsterdam said, “Major coronary events are reduced 18 percent by aspirin, but at the cost of an increase of 54 percent of major extracranial bleeding. Each two major coronary events have shown to be prevented by prophylactic aspirin at the cost of one major extracranial bleed. Yet, primary prevention with aspirin is widely applied.” The above article is based on materials provided by American College of Cardiology. It may be edited for content and length.

Mushroom extract, AHCC, helpful in treating HPV

by Deborah Mann Lake

HOUSTON – (Oct. 28, 2014) – A Japanese mushroom extract appears to show promise in the treatment of human papillomavirus (HPV), according to a pilot clinical trial at The University of Texas Health Science Center at Houston (UTHealth) Medical School.

The results were presented at the 11th International Conference of the Society for Integrative Oncology in Houston today by principal investigator Judith A. Smith, Pharm.D., associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the UTHealth Medical School.

Ten HPV-positive women were treated orally with the extract, AHCC (active hexose correlated compound), once daily for up to five months. Five achieved a negative-HPV test result – two with confirmed eradication after receiving AHCC for three months. One patient had confirmed eradication after taking AHCC for an additional two months off study for a total of five months of AHCC treatment. The remaining two women who achieved a negative-HPV test are continuing on the AHCC for two more months, when eradication status can be assessed.

Currently, there is no effective medicine or supplement to treat HPV, which is associated with more than 99 percent of cervical cancer cases. According to the Centers for Disease Control and Prevention, several other cancers are related to HPV, including 95 percent of anal cancer, 60 percent of oropharyngeal, 65 percent of vaginal cancer, 50 percent of vulvar cancer and 35 percent of penile cancer.

AHCC is a readily available nutritional supplement that works to improve the innate immune system. Human and preclinical studies have shown that AHCC increases the number and/or activity of Natural Killer (NK) cells, dendritic cells and cytokines, which can help the body fight off infections and block tumor growth.

“The results are very encouraging,” Smith said. “We were able to determine that at least three months of treatment is necessary but some need to extend treatment for up to five months. Since AHCC is a nutritional supplement with no known side effects and other immune modulating benefits, we will be planning on using six months of treatment in a phase II clinical study that is under review. This confirms our earlier preclinical research.”

Smith is director of UTHealth’s Women’s Health Integrative Medicine Research Team, which focuses on the safe and effective use of nutritional and herbal supplements with pharmacologic modalities as they relate to women’s health and cancer.

The above article is based on materials provided by University of Texas Health Science Center at Houston. Materials may be edited for content and length.