Warning: Daily use of aspirin can lead to side effects which may include total loss of impulse control, man boobs, toe hair, and third nipples. Please consult your doctor before taking this and other over the counter medicine.
Well, not really. But your really should know the risks and benefits of anything you take, even if it’s over the counter, even if it’s aspirin. I have an early memory, and I cannot have been beyond high school or early college, for I was still going to Friday night services with my Parents-of-Blessed-Memory. My father would not let me in the choir with the other retired senior types with weak voices; but, it seemed to amuse him to no end when I out sang them and the cantor from the congregation. The cantor had some kind of a congenital dislocation of the hip and some kind of back pain and I don’t know what else. My parents had discouraged my still premature medical curiosity and told me not to ask him. Read more on To Aspirin or Not To Aspirin; That Is the Question…
I was trying to remember when prescription drugs were allowed to advertise on television (called “Direct To Consumer Advertising, or DTCA”). Fortunately, I didn’t have to bust my memory cells – I just had to “Google it.”
1995. The year all HHHHell broke loose. At least if you were a doctor.
Suddenly, patients could make their own diagnoses and prescriptions and just phone the order in to their doctor. At least, that’s how most patients thought it should work. And – hoo boy! – were they upset when it wasn’t quite that easy.
Comedian Dennis Miller has a hilarious line: “I divide medical practitioners into two camps. Those who will give me a scrip for Vicodin over the phone, and those who won’t.”
Hilarious if you aren’t a doctor, that is. Read more on RX Package Insert — Just Read It!…
Why would a pharmaceutical manufacturer want to change a drug from prescription to over the counter (OTC)?
Well, one thing I’ve learned in my lifetime is – When the Question is “WHY?” then the answer is “MONEY.”
Oh, sure – in our economically-ignorant country, many people think – “Whee! I can buy any drug I want without spending money on a doctor’s appointment and without having to get a prescription! ”
These people are prime candidates for the Darwin Awards.
Yes, believe it or not, the “RX to OTC Switch” can actually HURT patients.
Drug patents expire relatively quickly, competitors are waiting at the gates with generic equivalents, and when a drug becomes OTC, there is a chance that insurance does not cover it.
This makes insurance companies and government programs (Medicare, Medicaid/Medi-Cal, etc.) very happy. They are so strapped for cash that even paying for a cheaper generic is a strain on the budget. When this kind of money is involved, you can bet that lobbyists are pressuring the government to ease their restrictions so that drugs once considered risky enough to warrant a prescription so that not just anybody can have access will be available to anyone who can walk into a drug store or click on a shopping cart on the web.
Patients will have to pay for OTC meds in cash money and doctors usually do not bother prescribing an equivalent drug. If they do not already know of an equivalent, they will probably — and generally do — just tell a patient to go buy it over the counter.
A patient who cannot afford the drug will go off it.
OK – so what’s the big deal if a cold medicine, allergy remedy or hair-restoring pill is no longer a prescription drug?
I was making one of my rare but periodic attempts to watch commercial television. Sometimes I amaze myself that I have not given up, especially when I saw a few minutes of “the View.” I mean, someone has to get in there and promote stereotypes about women, and they are doing an incredible job, what with asking women involved in politics about bathing their babies or something.
I admittedly learn a great deal from the commercials.
Like Claire Danes — whom I used to consider a Shakespearean-quality actress — does not seem to be getting any good roles, because she did this incredible commercial, where her eyelashes and face were photographed every couple of weeks. Admittedly, after four to six weeks, she had pretty lush looking eyelashes compared to week 1.
Here is the prescription drug– yes prescription drug — she was advertising. On the website they have Brooke Shields, too.
He was in his mid-fifties and seemed pretty clueless. What’s more, he had more abnormal movements than any 20 people and looked like he was dancing with an invisible partner.
He sat at home all day trying to get himself involved in things like doing laundry and watching television so that he could get himself tired enough to sleep, focused enough to avoid the voices. He was safe — no forced hospitalization was necessary or even possible here. He promised that he would not harm himself no matter what the voices said, but it became clear that he lived in a world where devils and demons gave him a continuous commentary on everything from why Obamacare would never help him to — the size of his wife’s behind. There may have been some exhortations to harm self or others in the distant past, but they were indeed distant.
He said he had no medicine for the past ten years. I asked how he lived and he said his family was no help, but his woman was. He was married to someone else but this woman was the only person who knew his day-to-day life and she had brought him to the clinic, so I got a release signed and got her in there. I told her he said he had no medicines in say, the past ten years or so. She started laughing.
For the kids who can’t manage to keep appointments — let alone blood tests — there are lots (and I mean lots) who qualify for the anti-psychotics that are also FDA approved as mood stabilizers.
Those who know me as The Renegade Doctor sometimes get the mistaken idea that I am against all prescription drugs and that pharmaceutical treatment should always be avoided. That could not be further from the truth. I believe in the proper treatment for the proper condition. At times, I may disapprove of the methods and conduct of “Big Pharma,” but I will always use the best treatment for my patients – especially if it is FDA approved and a legitimate indication.
My favorite mainstream choice in the above example is usually arapiperazole (Abilify). The case study I’ll share with you is a patient who sometimes hears some voices and would like to get rid of them. So that is the medicine I offer this 22 year old hip hop composer with one of those cylindrical “spreaders” that resembles a manhole cover in his right ear lobe (I wouldn’t have picked it myself, but he told me his girlfriend thought it was real hot). Now sometimes this drug is stimulating and people have trouble sleeping. So my usual suggestion with this would be a touch of Benadryl (diphenhydramine) – an over-the-counter allergy pill – which causes drowsiness and could help him sleep. It’s even available in those “99-cent” stores that dot the countryside. Read more on Promethazine On The Street…
One usually thinks of a doctor as one who gives out prescription – sometimes much too easily. I’m often known as the doctor who declines to push drugs.
I take these things seriously. I’ve studied long and hard and know what drugs can do – both positively and negatively. If the risks outweigh the benefits, I can be down-right stubborn. However, I’ll always have an alternative that can help.
I’m reminded of one case where a woman wanted Chantix (varenicline) – a prescription medicine FDA approved to help people stop smoking — and I said “No.” To my knowledge and experience, the drug has some problems. The last patient I saw who was already taking Chantix asked me for a renewal. I told her that the symptoms of which she was complaining would probably disappear completely if she got off the Chantix. I never saw her a second time. Read more on Its Not Only The Smoking That Can Kill You…