Commentary on medical news by a practicing physician.

  • Epocrates MedSearch Drug Lookup


    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

    email: medpundit-at-ameritech.net

    or if that doesn't work try:


    Medpundit RSS

    Quirky Museums and Fun Stuff

    Who is medpundit?

    Tech Central Station Columns

    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews


    Medical Blogs


    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc




    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It


    SOAP Notes


    Cut-to -Cure

    Black Triangle



    Kevin, M.D

    The Lingual Nerve

    Galen's Log



    Doctor Mental



    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House



    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day


    The Business Word Inc.

    Point of Law

    In the Pipeline


    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station





    The Skeptic's Dictionary

    Recommended Reading

    The Doctor Stories by William Carlos Williams

    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn

    Intoxicated by My Illness by Anatole Broyard

    Raising the Dead by Richard Selzer

    Autobiography of a Face by Lucy Grealy

    The Man Who Mistook His Wife for a Hat by Oliver Sacks

    The Sea and Poison by Shusaku Endo

    A Midwife's Tale by Laurel Thatcher Ulrich



    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info



    Saturday, January 15, 2005

    Statin Heaven: Drug companies met a roadblock in their efforts to make cholesterol lowering medication over-the-counter:

    A Food and Drug Administration advisory panel recommended against the over-the-counter sale of a Merck cholesterol-lowering drug, saying that while millions of Americans could benefit from taking it, they should not begin such a regimen without a doctor's advice.

    The F.D.A. typically heeds such recommendations, meaning that the drug industry has been at least temporarily thwarted from creating a new segment of the drug market. But Merck and its partner in the application, Johnson & Johnson, said they would continue trying to win approval.

    Although their real motive is to avoid patent expirations, they put a patient-friendly spin to their mission:

    The companies had sought to sell a nonprescription version of Mevacor, one of the oldest of the class of drugs known as statins. With the support of some cardiologists, the companies argued that over-the-counter statins could benefit many of the estimated 39 million people whose blood cholesterol might put them at moderate risk of a heart attack but who are reluctant to spend the time and money getting a doctor's prescription.

    The safe use of these drugs requires monitoring of subsequent cholesterol levels (to get the correct dose) and liver enzyme levels (to check for the not infrequent side effect of liver inflammation), which - suprise - require visits to the doctor, and time, and money. If these are granted over-the-counter status, then every other medication from antibiotics to blood pressure medication to anti-depressant medications might as well be made over-the-counter, too.

    UPDATE: UPDATE: Trent McBride disagrees and asks why I would force patients to see a doctor if they want to improve their health. That's not what I said, and that's not the way I view the issue. Certainly, people can do things to improve their health without seeing a doctor.

    But, what we can't do, is allow drug companies to sell drugs that need monitoring as if they don't. There's been a lot of hand wringing lately about the safety of prescription drugs. We seem to expect our prescription drugs to be without side-effects. But this is precisely why they're prescription drugs, because they do have side effects and they need close monitoring to insure they do minimal harm. They also need the input of a consultant - such as a doctor - to help a patient decide if the drugs' risks are worth their potential benefit.

    Statins aren't as safe as vitamins or antihistamines. They have the potential to cause serious adverse effects, contrary to the claims of their advocates. I've had many more patients develop liver inflammation and myositis from statins than I've had depressed patients attempt suicide because I treated their depression with an SSRI. In fact, it's about a 10 to 0 ratio in fifteen years of practice. It makes no sense to put a drug that requires careful monitoring for side effects over the counter.

    posted by Sydney on 1/15/2005 08:35:00 AM 0 comments


    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page


    Home   |   Archives

    Copyright 2006