This year for Hypertension Awareness Month and World Hypertension Day (May 17), I want to discuss about the role of single pill combination in the management of hypertension. Single Pill Combination has been consistently recommended in various Hypertension Guidelines to assist with blood pressure control. However, there is no great resource to guide available options of single pill combination in Ontario.
A patient was presented at the ER with an unprovoked deep vein thrombosis (DVT). It was eventually assessed to require indefinite oral anticoagulation therapy. He was started on rivaroxaban, a NOAC (novel oral anticoagulant). Rivaroxaban as well as other NOACs are recommended in the latest Chest guidelines as first line treatment options for venous thromboembolism disease. But the provincial drug plan does not recognize this update yet and is set up such that warfarin is the preferred agent for long term anticoagulation therapy. NOACs would only be reimbursed for the initial 6 months if treating conditions such as DVT.
From Apr 21 to 28, it’s National Immunization Awareness Week in Canada. So I think it is timely to share this story on immunization record. I have received few “threatening” letters from Public Health that my daughter would soon be expelled from school because her immunization records were incomplete.
I recently blogged about the drug shortage of Nabilone which I thought has resolved. So when I heard patients having difficulty with getting the medication again, I picked up the phone and started calling.
When patients indicate they cannot afford the medications you have prescribed for them, do you know what options are available to explore? Often prescribers may be quick to ask about compassionate programs or free supplies that are available to explore, but they are rarely the solution to a permanent problem.
When a new medication is available, there is often a lot of excitement and hype about how a new option may bring hope to a medical condition. The new medication may offer breakthrough in improving important clinical outcomes (e.g. improving survival, preventing disease complications and significantly offering better quality of life for patients). But before we jump on the bandwagon to start prescribing a new medication, here are few considerations the sales rep may not be quick to highlight or share.
Benztropine (Cogentin) is an anticholinergic that is commonly prescribed for the management of extrapyrimidal symptoms in patients on long term antipsychotics. Recently, there is a drug shortage with this medication which has prompted me to look closer at what are some of the alternatives.