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Preston Pharmacy News - October 2011

Medicare Part D Information

The 2012 Medicare Part D plans are now available to view on the CMS website. Beneficiaries/family should be expecting letters in the mail and can go to Medicare.gov for more information. Due to changes for 2012, some Dual Eligible and RX America patients will need to change their Medicare D plan. We know this can be confusing and sometimes frustrating. Please advise your residents or family members that they may contact the pharmacy if they have any questions. Our staff can guide them through the website and help set up their account to view the best plans for each individual.
Reminder: open enrollment for Medicare Part D is October 15 – December 7.

New Labeling for Zofran

The FDA is informing the public of an ongoing safety review and label changes for Zofran (ondansetron) because it may increase the potential for prolongation of the QT interval. Zofran is used to prevent nausea and vomiting caused by chemotherapy, radiation, and surgery. The product label contains information about the potential for QT prolongation and will be revised to include a warning to avoid use in patients with congenital long QT syndrome as well as recommendations for ECG monitoring in patients with hypokalemia or hypomagnesemia, congestive heart failure, bradyarrhythmias, or in those taking other meds that can lead to QT prolongation. Further studies determining the degree of QT prolongation are expected to be complete by the middle of 2012.1

Saw Palmetto Efficacy in BPH

Many men take saw palmetto to relieve lower urinary tract symptoms related to BPH. A recent study published in the Journal of the American Medical Association found that saw palmetto didn’t relieve symptoms of enlarged prostate any better than placebo. While it doesn’t appear to cause side effects, one may consider a trial discontinuation when streamlining a patient’s medication regimen.2

Medication Safety

Dangerous Drug Interaction3
Ace Inhibitors (benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril) and Spironolactone – may lead to elevated serum potassium levels. Monitor potassium levels and renal function periodically. Avoid use of potassium supplements unless needed and potassium is monitored closely.

Look-Alike and Sound-Alike Names4
Effexor confused with Effexor XR
Evista confused with Avinza
Femara confused with Femhrt
Fioricet confused with Fiorinal
Flonase confused with Flovent
Fluoxetine confused with Paroxetine
Foradil confused with Fortical
Foradil confused with Toradol
Glipizide confused with Glyburide
Guaifenesin confused with Guanfacine

New Drug Approvals

Xarelto (rivaroxaban) - oral anticoagulant indicated for the prevention of venous thromboembolism after hip and knee replacement surgery.5

Arcapta Neohaler (indacaterol inhaled powder)- once daily, long-acting beta2-adrenergic agonist (LABA) approved for long term maintenance treatment of COPD. Arcapta has a black box warning for use in asthma.6

Lazanda (fentanyl) Nasal Spray – opioid analgesic for breakthrough pain in cancer patients, 18 years of age and older, already receiving and tolerant to opioid therapy.7

Quote of the Month

“Too much of a good thing can be wonderful” – Mae West

References for October, 2011 Issue
  1. U.S. Food and Drug Administration. FDA Drug Safety Communication: Abnormal heart rhythms may be associated with use of Zofran (ondansetron). Available at: fda.gov. Accessed September 27, 2011.
  2. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA. 2011; 12: 1344-1351.
  3. Top ten drug interactions most dangerous to seniors in long-term-care. Available at: drugdanger.com. Accessed September 27, 2011.
  4. Institute for Safe Medication Practices. ISMP’s list of confused drug names. Available at: ismp.org. Accessed April 19, 2011.
  5. Xarelto Web site. Available at: www.xarelto.com. Accessed September 27, 2011.
  6. Arcapta Web site. Available at: www.Arcapta.com. Accessed September 27, 2011.
  7. Lazanda Web site. Available at: www.Lazanda.com. Accessed September 27, 2011.



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October, 2011