LE Magazine March 2003
You are about to discover an overlooked reason for why Americans suffer so many unpleasant and lethal side effects from their prescription medications. Armed with this knowledge, you will be able to reduce your risk of adverse drug reactions, while saving significant dollars on the cost of your prescription medications.
The information you are about to learn will forever alter how you interact with your physician and provide a greater sense of control over your future good health.
Drug side effects are the fourth leading cause of death in the United States. According to an article published in the Journal of the American Medical Association,1 about 106,000 Americans die and 2,000,000 suffer from severe reactions every year from drugs prescribed in hospitals.
These statistics understate the true magnitude of the problem, since people often die from adverse drug reactions outside the hospital. There are also many deaths that occur in hospitals caused by drugs prescribed outside the hospital. For example, some prescription drugs deplete calcium from bones, which causes elderly people to suffer fractures, which leads to their hospitalization. In the hospital, these people often develop pneumonia, vascular blood clots, sepsis or some other illness that kills them. The death certificate may list "pneumonia" as the cause of death, but it was the inappropriate prescribing of the bone-depleting drug in the first place that caused the fracture, which necessitated the hospital confinement that led to pneumonia.
An examination of the data beyond that recorded on death certificates reveals a shocking number of deaths related to inappropriate drug prescribing. Even when a drug like Rezulin2 was withdrawn because too many people were dying from liver failure,3,4 it was estimated that only one out of ten deaths caused by Rezulin was ever attributed to the drug.5
What makes prescription drugs so dangerous?
All drugs have the potential to cause side effects by themselves, or through interaction with other drugs. This is one reason why more people are turning to natural therapies that have proven track records of safety.
SAVING MONEY WITH ALTERNATE DAY RATHER THAN DAILY DOSING
Some drugs you are taking every day may work as well if you take them every other day.
In a study published in the American Heart Journal, * a comparison was done using the cholesterol-lowering drug Lipitor® every day or every other (alternate) day. The findings showed that alternate day dosing was comparable to every day dosing.
The patients were started at 10 mg and their dose increased to 20 mg if needed. The every day dosing schedule required a mean of 12 mg/day of Lipitor® to sufficiently lower cholesterol, whereas the alternate day group only required a mean 9 mg/day to achieve similar effects. The doctors concluded the study abstract by stating:
"…these results suggest that the alternate-day administration of atorvastatin (Lipitor®) can produce a reduction in LDL-C comparable to that of daily administration in patients with hypercholesterolemia, and yet provide some cost savings."
What was not revealed in this study was the enormous amount of the cost savings. Life Extension has calculated the exact amount one could save by switching to alternate day dosing. Here are the numbers:
The cost of taking 10 mg of Lipitor® every day is about $60.00 a month.
The cost of taking 10 mg of Lipitor® every other day is only $30.00 a month.
If 20 mg of Lipitor® is needed every other day, the cost of 15 20 mg tablets comes out to about $44.00 a month.
Armed with this knowledge, the Lipitor® consumer can save 50% ($30.00 each month) if they find they only need 10 mg of Lipitor® every other day. If 20 mg of Lipitor® is needed every other day, the consumer saves 26% ($16.00 each month).
Anyone contemplating changing their dosing schedule of any drug should notify their physician and verify that the changed dose is working. In the case of Lipitor®, one would want to check LDL, HDL, C-reactive protein and total cholesterol blood levels within 45 days of changing the dose. While "statin" drugs like Lipitor® are taken primarily to lower cholesterol, a side benefit is that they also lower the more dangerous C-reactive protein. New studies confirm that C-reactive protein is a greater risk factor for heart attack and stroke than is cholesterol.
Many drugs (such as anti-hypertensives) absolutely have to be taken every day or even several times throughout the day. Alternate day dosing should not be attempted with any medication without physician approval.
* American Heart Journal 2002 Oct;144(4):674-7.
In order for pharmaceutical companies to earn a profit, they must develop drugs that are potent enough to patent and be approved by the FDA. To gain FDA approval, these drugs must demonstrate an acceptable safety profile. However, the safe dose of potent drugs can vary considerably among individuals. What is safe for some people can be a lethal overdose for others. Yet doctors and drug companies usually recommend the same dose for everyone.
What will be revealed in this issue's cover story is that lower doses of many prescription drugs can achieve the same beneficial effects, while dramatically reducing side effect risk and the cost of the medications.
Take the cholesterol-lowering drug Zocor®, for example. The recommended starting dose is 20 mg, which has been shown to lower LDL cholesterol by an average of 38%. Scientific studies, however, show that 5-to-10 mg of Zocor® works almost as well as 20 mg. This lower dose could reduce the risk of side effects by as much as four-fold.
Lets say your LDL-cholesterol level is 130 (mg/dL), and your objective is to reduce it to under 100. Just 5 mg a day of Zocor® should accomplish this, yet the typical starting dose of Zocor® is 20 mg, and some doctors even start as high as 40 mg…eight times higher than the dose needed by many people!
New studies indicate that side effects (especially muscle aches) from statin drugs such as Zocor® are more common than originally thought. When a person is prescribed 20 mg of Zocor®, and encounters toxic side effects, they often abandon the drug. Yet, if only 5 mg of Zocor® was taken, the odds of encountering side effects would be reduced and the therapeutic target (LDL-cholesterol under 100) might be easily achieved.
It's not just Zocor® that is often overdosed. The number one statin drug sold in the United States is Lipitor®, which is typically prescribed in doses of 10 mg and higher. There are studies, however, showing as little as 2.5 mg a day is effective for many people.
If you are a statin drug user, have your blood tested to make sure your total cholesterol is not below 180 mg/dL. Cholesterol levels below 180 (mg/dL) can increase your risk of cerebral hemorrhage and other lethal diseases. Scientific studies show that the optimal total cholesterol range is 180-220, while LDL-cholesterol should be under 100 and beneficial HDL-cholesterol over 50. Some statin drug users drop their total cholesterol below 150. If these people had taken a lower dose of the drug, they would probably have adequately lowered their cholesterol levels, reduced their toxicity risk and saved a good deal of money.
Too much Prozac
Prozac® has received considerable media attention for allegedly causing serious psychological disturbances. Attorneys have blamed Prozac® for all kinds of criminal behaviors, and anecdotal reports abound about the adverse effects some people experience on the standard (20 mg) daily dose of this popular antidepressant.
SAVE MONEY BY
any prescription drugs do not come in the lower doses that are optimal for many patients. In these cases, the tablets have to be split or capsules opened in order to obtain the desired dose. While this is somewhat inconvenient, the cost savings can be substantial.
Zocor® is one drug that comes in a wide range of doses. Here are the typical prices in the United States for 100 tablets of each available dose of Zocor®:
5 mg $171.87
10 mg $221.78
20 mg $371.00
40 mg $390.00
80 mg $345.00
For the many Zocor® users who need only 5 mg a day (instead of 20 mg), the savings are 53% if one switches from the 20 mg dose to the 5 mg dose. For those who use a pill-splitter to break 20 mg tablets into four doses, the savings are 75%. Information about pill splitting devices appears later in this issue.
It is interesting to note that in today's upside down drug-pricing environment, 80 mg Zocor® tablets sometimes cost less than 40 mg tablets.
If you don't want to pay artificially inflated prices for prescription drugs, you can order from Internet pharmacies in Canada. A bottle of 100 20 mg Zocor® tablets that costs $371.00 in the United States costs only $192.12 in Canada, a 48% savings. A bottle containing 100 5 mg tablets of Zocor® costs $171.87 in the United States, but only $119.00 in Canada, a 30% savings.
That means if you buy 20 mg Zocor® tablets in Canada and split them into four doses (5 mg each), you can save 86%. Not everyone can get by with only 5 mg a day of Zocor®, but as you will read in this issue, many individuals are overdosing on statin and other drugs and can obtain better results by reducing their daily dose.
When Prozac® was introduced, it only came in 20 mg capsules and all patients were started at this dose. While Prozac® helped most people, it caused serious side effects in others. Among the side effects caused by Prozac® are headache, nausea, irritability, sexual dysfunction (impaired orgasm, reduced libido), low energy, dry mouth, tremor, anxiety and insomnia.
A study published before Prozac® was approved showed that a daily dose of 5 mg of Prozac® helped 54% of patients, while 20 mg helped 64%. In other words, administering four times the 5-mg dose only helped 10% more people!
Some doctors have found that lower doses of Prozac produce antidepressant benefits without causing side effects, yet the Physician's Desk Reference (PDR) and the drug's package insert still recommends 20 mg as a starting dose.
While overdosing on Prozac® can cause serious psychological side effects, other antidepressants like Elavil® can be lethal when taken in too high doses. The PDR still advises an initial dose of 75 mg for Elavil® (amitriptyline) followed by gradually higher doses. Yet 10-to-25 mg of Elavil® is frequently enough to treat mild depression or pain syndromes. Too much Elavil® can cause irreversible AV node block in the heart leading to fatal arrhythmia.
Antidepressant drugs are often prescribed in higher-than-needed doses, and the ensuing side effects cause many patients to abandon them altogether.
An epidemic of overdosing
The in-depth article in this month's issue exposes how drug companies, physicians and the FDA are all culpable in overdosing Americans with dangerous drugs. The article also explains the toxic mechanisms involved when too much of a drug is consumed, along with newly identified side effects of popular drugs.
Of practical value are charts showing lower doses of the most popular prescription drugs, how to determine if you should start off at a lower dose, and how to avoid lethal drug interactions.
This article also exposes today's flawed system of drug regulation. Prominent scientists accuse the FDA of failing to protect the American consumer against the drug companies. The FDA claims it is protecting Americans against dangerous drugs, yet the statistics show an epidemic of drug-induced injury and death.
Too many consumers unknowingly overdose on their prescription drugs. When unpleasant side effects develop, people often stop taking the drug completely, even though a lower dose might be safe and effective.
More than 100,000 Americans die every year from prescription drug side effects. In many cases, the drug-induced death could have been avoided if a lower dose had been used.
Chronic overdosing of prescription drugs is one of the greatest health hazards Americans face. How can the medical establishment ignore something so obvious? Unfortunately, obvious ways of improving patient care are routinely overlooked by medical professionals. Today's leading causes of disability and death are ignorance and apathy in applying proven scientific methods of preventing and treating disease.
This issue of Life Extension magazine will enable many members to save hundreds of dollars a year on their prescription drugs, while reducing their risk of debilitating or lethal side effects.
The title of the article about drug overdosing is Medications Side Effects: Why They Occur and How You Can Prevent Them. It provides a real world solution to the epidemic of drug-induced side effects.
For longer life,
1. Lazarou J., Pomerantz, B., Corey, P., Incidence of Asverse Drug Reactions in Hospitalized Patients, A Meta-analysis of Prospective Studeis, JAMA, April 15, 1998, 279(15): 1200-1205.
2. Sparano n., st al, Troglitazone in Type 11 Diabetes Mellitus, Pharmacotherapy, 1988, 18(3): 539-45.
3. Hepatic Dysfunction Associated with Troglitazone, NEJM, March 26, 1998, 338(13): 916-7.
4. Fukano M., et al, Subacute Hepatic Failure Associated with a new Antidiabetic Agent, Troglitazone: A Case Report with Autopsy Examination, Human Pathology, February 2000, 31(2): 250-3.
5. LATimes, The rise and fall of the killer drug Rezulin. Life Extension magazine, Sept. 2000 p. 31-39.
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