Check out my video below to find out! 

Just a little disclaimer to go with the clip: this is not my best video to date.  Don’t know what happened!

So, those potassium-sparing diuretics I mentioned that do not contain sulfa are amiloride, triamterene, and spironolactone. 

The additional diuretic that does not contain sulfa, but is not a potassium-sparing diuretic is ethacrynic acid. 

Just wanted to provide those medication names in case you absolutely cannot take a sulfa-containing diuretic!

Whoa, that was a little rough, but at least you’ve got some info to start with, and if you need some clarification on the matter, definitely get in touch with me at Cate@getpharmacyadvice.com.

Thanks for checking in!

Xopenex nebulized solution is super duper popular with pediatricians.  Xopenex (levalbuterol) is only available in brand.  It came out on the market with hopes that it would work better and with less side effects than good ole generic albuterol nebulized solution.

Unfortunately, Xopenex works only just as well as albuterol and has the same side effects.  There are a few patients that tell me that they feel Xopenex causes less aggitation but that hasn’t been proven.

So keep your money and stick with generic albuterol nebulized solution.  Did you know that Xopenex nebulized solution can be FIVE times more expensive than albuterol nebulized solution?  BTW -currently the albuterol 0.083% is on Walmart’s and Target’s $4 lists.

As for HFA inhalers, albuterol is not available in generic any longer but typically albuterol HFA inhalers are less expensive then Xopenex HFAs.

Want to learn more secrets on how to save some money?  Visit our FREE site all about How to Save Money on Your Prescription Drugs.

Go ahead, watch the video and learn some info on bug sprays and the answers to the questions above!

Want to know how to treat bug bites?  See How to Treat Insects and Home Remedies for Bug Stings and Bites.

This is a very popular question at the pharmacy…it’s prime travel time right now!  Have no fear, there’s an option or two for you depending on specific travel plans.

First, you may want to determine if your insurance will pay for your medication before you hit the road (or air).  This will save you a lot of worry about how you’re going to get your next refill.  Most insurances will  pay for your prescription a good 5 to 7 days before it’s due!  You can find this information by calling your insurance company or having the pharmacy process a refill for the medication in question.

If you’ll be taking off before your insurance will pay for your medication, give your insurance carrier a call to see if they’ll allow for a vacation override.  If you’re traveling within the country, you may find that an override will not be issued because you can easily get the prescription transferred to a pharmacy in the area of your destination. 

If you get your prescriptions at one of the various major retail pharmacy chains, you’ve got it made.  This is because these companies have pharmacies all over the country and every pharmacy within a particular company (i.e.  Rite Aid Pharmacy) is connected by internet…a pharmacy on one side of the country can pull your prescription from the pharmacy you use at home and fill it, so long as they are part of the same chain!

However, if you end up having to go to a pharmacy of a different company, have the pharmacist call your local pharmacy to transfer your prescription to the temporary location.  It’s an easy process and you can always have your local pharmacy call the temporary drugstore to get the prescription back once you return from your get-away.

There are certain laws that vary from state to state, especially with control substances so be patient with the pharmacy staff while they figure out how they can help you if a problem should arise!

Warning: based on many state laws, you may only be able to transfer your prescription for a control substance one time…meaning you won’t be able to transfer it back when you get home.  In this case, you would need to be prepared to get a new prescription from your physician!

Now, if you’re traveling abroad, your insurance will most likely issue you a vacation overide so you won’t run out of your medications while in another country.  The approval of an override may vary depending on the nature of the medication.  Some insurance companies require the pharmacy to call them for the override, so be sure to pass the word on to the pharmacy staff, if this is the case!  You may get a little resistance from the pharmacy staff (the unfortunate truth -some people work harder than others and some pharmacies are more hectic), but they’ll get over it!

If you’re calling the insurance company on your own, be prepared with the details of your travel plans (i.e. duration, destination, etc.) as the insurance company may need to document this before they’ll consider any vacation override requests.  If the pharmacy is making the call for you, leave your travel information with the staff so they can pass the info on to the insurance representative.

Here’s a special request I have of you: allow ample time for the pharmacy staff to call the insurance to get the override.  Being patient and coming back later in the day to pick up your medication will make for happy pharmacy employees, and you can bet there’ll be a greater willingness to help from the pharmacy people! 

Oh yeah, and don’t wait until the last minute!

Got it? E-mail me at Cate@getpharmacyadvice.com.  Don’t want to? Then definitely leave a comment below.

Wanna free-up some money for your trip?  Check out our free video course on how to save money on your prescription medications.  You can use the money saved for the fun stuff while you’re away!

Have a great trip!

This concerns me…only 35 minutes and the pigment of my skin has changed?  Yikes!

So, as a result, I’ve developed an obsession for sunscreen!  An obsession to the point where I found it necessary to post a video about protecting your skin from the sun. 

Check it out!

Got it?  Now go do it!

Let me know what you think  by leaving a comment below or e-mailing me at Cate@getpharmacyadvice.com.  I’d love to hear from others who are sunscreen crazed too!

Oh, make sure you grab our video course on how to save money on your prescription medications.  No worries, it’s free!

In general, to help prevent vitamin D deficiency, a safe bet is to take 1000-2000 IU/ day of vitamin D for adults and 400IU/day for infants and kids.  Supplements are usually the best deal because it is hard to get enough vitamin D through diet -a glass of milk only has 100IU!  But if you are deteremined to increase vitamin D levels by diet -milk, fish, fortified food, egg yolk and fish liver oil.

Just a note here -vitamin D is available as D2 (ergocalciferol) and D3 (cholecalciferol) -both are okay but D3 is more potent. 

When vitamin D levels are way too low, some patients will be started on prescription vitamin D 50,000 IU.  These supplements are usually taken weekly until levels normalize -then they are taken monthly.

The problem here is that physicians start patients on weekly vitamin D 50,000IU capsules and forget to change them to monthly…which can lead to vitamin D toxicity. 

Vitamin D toxicity is rare.  Symptoms consist of fatigue, nausea/vomiting, weakness and kidney problems.  If you have been taking vitamin D 50,000 IU weekly for more than 4 months -give your physician a call and ask them to check on your vitamin D levels.

Are you taking a vitamin D supplement?  We would love to hear about it! Go ahead and leave us a comment

Although polyethylene glycol is only FDA approved for patients 17 and up, clinicians are prescribing the medication more often to treat constipation in infants and children.  As clinical experience with polyethylene glycol increases in our pediatric population, so does awareness of its OTC existence.  For this reason, it seems appropriate to provide a brief discussion about this medication.

Why the Doctor might prescribe polyethylene glycol…

Clinicians would prescribe polyethylene glycol to your child to treat impaction and constipation that is not related to a serious illness (i.e. gastrointestinal disease, diabetes, cystic fibrosis, etc.).  Constipation can be defined as a delay in defecation or difficulty in having a bowel movement for more than two weeks.  Polyethylene glycol can be used for both acute and chronic constipation. 

Impaction would be described as a condition where dry, hard stools form into a mass that collects in the rectum.  The mass makes it very difficult, if not impossible, to have a bowel movement.  

Once the impacted stool has been evacuated or if impaction was not present to begin with, maintenance therapy would be implemented to help your child sustain normal bowel movements.  Polyethylene glycol used for maintenance therapy will improve stool frequency and/or consistency and ease your child’s pain and discomfort.     

The dose needed to bring about disimpaction will be higher than that used in maintenance therapy; but nonetheless, polyethylene glycol has been proven to be an effective option in both scenarios.     

Mechanism of Action

Polyethylene glycol falls into the class of medications known as osmotic laxatives.  The way the medication works is very straightforward: it decreases the amount of water absorbed from your intestines, which thereby increases the amount of water in your stools.  This increase of water content in your stools makes the stool softer and easier to pass.

 It may take less than a day for polyethylene glycol to do its job, but do not be surprised if it takes 2 to 3 days for your child to have a bowel movement.  If faster relief is needed, it may be a good idea to explore other medication options!

Precautions and Side Effects

Adverse reactions to polyethylene glycol may include cramping, abdominal bloating, gas, diarrhea, and nausea.  Serious adverse reactions to polyethylene glycol are not common at all.  There is a very rare chance that your child could be allergic to polyethylene glycol, in which case your child may present with hives, rash, dizziness, difficulty breathing, or swelling of the face, tongue, or throat.  The medication should be discontinued and a physician should be consulted if an allergic reaction does occur.   

There is limited information from quality studies on the use of polyethylene glycol in children less than 2 years of age.  That’s not to say this medication should not be used in infants.  In fact, prescribers have been progressively increasing their orders of polyethylene glycol for babies less than 6 months old even without the evidence from strong studies.  Just be sure to keep an extra watchful eye on your infant while their taking polyethylene glycol!         

In the case of chronic constipation, you should wean your child off polyethylene glycol once the goal of therapy, about one soft stool per day, is achieved (it may take months to get to this point).  Taper the dose down every 2 weeks until daily movements continue without the laxative.  If you discontinue the polyethylene glycol in a cold turkey kind of way, hard stools will likely recur! 

Other Common Osmotic Laxatives

Lactulose, sorbitol, Milk of Magnesia, and magnesium citrate are all osmotic laxatives that work in a similar fashion as polyethylene glycol.  Studies show they all have comparable efficacy, but recent findings suggest that polyethylene glycol has fewer side effects and greater acceptance by children.

The increasing comfort in using polyethylene glycol in infants and children is good news because magnesium citrate and Milk of Magnesia are a bit frightening due to possible magnesium poisoning in the littlest patients.  In addition, since Lactulose and sorbitol have a terrible taste, polyethylene glycol just offers a way out of the ensuing battle of getting your child to take a medication needed to relieve their constipation.  Polyethylene glycol is a well-accepted medication by an otherwise finicky group of patients!

Recommendations

Although polyethylene glycol is available over-the-counter and gaining ground in its use in infants and children, I would recommend bringing your child to their physician before starting this medication as the underlying constipation needs a workup first.

If the physician decides the issue needs to be treated, it may be in your child’s best interest to start with behavior modification and dietary changes before bringing polyethylene glycol on board. 

Once it’s determined that a medication is needed to help relieve your child’s constipation, typical age-based dosing used in clinical practice is as follows: younger than 18 months – ½ to 1 teaspoon once daily; 18 months to 3 years – 2 to 3 teaspoons once daily; older than 3 years – 2 to 4 teaspoons once daily. 

The teaspoon measurements refer to the amount of polyethylene glycol powder you would mix with 4 to 8 ounces of water, juice, or other flavored beverage (hot, cold, or room temperature).  The mixture can be taken without regard to meals and at any point during the day. 

There are specific weight-based dosing guidelines available, but regardless, I would verify the dose with your child’s physician or pharmacist just to be sure you are giving your child a safe, yet effective, amount.  

If your child’s physician suggests buying the OTC polyethylene glycol, it may be beneficial to ask them for a prescription instead because most insurance companies still cover the prescription version.  The prescription formulation is the same as the OTC product, comes in generic, and is equally effective and safe.  It’s definitely worth the trip to the pharmacy because as we all know, a penny saved is a penny earned!

Whoa, I know that was an eyeful, but please let me know if you have any questions or need more information by leaving a comment below or e-mailing me at Cate@getpharmacyadvice.com.

I know you’ve already heard, but we have this fabulous video course available for free that will teach you how to save money on your prescription medications.  It’s all your’s so long as you click here! 

Peace out for now!

Save some greenbacks -90 Ways to Save Money on Your Prescription Medications *FREE*!

Want more info on -Boric Acid for Yeast Infections.

Want to learn about how to save some money at the pharmacy?  90 Ways to Save on Your Prescription Drugs -totally free, ya’ll!

Do I really need the Zostavax vaccine?

The target population for this vaccine is adults 60 years of age and older.   This age group is targeted because they are more susceptible to becoming inflicted with shingles.  

You are also at higher risk of developing shingles if you have a weakened immune system,  had chickenpox when you were younger than 18 months, and were exposed to the virus while in your mother’s womb.  

Even with these other risk factors in mind, the vaccine should be reserved for those older than 60 years of age because no safety or efficacy data are available for patients in the younger age groups.  Since we don’t know how well it works or how safe it is for younger folks, why bother getting it if you younger than 60 years old?

If you’re younger than 60 years of age, I wouldn’t bother getting a prescription! 

So, if you are 60 years of age or older, you still should be given the choice as to whether you think it’s important to get the Zostavax vaccine or not.  To help you make this decision, I’ll layout the complications that can be acquired from getting shingles and the possible adverse reactions to the Zostavax vaccine.

Serious, but very rare complications that may arise from getting shingles are pneumonia, hearing problems, blindness, encephalitis (inflammation of the brain), or death (rare is the key word here!). 

The other less serious and more common symptoms of shingles are rash, acute pain, itching, nerve pain, fever, headache, upset stomach, chills and overall feeling of discomfort or fatigue.   The pain related to shingles may last up to 90 days or longer in some cases.

The most common adverse reactions after getting the Zostavax vaccine are headache and itching, swelling, redness, pain, or tenderness at the injection site. 

Now, the Zostavax vaccine is fairly new to the world of drugs -introduced to the market in 2006, it may be too soon still to write off the idea of Zostavax being free of serious adverse reactions.   Long-term studies will have to be done down the road to evaluate how safe Zostavax truly is! 

Knowing the complications of shingles are rare, I would hold off from getting the Zostavax vaccine until it has been out on the market a little longer.  I’d rather see more clinical experience with Zostavax before I had it injected into me (that’s if I was older than 60 years of age!).  That’s just me though…you’re free to do as you please, as we all know!  In fact, where the adverse reactions appear to be quite mild so far, I can see why people would be at ease with getting the vaccine. 

Does my insurance cover the Zostavax vaccine?

This is a great question to ask yourself and to find the answer to because the Zostavax vaccine runs somewhere around $200 if not covered by insurance!  I’m pretty sure the only insurances that are covering it right now are certain Medicare Part D plans, but I’m willing to stand corrected if someone knows of other insurance companies that are willing to foot the bill. 

It certainly will save you time and energy to first find out if your insurance covers the vaccine.  Who wants to head to the doctor’s office to get the prescription and then to the pharmacy to have the prescription processed, only to find out it’s not covered…not I! 

That just about covers what I have to say about the recent surge on the Zostavax vaccine.  Please leave a comment below if you have anything to add or contact me at Cate@getpharmacyadvice.com.

And if you find yourself in a position where your insurance doesn’t cover a medication or if you do not have insurance at all, check out our FREE video course that will provide you with numerous tips on how you can save money on your prescription medications.

Thanks for stopping by and please come again!