vomiting

  1. The darkest shade of green

    Imagine a drug that failed to meet basic targets set by the FDA, came with a higher risk of side effects than its predecessors, and was found to be so unimpressive and even dangerous that the agency's own experts advised against approving it.

    Now, stop imagining -- and just take a look at Aricept 23, because an explosive new analysis in BMJ says that's exactly how this drug reached the market.

    How did it happen? Let me back up to 2010, when the original Aricept -- a drug that did up to $2 billion a year in sales -- was about to lose its patent protection.

    Once cheap generics flood the market, it's usually the end of the line for the money train -- unless you have a few tricks up your sleeve, like what the industry calls "evergreening."

    That's a slight tweak to help extend the drug's profitable life. It might be a timed-release formula, the addition of a second drug to the mix, or even a change to the dosage itself -- and when the FDA signs off on it, the "new" drug gets three more years of protection.

    In this case, it was a change to the dose. While "old" Aricept had been approved in 5 mg and 10 mg doses, Aricept 23 is -- as the name implies -- 23 milligrams of the drug.

    The feds said this high dose would be approved only if it beat the lower doses in two key areas: overall cognition and global functioning.

    That shouldn't have been too hard, since the old formula was thoroughly unimpressive itself. But Aricept 23 offered only tiny improvements in cognition and no changes at all in the more important measure of global function -- and came with a higher risk of nausea and vomiting as well.

    Those side effects are bad enough for a healthy person. But for an Alzheimer's patient, they could be dangerous and even deadly.

    No matter. An agency bigwig went against the advice of his own experts and approved the drug anyway -- just four months before the expiration of the original Aricept patent.

    Since the generics would only be available in the old 5 mg and 10 mg doses, even a combination of pills wouldn't add up to the "new and improved" dose. The only way to get it was to keep buying the expensive brand-name version.

    In other words, the new formula of Aricept didn't protect dementia patients from the ravages of the disease -- but it did protect the profits of the drug's makers, with three years of fresh patent protection.

  2. How to know when you're having a heart attack

    You might think heart attacks don't discriminate, but that's not actually true. They do discriminate -- and it's a form of discrimination that's killing women.

    Believe it or not, women are actually more likely to die and more likely to die young as a result of a heart attack, and it's because they don't always experience the classic heart attack warning signs.

    You know the big one: chest pain. That sudden pain is a direct and urgent message from the body that something's wrong -- and you need to get to the hospital.

    But according to a study of more than 1.4 million heart patients tracked for up to 12 years, only 58 percent of women experience chest pain during a heart attack. Compare that to 70 percent of men who feel chest pain, and it's not hard to see why women are 40 percent more likely to die as a result.

    They simply never had a fair chance in the first place.

    Overall, the study in the Journal of the American Medical Association finds that 10.3 percent of men who experience heart attacks die as a result of them, versus 14.6 percent of women -- with the biggest increase in risk among younger women, especially those 55 years old or younger.

    Because they feel just about anything other than chest pain, these women are more likely to blame their symptoms on just about anything else: the flu, nerve or muscle pain, simple stress or something else entirely.

    So instead of getting help, they pop a few painkillers or go lay down for a little while.

    And some of them never get back up.

    Don't let this happen to you or your loved ones. Make it your mission to get to know the rest of the heart attack warning signs, which include:

    • Pain or a numb sensation in other parts of the body -- including the jaw, arms, stomach or back;
    • Sudden fatigue;
    • Difficulty breathing or shortness of breath;
    • Dizziness;
    • Nausea, vomiting and/or stomachache;
    • Anxiety;
    • Lightheadedness; and
    • A cold sweat.

    Don't wait to see if these symptoms pass. Get help -- especially if you're younger and especially if you're thinking "I couldn't possibly be having a heart attack."

    That's the kind of attitude that's clearly getting people killed.

    For more on heart protection, keep reading.

  3. Natural solutions for gout

    Gout used to be known as "the rich man's disease" because it usually struck the wealthy -- the only ones who could afford to over-consume the foods that cause this painful form of arthritis. Today, you don't have to be rich (or even a man) to suffer from gout -- just fat. And since more people are fatter than ever before, more people are also battling the foot pain that marks this condition.
  4. New instructions for Tylenol

    J&J says the changes it will make -- next year, mind you, not today -- will help stop the overuse that's turned the drug's main ingredient, acetaminophen, into the leading cause of liver failure in the United States. But they're not changing the drug.
  5. Dangers of "morning sickness pill"

    Metoclopramide is typically used to treat nausea and vomiting. Since those happen to be the main symptoms of morning sickness, some folks think it might be a good idea to give it to pregnant women.

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