. . . with a Pfizer rep yesterday led to their new medication, Caduet. This is simply a combination of Pfizer’s best-selling medications, Norvasc and Lipitor. I was commenting on how this medication is convenient for those concurrently taking the two medications separately. Then, to my surprise the rep suggested that I use this first-line for hypertension, saying that “people with hypertension have high cholesterol anyways”.
Pretty dangerous thinking. First off, Norvasc (amlodipine) isn’t even a first-line hypertensive medication. From UptoDate:
As previously mentioned, the ALLHAT trial showed that, although there were no differences in the rate of coronary death and nonfatal myocardial infarction, amlodipine increased the risk of heart failure compared to chlorthalidone (10.2 versus 7.7 percent for chlorthalidone, relative risk 1.38).
Thus, a calcium channel blocker should not be used as routine first line treatment of hypertension.
It would have made much more sense to combine Lipitor with Pfizer’s ace-inhibitor, Accupril instead. An ace-inhibitor/statin combination would have been a perfect drug for diabetics. I suspect that money was behind the decision to combine Lipitor with Norvasc instead.
Secondly, despite the recent hype on the revised NCEP recommendations, not all hypertensives need to be on Lipitor. Blindly adding Lipitor so caverlierly is simply a blatant revenue-builder for Pfizer.
Related posts:
- Pfizer gives up on cardiac drugs
- Pfizer: Going to the dogs
- Why is chlorthalidone underused?
- Generics are killing Pfizer
- Torcetrapib failed even worse than thought
- RIP Torcetrapib
- The torcetrapib disaster: Blogosphere response
{ 4 comments }
But you have to like the name, Kevin. I didn’t get it at first: “CAD duet…”
Interesting conversation. I’ve actually seen ads for Caduet all over medical journals (i’ll save the rant on how “uncool” (aesthetically, graphically) drug ad designs are these days), and have been wondering about this drug.
Thanks for the information from the ALLHAT trial. I’m amazed at how drug reps are taught to sneak in the information about putting patients on an unnecessary drug.
I’m also always shocked to see how many free clinic patients at our student clinic are put on norvasc right away.
Lulu said::
This day, 04-20-2006, I swallowed my first and last Norvasc 20mg…Within 2 hours I was sound asleep at my desk….I finally roused around enough to where my car was parked and DROVE about 6 blocks to my house., and got into my bed..slept for 4 hours.
WHAT SHOULD I DO ABOUT THIS RECENTLY ACQUIRED AFFLICTION OF HP ???
Thanks for any and all answers…
http://www.physorg.com/news88138832.html
Researchers are sufficiently worried by new study results that they are planning clinical trials involving thousands of people to examine the possible link between Parkinson’s disease and statins, the world biggest selling drugs, reports Patrick Walter in Chemistry & Industry, the magazine of the SCI.
Suggestions of a statin link are not new, but the results of a recent study linking low LDL cholesterol to Parkinson’s provide the strongest evidence to date that it could be real, because statins work by reducing LDL cholesterol. The study by researchers at University of North Carolina showed that patients with low levels of LDL cholesterol are more than three and a half times more likely to develop Parkinson’s disease than those with higher LDL levels.
When asked whether she was concerned by the new results, study leader Xuemei Huang said: ‘Yes I am very concerned, which is why I am planning a 16000-patient prospective study to examine the possible role of statins.’ Huang was quick to point out, however, that a causal link with statins had not yet been proven. And Yoav Ben-Shlomo, a professor of clinical epidemiology at University of Bristol said that it is also a possibility that LDL cholesterol is a consequence rather than a cause of Parkinson’s.
But according to Huang, the well-established link between Parkinson’s and apoE2, a gene associated with lower LDL cholesterol, supports her theory that low LDL is the culprit in many cases of Parkinson’s.
Drug Saf. 2007;30(6):515-25. LinkOut
Statins, neuromuscular degenerative disease and an amyotrophic lateral sclerosis-like syndrome: an analysis of individual case safety reports from vigibase.Edwards IR, Star K, Kiuru A.
The WHO Foundation Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre (UMC), Uppsala, Sweden.
BACKGROUND: The WHO Foundation Collaborating Centre for International Drug Monitoring (Uppsala Monitoring Centre [UMC]) has received many individual case safety reports (ICSRs) associating HMG-CoA reductase inhibitor drug (statin) use with the occurrence of muscle damage, including rhabdomyolysis, and also peripheral neuropathy. A new signal has now appeared of disproportionally high reporting of upper motor neurone lesions.
AIM AND SCOPE: The aim of this paper is to present the upper motor neurone lesion cases, with other evidence, as a signal of a relationship between statins and an amyotrophic lateral sclerosis (ALS)-like syndrome. The paper also presents some arguments for considering that a spectrum of severe neuromuscular damage may be associated with statin use, albeit rarely. The paper does not do more than raise the signal for further work and analysis of what must be regarded as a potentially very serious and perhaps avoidable or reversible adverse reaction, though it also suggests action to be taken if an ALS-like syndrome should occur in a patient using statins.
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