A recent conversation . . .

. . . 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.


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