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Miconazole buccal tablets (Oravig): An –azole antifungal indicated for the local treatment of oropharyngeal candidiasis in adults
New Formulation: Miconazole buccal tablets (Oravig) was approved in April 2010 for the local treatment of oropharyngeal candidiasis in adults.
Miconazole buccal tablets (MBTs) are indicated for the local treatment of oropharyngeal candidiasis (OPC) in adults. Miconazole, an –azole antifungal, inhibits the enzyme cytochrome P450 14-α-demethylase. This inhibition leads to decreased ergosterol synthesis, an essential component of the fungal cell membrane, and ultimately disruption of fungal growth.
Efficacy. MBTs have been studied using a randomized trial design in both HIV-1 positive and head and neck cancer patients who had received radiation therapy. In these trials, patients (typically infected with Candida albicans or Candida tropicalis) were administered MBT 50 mg once daily for 14 consecutive days. In the HIV-1 positive trial, MBT therapy (n=290) was compared with clotrimazole troches 10 mg, 5 times per day for 14 days (n=287). Clinical cure defined as a complete resolution of both signs and symptoms of OPC (at days 17–22), was similar between groups (difference in clinical cure rates was –4.5%, 95% CI –12.4% to 3.4%). Similarly in head and neck cancer patients who had received radiation therapy, those receiving MBT (n=148) had similar efficacy (complete or partial response) to those receiving miconazole oral gel 125 mg 4 times daily (n=146) for 14 days (53.4% to 46.6%, respectively).
Safety. Overall, 43.5% of patients experienced at least 1 adverse event. The most common ones reported in the overall safety database of 480 patients who received MBTs included diarrhea (6.0%), nausea (4.6%), upper abdominal pain (2.5%), vomiting (2.5%), infections (11.9%), and headache (5.0%).
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
