It’s the beginning of the school year, which means that it is time to prepare for the little bugs that get passed around the classroom, lice!
Head lice are parasitic insects that can be found on the head, eyebrows, and eyelashes. Preschool and elementary school-aged children, as well as their parents and caregivers, are at the greatest risk for lice infestation. The most common way to spread lice is through head-to-head contact, which can easily happen when children are playing.
Here are some tips from the pharmacist to help prevent and treat head lice.
Try over the counter options first
There are over the counter (OTC) options that can be used if your child has lice. OTC items like Nix are available at your local grocery store. Using an OTC option first can save you money, as many of the prescription-only items can be costly, and may not be covered by your insurance.
Prescription treatment is available
If you’re unable to get rid of lice using OTC products, your doctor can write you a prescription for lice treatment. The following are examples of prescription-only lice treatment.
- Sklice is for children 6 months of age and older. It is a 10-minute treatment that doesn’t require any nit combing. The manufacturer offers a savings program that can reduce your co-pay to at least $30. For more information, visit their website here.
- Ovide is a lotion used on children 6 years of age and older. Keep in mind that it is flammable, and a second treatment may be required after seven days if lice are still present.
- Ulesfia is for children 6 months of age and older. Be sure to repeat the treatment after seven days. The manufacturer offers a savings program that can reduce your co-pay to as little as $10. For more information, visit their website here.
- Natroba is a topical solution indicated for children 6 months of age and older. Nit combing is not required, but using a fine-tooth comb may be helpful to remove dead lice and nits.
Don’t share personal items
Teaching your child to share is an important life lesson; however, some personal items should not be shared in order to protect against spreading lice. Make sure your child knows that personal items like brushes, hats, helmets, headbands, and towels should not be shared.
Check with your state department of health
Each state department will have information on symptoms, treatments, and guidance for lice prevention and treatment. Refer to your state’s department of health website for more information.
Cialis, approved to treat both ED and benign prostatic hyperplasia (BPH), has about a year left on the countdown to its generic. Viagra will likely be available as a generic before Cialis.
Here’s all you need to know about the upcoming generic launch and how to keep your costs down while you wait.
When will generic Cialis be available?
After a patent dispute was resolved in the summer of 2017, Cialis is expected to be available as generic tadalafil as early as September of 2018. Previously, Cialis was expected to remain brand-only until 2020.
How popular is Cialis?
On GoodRx, Cialis is currently the second most popular PDE5 inhibitor, the class of medications that also includes Viagra and Levitra. It’s the most popular of the medications specifically used to treat ED (sildenafil / Revatio is the most popular in the class, but it is only approved for pulmonary arterial hypertension).
Have Cialis prices changed recently?
Cialis prices have moderately increased. Cialis is already expensive, and as a brand with no generic, there isn’t much competition. Like many brand-only drugs, Cialis prices have crept up slowly. Over the past 6 months, cash prices for Cialis have increased from about $370 to over $400—based on actual pharmacy claims for fills of thirty 5 mg tablets.
What will generic Cialis cost?
Generally, generic drugs first appear on the market at about a 15% discount to the brand. Unlike the brand, however, generic drug prices typically decrease very quickly. Within a year of release, many generics versions of prescriptions can become very affordable, especially if multiple companies are making the generic.
Cash prices for Cialis—thirty 5 mg tablets, the most common dosage—are currently about $400.
The latest GoodRx estimate is that generic Cialis will initially cost between $300 – 350. While this is still not affordable for most people, keep in mind:
- Discount prices will also decrease, probably by a similar amount. That could mean GoodRx prices at less than $275 for the same prescription, a savings of almost $100.
- Generics are more likely to be covered by insurance, so you may end up with a far lower out-of-pocket cost if you’re insured.
- Again, generic prices tend to go down quickly. Many generics drop to about 50% of the brand price after more than one manufacturer enters the market—increasing competition.
Are there any cheaper medications I can try for ED?
While Cialis doesn’t have a generic yet, there are other options to consider.
- First and possibly most important—Viagra will get a generic alternative before Cialis, by the end of 2017.
- Compare prices (whether you have insurance or not). Look at Cialis vs Viagra (sildenafil) or Levitra (vardenafil)—other common choices in the same class—along with Stendra (avanafil) and Staxyn (vardenafil). They may or may not be cheaper now—but both do offer manufacturer coupons and patient assistance programs, which Cialis does not. See manufacturer offers for Viagra here and Levitra here.
- If you have insurance, check your coverage. Many plans don’t cover ED drugs, but some will offer coverage for one or two preferred brands. You may be able to pay less at the pharmacy for Viagra or Levitra.
- Generic sildenafil (Revatio) is much less expensive, and is used by some patients to treat erection problems. However, take note that it is only approved by the FDA for the treatment of pulmonary arterial hypertension. Your doctor will be able to give you advice on whether sildenafil could be an option for you.
- For more information on how Cialis, Cialis side effects, and how Cialis compares to other ED medications, check out Iodine’s comparisons with Viagra here and Levitra here. As always, you’ll want to discuss with your doctor if you think another medication might work better for you.
Cialis still works best for me—how can I save before the generic is released?
- Filling a 90-day supply at once can often help shave a little more off your out-of-pocket costs. You may also need a new prescription from your doctor, or approval from your insurance to fill a higher quantity, so check with your doctor, pharmacist, and/or insurance.
- Splitting a higher dosage pill can also help decrease costs, especially if two strengths are priced similarly. You’ll want to ask your doctor to make sure this is safe and a good option for you.
- Use a Cialis coupon. GoodRx does offer discounts for Cialis online. While this may not make it affordable for everyone, a coupon can still knock at least 15% off the full retail price.
- Try again to get it covered. If you have insurance and your plan doesn’t cover Cialis, ask your doctor about submitting an appeal. For conditions like ED this may not always work, but could still be worth a try.
GoodRx has been focused on helping Americans for more than 6 years. This month, as hurricanes hit Florida and Texas, we realized that our mission to help goes beyond healthcare, and we wanted to do our part to help.
A few days after Hurricane Harvey, we sent members of the GoodRx team to Houston to help relief efforts. GoodRx employees spent the night NRG Stadium, a massive shelter in Houston. The following day, our team visited local shops and markets in affected areas, paying for food and prescriptions for local Houston residents. You can read more on how #GoodRxHelps Houston here and here.
Just one week later, Hurricane Irma hit the Caribbean and Florida. GoodRx pledged to make a significant donation to help those affected by Hurricane Irma, but we asked for your help. We asked visitors to GoodRx.com which charities they though most deserved assistance, and we received hundreds of responses.
GoodRx is sending $5,000 donations to 3 charities that were selected by you. To learn more about these charities or make your own donation, see below:
ASPCA (American Society for the Prevention of Cruelty to Animals). The ASPCA transported sheltered animals out of Irma’s path before the storm, and are now working hard to find and help abandoned and injured animals in the aftermath. They are also continuing efforts in Texas post-Harvey.
ShelterBox USA. ShelterBox provides everything from supplies like water and blankets to tents and more—that can help make cramped shelter quarters bearable, and help people who’ve been displaced by disasters. They are on the ground in the Caribbean, and still working in Texas.
MedShare. MedShare is coordinating with local medical organizations in Florida and the Caribbean to get medical supplies and equipment to those in need after the storm. They are also continuing efforts and coordination with charities in Texas.
With millions still without power in Florida, Georgia, and the Carolinas, an enormous amount of rebuilding ahead for Texas and the islands in the Caribbean—and now, the potential for more trouble from Hurricane Maria—there’s still so much to do. We want to thank you for helping us continue to make a difference. We’ll continue to do everything we can to help Americans in any capacity we can.
First, a little reminder about taste. Our sensory system for taste is remarkably sensitive, made possible by our taste buds. Taste buds are each made up of taste receptor cells which bind to small molecules related to flavor. Through sensory nerves, the receptors relay the taste information to the brain and this allows us to discern five basic tastes (sweet, salty, bitter, sour, and umami/savory).
An unpleasant taste or lack of taste can affect appetite, and even lead to depression. If your taste buds don’t seem right, rule out sinus or nasal issues, viral upper respiratory infections, or other common causes, then take a look at your meds.
With certain medications, these changes in taste may occur:
- Stimulants used in the treatment of ADHD may cause a bitter taste in your mouth. Adderall and methylphenidate (Ritalin, Concerta, Daytrana) decrease the threshold for the bitter taste in your mouth, making you more sensitive to the perception that something is bitter.
- Altitude sickness prevention in travelers can be overcome with Diamox (acetazolamide)—which may also leave you with a bitter taste in your mouth.
- Many antibiotics cause a metallic taste in the mouth. Penicillin, amoxicillin, Augmentin, and cephalosporins (Ancef, Keflex) are commonly prescribed for acute sore throat, and ear and sinus infections, and they may lead to a metallic taste in your mouth. Why? The antibiotics listed above may affect the absorption of zinc, and zinc deficiency leads to a metallic bad taste in the mouth. Clarithromycin (Biaxin), metronidazole (Flagyl), and tetracycline are other antibiotics that may also cause metallic taste—but we don’t know why that occurs.
- Allopurinol, used for the prevention of gouty attacks, may cause a metallic taste in your mouth.
- Lithium is prescribed for the treatment of bipolar disorder and may also lead to a metallic taste in your mouth.
Loss of sour taste:
- Isotretinoin (Absorica, Accutane) is used for the treatment of severe acne, and you may notice the loss of sour taste while taking it. Isotretinoin disrupts ion channels, leading to loss of sour taste.
Persistent sweet, sour, salty, bitter or metallic taste (aka dysgeusia):
- Captopril, enalapril and lisinopril are ACE inhibitors used to lower blood pressure. They cause disrupted taste, likely by causing zinc deficiency.
Less or lack of taste:
- Carbamazepine (Tegretol, Carbatrol, Equetro) is used for seizures, bipolar disorder, restless legs, and neuropathic pain. It may lead to diminished taste by decreasing calcium mediated neurotransmission (it keeps taste signals from getting to your brain).
- Levodopa is half of the Parkinson’s drug Sinemet and it loves to cause decreased taste in those taking it. Levodopa/carbidopa (Sinemet) works to help increase levels of circulating dopamine in Parkinson’s patients—but one downside is that results in lowered taste transmission.
- Used for the treatment of symptoms related to irritable bowel syndrome (IBS), Bentyl (dicyclomine) and Levsin (hyoscyamine) may cause loss of taste.
- Diltiazem (cardizem) is a calcium channel blocker often used for heart rate control in patients with atrial fibrillation, and to lower blood pressure. Diltiazem also decreases calcium mediated neurotransmission, causing loss of taste or diminished taste.
- Hydrochlorothiazide (HCTZ) is prescribed to lower blood pressure, and it can also cause loss of taste.
- Spironolactone (Aldactone) is a potassium-sparing diuretic used in the treatment of heart failure, acne, and ascites from liver disease, and it may lead to loss of taste.
- Terbinafine (Lamisil) is prescribed for the treatment of nail fungus. Terbinafine may cause loss of taste to the point where it results in weight loss and depression in as many as 3% of folks taking it.
- Methimazole (Tapazole) is used to treat hyperthyroidism associated with Graves Disease, and may cause loss of taste due to zinc depletion.
Remember if your medications are altering your taste, discontinuing them should fix that. So ask your doctor about alternatives.
What is a biosimilar?
Without getting too technical, biosimilars are basically the generic product of a biologic (a medication made from a living organism). However, because these medications are made out of living cells they are slightly different. The good news about biosimilars is that they are typically 15%-30% less expensive than their reference drug.
For more information about biologics and biosimilars, read our blog here.
What is Cyltezo indicated for?
Cyltezo is approved for the following 7 conditions:
- Pediatric patients 4 years of age and older with moderate to severe active polyarticular juvenile idiopathic arthritis
- Moderate to severe active rheumatoid arthritis
- Moderate to severe active adult Crohn’s disease
- Moderate to severe active ulcerative colitis
- Moderate to severe plaque psoriasis
- Active ankylosing spondylitis (arthritis of the spine)
- Active psoriatic arthritis
Keep in mind that Cyltezo is only approved for 7 indications whereas Humira has 10 indications. These three indications that Humira also treats include uveitis, hidradenitis suppurativa, and pediatric Crohn’s disease.
How will Cyltezo be sold?
Cyltezo will be available in a single-use prefilled glass syringe in the dosage of 40 mg/0.8 ml. The manufacturer, Boehringer Ingelheim, will also seek approval for an auto-injector in the future.
What are the most common side effects of Cyltezo?
The most common side effects include infections, injection site reactions, headache or rash.
Although these two are both biosimilars for Humira, they are different. Amjevita will be available additionally in a single-use prefilled glass syringe in the 20 mg/0.4 mL strength as well as a SureClick autoinjector in the 40 mg/0.8 mL strength.
Is Amjevita currently available?
How much will Cyltezo cost?
No. Although Cyltezo is a biosimilar, it is not interchangeable.
Interchangeable products are usually known as generic medications and can be substituted for a brand name medication if available and without needing to consult the prescriber. Your doctor must write your prescription for Cyltezo if this is the medication that is intended for you to use.