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trade event (*this news item will not be available after 01/30/2018) Wednesday, November 1, 2017 TUESDAY, Oct. 31, 2017 (HealthDay News) -- Popping certain heartburn drugs like they're candy might up your odds for stomach cancer, new research suggests. The risk was proportionate to how long and how often these drugs, called proton pump inhibitors (PPIs), were taken. That risk increased anywhere from two to eight times, the study authors said. Although the relative risk seems high, the absolute risk was small. But it was statistically significant, especially for people infected with Helicobacter pylori , a bacteria linked to stomach cancer, the researchers explained. "While PPIs are one of the most commonly used medications for treating reflux disease as well as dyspepsia, clinicians should exercise caution when prescribing long-term PPIs, even to patients who have H. pylori eradicated," said lead researcher Dr. Wai Keung Leung. He is a professor of gastroenterology at the University of Hong Kong. PPIs include commonly used drugs like Prilosec, Nexium and Prevacid. Eliminating H. pylori lowers the risk of stomach cancer significantly, Leung noted. But even after the bacteria is treated, many people still develop stomach cancer. However, this study couldn't prove PPIs cause stomach cancer, only that an association exists. PPIs are generally considered safe. "The advice to PPI users, particularly those with past H. pylori infection, is to be cautious with the prolonged usage of PPIs," Leung said. "Doctors should review the indications and needs of long-term PPIs in these patients." The small increase in the risk of stomach cancer with PPIs was not enough to prompt one gastrointestinal specialist to abandon their use. "In my own experience, I have seen medicine evolve. And one thing that I try to keep in mind is, while many studies exist and treatment is evolving, we must tailor treatment on an individual basis," said Dr. Sherif Andrawes. He is director of endoscopy at Staten Island University Hospital in New York City. Even with this new study, "there are medical situations in which PPI therapy is necessary and the risk of side effects is lesser than the risk of developing bleeding or cancer of another area in the GI [gastro-intestinal] tract," Andrawes said. For example, he explained, the medications can help suppress stomach acids and guard against esophageal cancer in those with Barrett's esophagus. But, "I also try to ensure that if a patient comes in for reflux symptoms, that we try work on lifestyle modification and diet first, rather than initiating PPI therapy," Andrawes added. Stomach cancer is the third leading cause of cancer death in the world, he noted, and earlier studies have found a link between PPIs and stomach cancer. But the role of H. pylori was less clear. To try to assess the role the bacteria played, Leung and his colleagues compared the use of PPIs with another class of drugs used to lower stomach acid -- histamine H2-receptor antagonists (H2 blockers). The study followed nearly 63,400 patients treated with a combination of a PPI and two antibiotics to kill H. pylori . The treatment was given over seven days between 2003 and 2012. The patients were followed for an average of seven years, until the participants either developed stomach cancer, died, or the study ended. During this time, more than 3,200 people took PPIs for nearly three years, while nearly 22,000 took H2 blockers (Pepcid, Zantac, Tagamet). In total, 153 people developed stomach cancer after being treated with a PPI and two antibiotics. None of these patients tested positive for H. pylori , but they all had chronic gastritis (inflammation of the stomach lining). Taking PPIs was linked with more than twice the risk of developing stomach cancer, while taking H2 blockers was not associated with any increased risk, the researchers found. In addition, people who took PPIs every day had more than four times the risk for stomach cancer, compared with those who used the drug once a week. And the longer PPIs were used, the greater the risk of developing stomach cancer, the findings showed. The risk rose five times after more than a year, to more than six times after two or more years, and to more than eight times after three or more years, Leung said. Recent reports have also linked long-term use of PPIs with pneumonia, heart attack and bone fracture, he added. The report was published online Oct. 31 in the journal Gut . SOURCES: Wai Keung Leung, M.D., professor, gastroenterology, University of Hong Kong; Sherif Andrawes, M.D., director, endoscopy, Staten Island University Hospital, New York City; Oct. 31, 2017, Gut , online HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Stomach Cancer Recent Health News minimize


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each time Abaloparatide Class: Parathyroid Agents Brands: Tymlos Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Warning(s) Warning: Risk Of Osteosarcoma 1 See full prescribing information for complete boxed warning. 1 Abaloparatide caused a dose-dependent increase in the incidence of osteosarcoma, a malignant bone tumor, in male and female rats. It is unknown whether abaloparatide will cause osteosarcoma in humans. 1 Use of abaloparatide is not recommended in patients at increased risk for osteosarcoma. 1 Cumulative use of abaloparatide and parathyroid hormone analogs (e.g., teriparatide) for more than 2 years during a patient s lifetime is not recommended. 1 Introduction Abaloparatide is a human parathyroid hormone related peptide [PTHrP(1-34)] analog. 1 Slideshow View Frightful (But Dead Serious) Drug Side Effects Uses for Abaloparatide Abaloparatide has the following uses: Abaloparatide is a PTHrP(1-34) analog indicated for the treatment of postmenopausal women with osteoporosis at high risk for fracture. 1 Abaloparatide Dosage and Administration General Abaloparatide is available in the following dosage form(s) and strength(s): Injection: 3120 mcg/1.56 mL (2000 mcg/mL) in a single-patient-use prefilled pen. The prefilled pen delivers 30 daily doses of 80 mcg abaloparatide in 40 mcL of sterile, clear, colorless solution. 1 Dosage It is essential that the manufacturer's labeling be consulted for more detailed information on dosage and administration of this drug. Dosage summary: Recommended dose is 80 mcg subcutaneously once daily; patients should receive supplemental calcium and vitamin D if dietary intake is inadequate. 1 Administer as a subcutaneous injection into periumbilical region of abdomen. 1 Administer initially where the patient can sit or lie down in case symptoms of orthostatic hypotension occur. 1 Cautions for Abaloparatide Contraindications None. 1 Warnings/Precautions Risk of Osteosarcoma Abaloparatide caused a dose-dependent increase in the incidence of osteosarcoma in male and female rats after subcutaneous administration at exposures 4 28 times the human exposure at the clinical dose of 80 mcg. It is unknown whether abaloparatide will cause osteosarcoma in humans. 1 The use of abaloparatide is not recommended in patients at increased risk of osteosarcoma including those with Paget's disease of bone or unexplained elevations of alkaline phosphatase, open epiphyses, bone metastases or skeletal malignancies, hereditary disorders predisposing to osteosarcoma, or prior external beam or implant radiation therapy involving the skeleton. 1 Cumulative use of abaloparatide and parathyroid hormone analogs (e.g., teriparatide) for more than 2 years during a patient s lifetime is not recommended. 1 Orthostatic Hypotension Orthostatic hypotension may occur with abaloparatide, typically within 4 hours of injection. Associated symptoms may include dizziness, palpitations, tachycardia, or nausea, and may resolve by having the patient lie down. For the first several doses, abaloparatide should be administered where the patient can sit or lie down if necessary. 1 Hypercalcemia Abaloparatide may cause hypercalcemia. Abaloparatide is not recommended in patients with pre-existing hypercalcemia or in patients who have an underlying hypercalcemic disorder, such as primary hyperparathyroidism, because of the possibility of exacerbating hypercalcemia. 1 Hypercalciuria and Urolithiasis Abaloparatide may cause hypercalciuria. It is unknown whether abaloparatide may exacerbate urolithiasis in patients with active or a history of urolithiasis. If active urolithiasis or pre-existing hypercalciuria is suspected, measurement of urinary calcium excretion should be considered. 1 Specific Populations Pregnancy Abaloparatide is not indicated for use in females of reproductive potential. There are no human data with abaloparatide use in pregnant women to inform any drug-associated risks. Animal reproduction studies with abaloparatide have not been conducted. Lactation Abaloparatide is not indicated for use in females of reproductive potential. There is no information on the presence of abaloparatide in human milk, the effects on the breastfed infant, or the effects on milk production. Pediatric Use Safety and effectiveness of abaloparatide have not been established in pediatric patients. Abaloparatide is not recommended for use in pediatric patients with open epiphyses or hereditary disorders predisposing to osteosarcoma because of an increased baseline risk of osteosarcoma. 1 Geriatric Use Of the total number of patients in the postmenopausal osteoporosis clinical studies of abaloparatide, 82% were age 65 years and over, and 19% were age 75 years and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, but greater sensitivity of some older individuals cannot be ruled out. 1 Renal Impairment No dosage adjustment is required for patients with mild, moderate, or severe renal impairment. A study of a single dose of abaloparatide 80 mcg given subcutaneously was conducted in subjects with normal renal function or mild, moderate, or severe renal impairment. The maximal concentration (C max ) and area under the concentration-time curve (AUC) of abaloparatide increased 1.4- and 2.1-fold, respectively, in subjects with severe renal impairment, compared to subjects with normal renal function. Patients with severe renal impairment may have increased abaloparatide exposure that may increase the risk of adverse reactions; therefore, monitor for adverse reactions. 1 Common Adverse Effects The most common adverse reactions (incidence 2%) are hypercalciuria, dizziness, nausea, headache, palpitations, fatigue, upper abdominal pain, and vertigo. 1 Drug Interactions Specific Drugs It is essential that the manufacturer's labeling be consulted for more detailed information on interactions with this drug, including possible dosage adjustments. Interaction highlights: No specific drug-drug interaction studies have been performed. 1 Actions Mechanism of Action Abaloparatide is a PTHrP(1-34) analog which acts as an agonist at the PTH1 receptor (PTH1R). This results in activation of the cAMP signaling pathway in target cells. In rats and monkeys, abaloparatide had an anabolic effect on bone, demonstrated by increases in bone mineral density (BMD) and bone mineral content (BMC) that correlated with increases in bone strength at vertebral and/or nonvertebral sites. 1 Advice to Patients Advise the patient to read the FDA-approved patient labeling. 1 Risk of Osteosarcoma Advise patients that abaloparatide caused a dose-dependent increase in the incidence of osteosarcoma in male and female rats and that it is unknown whether abaloparatide will cause osteosarcoma in humans. Instruct patients to promptly report signs and symptoms of possible osteosarcoma such as persistent localized pain or occurrence of a new soft tissue mass that is tender to palpation. 1 Hypercalcemia Advise patients that abaloparatide may cause hypercalcemia, and discuss the symptoms of hypercalcemia (e.g., nausea, vomiting, constipation, lethargy, muscle weakness). 1 Instruct patients to promptly report signs and symptoms of hypercalcemia. 1 Orthostatic Hypotension Advise patients to sit or lie down if they feel lightheaded or have palpitations after the injection until their symptoms resolve. If these symptoms persist or worsen, advise patients to consult their healthcare provider before continuing treatment. Use of Abaloparatide Pen Instruct patients and caregivers who administer abaloparatide on how to properly use the abaloparatide pen and to follow sharps disposal recommendations. Advise patients not to share their abaloparatide pen or needles with other patients and not to transfer the contents of the pen to a syringe. Advise patients that each abaloparatide pen can be used for up to 30 days, and after the 30-day use period to discard the abaloparatide pen, even if it still contains unused solution. 1 Additional Information AHFS First Release . For additional information until a more detailed monograph is developed and published, the manufacturer's labeling should be consulted. It is essential that the manufacturer's labeling be consulted for more detailed information on usual uses, dosage and administration, cautions, precautions, contraindications, potential drug interactions, laboratory test interferences, and acute toxicity. Preparations Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Abaloparatide Routes Dosage Forms Strengths Brand Names Manufacturer Parenteral Injection, Solution 2000 mcg/1 mL Tymlos Radius Health Inc. AHFS Drug Information. Copyright 2017, Selected Revisions August 28, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. References 1. Radius Health, Inc.. Tymlos (abaloparatide) SUBCUTANEOUS prescribing information. 2017 Apr. Next Interactions Print this page Add to My Med List More about abaloparatide Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: parathyroid hormone and analogs Consumer resources Abaloparatide Professional resources Other brands: Tymlos Related treatment guides Osteoporosis} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx Availability Prescription only N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Parathyroid hormone and analogs Related Drugs Osteoporosis hydrochlorothiazide , alendronate , calcium carbonate , estradiol , Fosamax , Prolia , Caltrate , Premarin , Evista , raloxifene , Boniva , Actonel , Citracal + D , calcium / vitamin d , Reclast , ibandronate , Zometa , Caltrate 600+D , risedronate , Forteo , denosumab , zoledronic acid , Prempro , More... Abaloparatide Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first!} } service provider


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fulfillment Abacavir, Lamivudine, and Zidovudine Generic Name: Abacavir, Lamivudine, and Zidovudine (a BAK a veer, la MI vyoo deen, & zye DOE vyoo deen) Brand Name: Trizivir Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Drug Images Support Group Q & A Pricing & Coupons Warning Unsafe and sometimes deadly allergic effects with organ failure may happen with abacavir, lamivudine, and zidovudine. Tell your doctor about any fever, rash, feeling tired, upset stomach, throwing up, loose stools, belly pain, flu-like signs, sore throat, cough, or trouble breathing. Do not restart this medicine if you have had an allergic reaction. The chance of allergic effects is raised in people who have a certain gene called HLA-B*5701. Do not take abacavir, lamivudine, and zidovudine if you have the HLA-B*5701 gene. Your doctor will check you for this gene before you start this medicine. Talk with your doctor. Read the warning card and carry it with you at all times. It tells the signs to watch for in case an allergy happens. This medicine may rarely cause swollen liver and an acid health problem in the blood. This may be deadly in some cases. The chance may be higher in women, in overweight people, and in people who have taken drugs like this one for a long time. Talk with your doctor. Hepatitis B has gotten worse when abacavir, lamivudine, and zidovudine was stopped in some people with hepatitis B. Close follow-up for a few months is needed when therapy is stopped in people who have hepatitis B. Do not stop taking this medicine without calling your doctor. Talk with your doctor. This medicine may have unsafe effects on the bone marrow. This includes low white blood cell counts and very bad anemia. The bone marrow may not be able to make cells found in the blood as well as it used to. This medicine may cause muscle aches and stiffness if it is used for long periods of time. Closely read the part in this leaflet that lists when to call the doctor. Uses of Abacavir, Lamivudine, and Zidovudine: It is used to treat HIV infection. What do I need to tell my doctor BEFORE I take Abacavir, Lamivudine, and Zidovudine? If you have an allergy to abacavir, lamivudine, zidovudine, or any other part of abacavir, lamivudine, and zidovudine. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. If you have any of these health problems: Kidney disease or liver disease. If you weigh less than 88 pounds (40 kilograms). If you are taking any of these drugs: Doxorubicin, ribavirin, or stavudine. If you are breast-feeding. Do not breast-feed while you take this medicine. This is not a list of all drugs or health problems that interact with abacavir, lamivudine, and zidovudine. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medicine with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. Slideshow Ladies A Moment: 10 Health Screenings That All Women Need What are some things I need to know or do while I take Abacavir, Lamivudine, and Zidovudine? Tell all of your health care providers that you take abacavir, lamivudine, and zidovudine. This includes your doctors, nurses, pharmacists, and dentists. This medicine may raise the chance of heart attack. Talk with the doctor. Use care if you have risks for heart disease (high blood pressure, high cholesterol, overweight, high blood sugar or diabetes, cigarette smoking, man older than 40 years of age, other family members with early heart disease, woman after change of life). Talk with your doctor. Have blood work checked as you have been told by the doctor. Talk with the doctor. If this medicine is stopped because you have an allergy to it, do not restart it. It may not be safe to restart abacavir, lamivudine, and zidovudine. Throw away any of this medicine that you have not taken. If you are not sure how to throw away unused drugs, check with your pharmacist. If abacavir, lamivudine, and zidovudine is stopped for any other reason, do not restart it without talking to the doctor. It could be very risky to restart on your own. Do not run out of this medicine. Talk with your doctor before you drink alcohol. This medicine is not a cure for HIV. Stay under the care of your doctor. This medicine does not stop the spread of diseases like HIV or hepatitis that are passed through blood or having sex. Do not have any kind of sex without using a latex or polyurethane condom. Do not share needles or other things like toothbrushes or razors. Talk with your doctor. Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using abacavir, lamivudine, and zidovudine while you are pregnant. How is this medicine (Abacavir, Lamivudine, and Zidovudine) best taken? Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely. Take with or without food. Keep taking abacavir, lamivudine, and zidovudine as you have been told by your doctor or other health care provider, even if you feel well. It is important that you do not miss or skip a dose of this medicine during treatment. If you have trouble swallowing, talk with your doctor. What do I do if I miss a dose? Take a missed dose as soon as you think about it. If it is close to the time for your next dose, skip the missed dose and go back to your normal time. Do not take 2 doses at the same time or extra doses. If you are not sure what to do if you miss a dose, call your doctor. Dosage Information (comprehensive) What are some side effects that I need to call my doctor about right away? WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat. Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes. Signs of too much lactic acid in the blood (lactic acidosis) like fast breathing, fast heartbeat, a heartbeat that does not feel normal, very bad upset stomach or throwing up, feeling very sleepy, shortness of breath, feeling very tired or weak, very bad dizziness, feeling cold, or muscle pain or cramps. Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up. Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain. Feeling very tired or weak. Chest pain or pressure. Low mood (depression). Very bad dizziness or passing out. Mouth sores. Muscle pain or weakness. A burning, numbness, or tingling feeling that is not normal. Shortness of breath. Swelling. Change in body fat. This medicine may help the immune system work. If you have an infection that you did not know you had, it may show up when you take abacavir, lamivudine, and zidovudine. Tell your doctor right away if you notice any signs of infection like fever, sore throat, weakness, cough, or shortness of breath after you start this medicine. What are some other side effects of Abacavir, Lamivudine, and Zidovudine? All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: Headache. Joint pain. Feeling nervous and excitable. Feeling tired or weak. Upset stomach or throwing up. Loose stools (diarrhea). These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch. Side Effects (complete list) If OVERDOSE is suspected: If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. How do I store and/or throw out Abacavir, Lamivudine, and Zidovudine? Store at room temperature. Store in a dry place. Do not store in a bathroom. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Check with your pharmacist about how to throw out unused drugs. Consumer Information Use and Disclaimer If your symptoms or health problems do not get better or if they become worse, call your doctor. Do not share your drugs with others and do not take anyone else's drugs. Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor. Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins. This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time abacavir, lamivudine, and zidovudine is refilled. If you have any questions about this medicine, please talk with the doctor, pharmacist, or other health care provider. If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened. This information should not be used to decide whether or not to take abacavir, lamivudine, and zidovudine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to abacavir, lamivudine, and zidovudine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine. Review Date: November 1, 2017 Next Side Effects Print this page Add to My Med List More about abacavir/lamivudine/zidovudine Side Effects During Pregnancy Dosage Information Drug Images Drug Interactions Support Group Pricing & Coupons En Español 1 Review Add your own review/rating Drug class: antiviral combinations Consumer resources Abacavir, lamivudine, and zidovudine Abacavir, lamivudine, and zidovudine (Advanced Reading) Other brands: Trizivir Professional resources Abacavir, Lamivudine and ZidovudineTablets (FDA) Abacavir, Lamivudine, and Zidovudine (Wolters Kluwer) Related treatment guides HIV Infection Nonoccupational Exposure Occupational Exposure} Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Abacavir / lamivudine / zidovudine Rating 1 User Review 9.0 /10 1 User Review 9.0 Rate it! Manufacturer Lupin Pharmaceuticals, Inc. Drug Class Antiviral combinations Related Drugs HIV Infection Truvada , Atripla , Norvir , Viread , Isentress , Prezista , Stribild , lamivudine , More... Occupational Exposure Truvada , Atripla , Viread , Isentress , lamivudine , abacavir , tenofovir , Epzicom , More... Nonoccupational Exposure Truvada , Atripla , Viread , lamivudine , abacavir , tenofovir , Epzicom , Reyataz , More... Abacavir / lamivudine / zidovudine Images Abacavir / lamivudine / zidovudine systemic 300 mg (base) / 150 mg / 300 mg (LU N51) View larger images Related: HIV/AIDS} } is trying


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enterprise [750:<7.5 g/dL or 4.65 mmol/L Dosing: Adult HIV-1 infection, treatment: Oral: One tablet twice daily. Dosing: Geriatric Refer to adult dosing. Dosing: Pediatric HIV-1 infection, treatment: Children and Adolescents 40 kg: Refer to adult dosing. Note: Not recommended for pediatric patients> <40 kg. Dosing: Renal Impairment CrCl 50 mL/minute: No dosage adjustment necessary. CrCl> <50 mL/minute: Use is not recommended (use dose-adjusted individual components). Dosing: Hepatic Impairment Mild impairment (Child-Pugh class A): Use is not recommended (use dose-adjusted individual components). Moderate to severe hepatic impairment (Child-Pugh Class B or C): Use is contraindicated. Administration Administer without regard to food. Storage Store at 25 C (77 F); excursions permitted to 15 C to 30 C (59 F to 86 F). Drug Interactions Acemetacin: May enhance the adverse/toxic effect of Zidovudine. Specifically, the risk for hematologic toxicity may be increased. Monitor therapy Acyclovir-Valacyclovir: May enhance the CNS depressant effect of Zidovudine. Monitor therapy Amodiaquine: Zidovudine may enhance the neutropenic effect of Amodiaquine. Avoid combination BCG (Intravesical): Myelosuppressive Agents may diminish the therapeutic effect of BCG (Intravesical). Avoid combination Cabozantinib: MRP2 Inhibitors may increase the serum concentration of Cabozantinib. Monitor therapy Clarithromycin: May enhance the myelosuppressive effect of Zidovudine. Clarithromycin may decrease the serum concentration of Zidovudine. Management: Monitor response to zidovudine closely when used with clarithromycin, and consider staggering zidovudine and clarithromycin doses when possible in order to minimize the potential for interaction. Consider therapy modification CloZAPine: Myelosuppressive Agents may enhance the adverse/toxic effect of CloZAPine. Specifically, the risk for neutropenia may be increased. Monitor therapy Deferiprone: Myelosuppressive Agents may enhance the neutropenic effect of Deferiprone. Avoid combination Dexketoprofen: May enhance the adverse/toxic effect of Zidovudine. Monitor therapy Dipyrone: May enhance the adverse/toxic effect of Myelosuppressive Agents. Specifically, the risk for agranulocytosis and pancytopenia may be increased Avoid combination DOXOrubicin (Conventional): May enhance the adverse/toxic effect of Zidovudine. DOXOrubicin (Conventional) may diminish the therapeutic effect of Zidovudine. Consider therapy modification DOXOrubicin (Liposomal): May enhance the adverse/toxic effect of Zidovudine. DOXOrubicin (Liposomal) may diminish the therapeutic effect of Zidovudine. Consider therapy modification Emtricitabine: LamiVUDine may enhance the adverse/toxic effect of Emtricitabine. Avoid combination Fluconazole: May decrease the metabolism of Zidovudine. Monitor therapy Ganciclovir-Valganciclovir: May enhance the adverse/toxic effect of Zidovudine. Specifically, hematologic toxicity may be enhanced. Monitor therapy Interferons: May enhance the adverse/toxic effect of Zidovudine. Interferons may decrease the metabolism of Zidovudine. Monitor therapy Methadone: May increase the serum concentration of Zidovudine. Monitor therapy Methadone: May diminish the therapeutic effect of Abacavir. Abacavir may decrease the serum concentration of Methadone. Monitor therapy Orlistat: May decrease the serum concentration of Antiretroviral Agents. Monitor therapy Probenecid: May decrease the metabolism of Zidovudine. Monitor therapy Promazine: May enhance the myelosuppressive effect of Myelosuppressive Agents. Monitor therapy Protease Inhibitors: May decrease the serum concentration of Zidovudine. Monitor therapy Protease Inhibitors: May decrease the serum concentration of Abacavir. Monitor therapy Raltegravir: May enhance the myopathic (rhabdomyolysis) effect of Zidovudine. Monitor therapy Ribavirin (Oral Inhalation): Zidovudine may enhance the adverse/toxic effect of Ribavirin (Oral Inhalation). Specifically, the risk/severity of anemia may be increased. Management: Due to significantly increased risk of anemia, consider even closer monitoring for anemia than routinely recommended. Alternative therapies should be considered when clinically possible, particularly for patients with other risk factors. Consider therapy modification Ribavirin (Systemic): Zidovudine may enhance the adverse/toxic effect of Ribavirin (Systemic). Specifically, the risk/severity of anemia may be increased. Management: Due to significantly increased risk of anemia, consider even closer monitoring for anemia than routinely recommended for ribavirin. Alternative therapies should be considered when clinically possible, particularly for patients with other risk factors. Consider therapy modification Rifamycin Derivatives: May decrease the serum concentration of Zidovudine. Exceptions: Rifabutin. Monitor therapy Sorbitol: May decrease the serum concentration of LamiVUDine. Management: When possible, avoid chronic coadministration of sorbitol-containing solutions with lamivudine, but if this combination cannot be avoided, monitor patients more closely for possible therapeutic failure associated with decreased lamivudine exposure. Consider therapy modification Stavudine: Zidovudine may diminish the therapeutic effect of Stavudine. Avoid combination Tenoxicam: May enhance the adverse/toxic effect of Zidovudine. Monitor therapy Teriflunomide: May increase the serum concentration of OAT3 Substrates. Monitor therapy Trimethoprim: May increase the serum concentration of LamiVUDine. Monitor therapy Valproate Products: May increase the serum concentration of Zidovudine. Monitor therapy Adverse Reactions See individual agents as well as other combination products for additional information. Frequency not always defined. Central nervous system: Headache (13%), fatigue (12%), malaise (12%), depression (6%), anxiety (5%), Dermatologic: Skin rash (5%) Endocrine & metabolic: Increased amylase (2%), increased serum triglycerides (grade 3-4: 2%), increased gamma-glutamyl transferase, redistribution of body fat Gastrointestinal: Nausea (19%), nausea and vomiting (10%), diarrhea (7%), pancreatitis Hematologic & oncologic: Neutropenia (5%) Hepatic: Increased serum ALT (6%) Hypersensitivity: Hypersensitivity (1% to 9%; based on abacavir component; higher risk in carriers of the HLA-B*5701 allele) Immunologic: Immune reconstitution syndrome Infection: Viral infection (5%) Miscellaneous: Fever and chills (6%) Neuromuscular & skeletal: Increased creatine phosphokinase (7%) Respiratory: ENT infection (5%)> <1% (Limited to important or life-threatening): Abdominal pain, allergic sensitization (including anaphylaxis), alopecia, anemia, anorexia, aplastic anemia, cardiomyopathy, decreased appetite, dyspepsia, erythema multiforme, exacerbation of hepatitis B (posttreatment), gynecomastia, increased serum bilirubin, increased serum transaminases, insomnia, lactic acidosis, liver steatosis, lymphadenopathy, myalgia, myasthenia, oral mucosa hyperpigmentation, paresthesia, peripheral neuropathy, rhabdomyolysis, seizure, sleep disorder, splenomegaly, Stevens-Johnson syndrome, stomatitis, thrombocytopenia, urticaria, vasculitis, wheezing ALERT: U.S. Boxed Warning Hypersensitivity reactions: Serious and sometimes fatal hypersensitivity reactions, with multiple organ involvement, have occurred with abacavir. Patients who carry the HLA-B*5701 allele are at a higher risk of a hypersensitivity reaction to abacavir; although, hypersensitivity reactions have occurred in patients who do not carry the HLA-B*5701 allele. Abacavir/lamivudine/zidovudine is contraindicated in patients with a prior hypersensitivity reaction to abacavir and in HLA-B*5701-positive patients. All patients should be screened for the HLA-B*5701 allele prior to initiating therapy with abacavir/lamivudine/zidovudine or reinitiation of therapy with abacavir/lamivudine/zidovudine, unless patients have a previously documented HLA-B*5701 allele assessment. Discontinue abacavir/lamivudine/zidovudine immediately if a hypersensitivity reaction is suspected, regardless of HLA-B*5701 status and even when other diagnoses are possible. Following a hypersensitivity reaction to abacavir, never restart abacavir/lamivudine/zidovudine or any other abacavir-containing product because more severe symptoms, including death, can occur within hours. Similar severe reactions have also occurred rarely following the reintroduction of abacavir-containing products in patient who have no history of abacavir hypersensitivity. Hematologic toxicity: Zidovudine has been associated with hematologic toxicity, including neutropenia and severe anemia, particularly in patients with advanced HIV-1 disease. Myopathy: Prolonged use of zidovudine has been associated with symptomatic myopathy. Lactic acidosis and severe hepatomegaly with steatosis: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues and other antiretrovirals. Discontinue abacavir/lamivudine/zidovudine if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur. Exacerbations of hepatitis B: Severe acute exacerbations of hepatitis B have been reported in patients who are coinfected with hepatitis B virus (HBV) and HIV-1 and have discontinued lamivudine, which is one component of abacavir/lamivudine/zidovudine. Monitor hepatic function closely with both clinical and laboratory follow-up for at least several months in patients who discontinue abacavir/lamivudine/zidovudine and are coinfected with HIV-1 and HBV. If appropriate, initiation of anti-HBV therapy may be warranted. Warnings/Precautions Concerns related to adverse effects: Fat redistribution: May cause redistribution of fat (eg, buffalo hump, peripheral wasting with increased abdominal girth, cushingoid appearance). Hematologic toxicity: [US Boxed Warning]: Zidovudine has been associated with hematologic toxicities (eg, neutropenia, anemia); use with caution in patients with bone marrow compromise (eg, granulocyte count> <1,000 cells/mm 3 or hemoglobin> <9.5 g/dL). Frequent complete blood counts are recommended in patients with advanced HIV-1 disease. Dosage interruption may be needed if anemia or neutropenia develops. Hypersensitivity reactions: [US Boxed Warning]: Serious hypersensitivity reactions (sometimes fatal) have occurred in patients taking abacavir (in Trizivir). Patients who carry the HLA-B*5701 allele are at a higher risk for a hypersensitivity reaction to abacavir, although hypersensitivity reactions have occurred in patients who do not carry the HLA-B*5701 allele. All patients should be screened for the HLA-B*5701 allele prior to initiating therapy with Trizivir or reinitiation of therapy with Trizivir unless patients have had a previously documented HLA-B*5701 allele assessment. Discontinue Trizivir if a hypersensitivity reaction is suspected. Trizivir is contraindicated in patients who have the HLA-B*5701 allele or in patients with a prior hypersensitivity reaction to abacavir. Reintroduction of Trizivir or any other abacavir-containing product can result in life-threatening or fatal hypersensitivity reactions, even in patients who have no history of hypersensitivity to abacavir therapy. Such reactions can occur within hours. Additionally, allele-positive patients (including abacavir treatment naive) should have an allergy to abacavir documented in their medical record. Reactions usually occur within 9 days of starting abacavir; ~90% occur within 6 weeks, although these reactions may occur at any time during therapy (HHS [adult] 2015). These reactions usually include signs or symptoms in 2 or more of the following groups: fever; rash; gastrointestinal (eg, nausea, vomiting, diarrhea, abdominal pain); constitutional (eg, generalized malaise, fatigue, achiness); respiratory (eg, dyspnea, cough, pharyngitis). Other signs and symptoms include lethargy, headache, myalgia, edema, abnormal chest x-ray findings, arthralgia and paresthesia. Anaphylaxis, liver failure, renal failure, hypotension, adult respiratory distress syndrome, respiratory failure, myolysis, and death have occurred in association with hypersensitivity reactions. Physical findings (lymphadenopathy, mucous membrane lesions, and rash [maculopapular, urticarial or variable]) may occur. Erythema multiforme has also been reported. Laboratory abnormalities (eg, elevated liver function tests, elevated creatine phosphokinase, elevated creatinine, and lymphopenia) may occur. Trizivir should be permanently discontinued if hypersensitivity cannot be ruled out, even when other diagnoses are possible. Following a hypersensitivity reaction, Trizivir SHOULD NOT be restarted because more severe symptoms may occur within hours, including LIFE-THREATENING HYPOTENSION AND DEATH. If Trizivir is to be restarted following an interruption in therapy not associated with symptoms of a hypersensitivity reaction, carefully evaluate the patient for previously unsuspected symptoms of hypersensitivity. Do not restart if hypersensitivity is suspected or cannot be ruled out regardless of HLA-B*5701 status. If Trizivir is restarted, continually monitor for symptoms of a hypersensitivity reaction. Make the patient aware that reintroduction should only take place if medical care is readily accessible. Immune reconstitution syndrome: Patients may develop immune reconstitution syndrome resulting in the occurrence of an inflammatory response to an indolent or residual opportunistic infection during initial HIV treatment or activation of autoimmune disorders (eg, Graves disease, polymyositis, Guillain-Barré syndrome) later in therapy; further evaluation and treatment may be required. Lactic acidosis/hepatomegaly: [US Boxed Warning]: Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues; use with caution in patients with risk factors for liver disease (risk may be increased with female gender, obesity, pregnancy or prolonged exposure) and suspend treatment in any patient who develops clinical or laboratory findings suggestive of lactic acidosis or hepatotoxicity (transaminase elevation may/may not accompany hepatomegaly and steatosis). Myopathy: [US Boxed Warning]: Prolonged use of zidovudine has been associated with symptomatic myopathy and myositis. Pancreatitis: Pancreatitis has been observed with abacavir, lamivudine and zidovudine; rule out pancreatitis in patients who develop signs/symptoms (eg, nausea/vomiting, abdominal pain, elevated lipase and amylase) during therapy. Disease-related concerns: Chronic hepatitis B: [US Boxed Warning]: Exacerbation of hepatitis B (including fatalities) has been reported with discontinuation of lamivudine in coinfected HIV/HBV patients; monitor hepatic function (eg, serum ALT) and HBV viral DNA closely for several months after discontinuing Trizivir in coinfected patients. Coronary heart disease: Use has been associated with an increased risk of myocardial infarction (MI) in observational studies; however, based on a meta-analysis of 26 randomized trials, the FDA has concluded there is not an increased risk. Consider using with caution in patients with risks for coronary heart disease and minimizing modifiable risk factors (eg, hypertension, hyperlipidemia, diabetes mellitus, and smoking) prior to use. Lamivudine-resistant HBV: Emergence of HBV virus variants associated with resistance to lamivudine have been reported in HIV-1 infected subjects who have received lamivudine-containing antiretroviral regimens in the presence of HBV coinfection. Renal impairment: Trizivir, as a fixed-dose combination tablet, should not be used in patients with CrCl> <50 mL/minute. Concurrent drug therapy issues: Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information. Special populations: Pediatric patients> <40 kg: Trizivir, as a fixed-dose combination tablet, should not be used in patients> <40 kg or those requiring dosage adjustment. Therapy-experienced patients: Patients with prolonged prior nucleoside reverse transcriptase inhibitor (NRTI) exposure or presence of HIV-1 isolates containing multiple mutations conferring resistance to NRTIs have limited response to abacavir. The potential for cross resistance between abacavir and other NRTIs should be considered when evaluating new regimens in therapy experienced patients. Monitoring Parameters Blood glucose, CBC with differential, serum creatine kinase, CD4 count, HIV RNA plasma levels, bilirubin, serum transaminases, triglycerides, serum amylase; HLA-B*5701 genotype status prior to initiation of therapy and prior to reinitiation of therapy in patients of unknown HLA-B*5701 status; signs and symptoms of hypersensitivity, particularly in patients untested for the HLA-B*5701 allele; signs and symptoms of pancreatitis; observe for appearance of opportunistic infections Pregnancy Considerations In general, women who become pregnant on a stable combination antiretroviral therapy (cART) regimen may continue that regimen if viral suppression is effective, appropriate drug exposure can be achieved, contraindications for use in pregnancy are not present, and the regimen is well tolerated. The Health and Human Services (HHS) Perinatal HIV Guidelines generally do not recommend this combination as initial therapy in antiretroviral-naive pregnant women due to inferior virologic activity (HHS [perinatal] 2016). See individual agents. Patient Education Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?) Patient may experience headache, joint pain, anxiety, drowsiness, nausea, vomiting, or diarrhea. Have patient report immediately to prescriber signs of allergic reaction with organ failure (fever, rash, fatigue, flu-like signs, nausea, vomiting, diarrhea, abdominal pain, pharyngitis, cough, or difficulty breathing), signs of bone marrow depression (neutropenia or anemia), signs of liver problems (dark urine, fatigue, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or jaundice), signs of lactic acidosis (fast breathing, tachycardia, abnormal heartbeat, vomiting, fatigue, shortness of breath, severe loss of strength and energy, severe dizziness, feeling cold, or muscle pain or cramps), signs of pancreatitis (severe abdominal pain, severe back pain, severe nausea, or vomiting), signs of kidney problems (urinary retention, hematuria, change in amount of urine passed, or weight gain), loss of strength or energy, angina, depression, severe dizziness, passing out, mouth sores, muscle pain, burning or numbness feeling, shortness of breath, edema, change in body fat, or signs of infection (HCAHPS). Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions. Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients. Next Interactions Print this page Add to My Med List More about abacavir/lamivudine/zidovudine Side Effects During Pregnancy Dosage Information Drug Images Drug Interactions Support Group Pricing & Coupons En Español 1 Review Add your own review/rating Drug class: antiviral combinations Consumer resources Abacavir, lamivudine, and zidovudine Abacavir, lamivudine, and zidovudine (Advanced Reading) Professional resources Abacavir, Lamivudine and ZidovudineTablets (FDA) Other brands: Trizivir Related treatment guides HIV Infection Nonoccupational Exposure Occupational Exposure> ]} Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Abacavir / lamivudine / zidovudine Rating 1 User Review 9.0 /10 1 User Review 9.0 Rate it! Manufacturer Lupin Pharmaceuticals, Inc. Drug Class Antiviral combinations Related Drugs antiviral combinations Harvoni , Truvada , Atripla , Genvoya , Triumeq , Stribild HIV Infection Truvada , Atripla , Norvir , Viread , Isentress , Prezista , Stribild , lamivudine , More... Occupational Exposure Truvada , Atripla , Viread , Isentress , lamivudine , abacavir , tenofovir , Epzicom , More... Nonoccupational Exposure Truvada , Atripla , Viread , lamivudine , abacavir , tenofovir , Epzicom , Reyataz , More... Abacavir / lamivudine / zidovudine Images Abacavir / lamivudine / zidovudine systemic 300 mg (base) / 150 mg / 300 mg (LU N51) View larger images} } a variety of


the protection Abacavir, Lamivudine, and Zidovudine a hundred and fortieth

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protecting abaloparatide (Subcutaneous route) a-bal-oh-PAR-a-tide Subcutaneous route(Solution) Risk of Osteosarcoma: Abaloparatide caused a dose-dependent increase in the incidence of osteosarcoma, a malignant bone tumor, in male and female rats. It is unknown whether abaloparatide will cause osteosarcoma in humans. Use of abaloparatide is not recommended in patients at increased risk of osteosarcoma. Cumulative use of abaloparatide and parathyroid hormone analogs (eg, teriparatide) for more than 2 years during a patient s lifetime is not recommended . Commonly used brand name(s) In the U.S. Tymlos Available Dosage Forms: Solution Therapeutic Class: Endocrine-Metabolic Agent Uses For abaloparatide Abaloparatide is used to treat osteoporosis in postmenopausal women who are at high risk for bone fracture. It reduces the risk of having bone and spine fracture in postmenopausal women with osteoporosis. abaloparatide is available only with your doctor's prescription. Before Using abaloparatide In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For abaloparatide, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to abaloparatide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of abaloparatide injection in the pediatric population. Safety and efficacy have not been established. However, use is not recommended in children with open epiphyses (bones are still growing) or genetic disorders. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of abaloparatide injection in the elderly. However, elderly patients are more sensitive to the effects of abaloparatide than younger adults. Breast Feeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine. Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. Other Medical Problems The presence of other medical problems may affect the use of abaloparatide. Make sure you tell your doctor if you have any other medical problems, especially: Bone cancer, or history of or High levels of alkaline phosphatase (enzyme found in the bones) or Paget's disease of the bone Use with caution. May increase the risk of developing bone cancer (osteosarcoma). Hypercalcemia (high calcium levels in the blood) or Hypercalciuria (high calcium levels in the urine) or Hyperparathyroidism (overactive parathyroid) or Kidney stones, history of Use with caution. May cause side effects to become worse. Proper Use of abaloparatide A nurse or other trained health professional will give you abaloparatide. It is given as a shot under your skin, usually in the abdomen (stomach) area. abaloparatide comes with a Medication Guide and patient instructions. Read and follow the instructions carefully. Ask your doctor if you have any questions. Abaloparatide may sometimes be given at home to patients who do not need to be in a hospital or clinic. If you are using abaloparatide at home, your doctor or nurse will teach you how to prepare and inject the medicine. Be sure that you understand how to use the medicine. You should receive the first several injections of abaloparatide while sitting or lying down if needed, until you know how abaloparatide affects you. If you use abaloparatide at home, you will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems. Do not inject into skin areas that are tender, bruised, red, scaly, or hard. Use a new needle each time you inject your medicine. Do not store the prefilled pen with the needle attached. If the medicine in the prefilled syringe has changed color, or if you see particles in it, do not use it. You may take calcium and vitamin D supplements while you are using abaloparatide if needed. Follow your doctor's instructions about how to take these supplements. Use of abaloparatide and parathyroid hormone analogs for more than 2 years during your lifetime is not recommended. Dosing The dose of abaloparatide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of abaloparatide. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For injection dosage form (prefilled pen): For osteoporosis in postmenopausal women: Adults 80 micrograms (mcg) injected under the skin once a day. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of abaloparatide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Before first use: Store the medicine in the refrigerator. Do not freeze. After first use: Store the medicine at room temperature, away from heat and direct light for up to 30 days. Do not freeze. You might not use all of the medicine in each prefilled pen. Throw away any unused medicine that has been stored at room temperature after 30 days. Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets. Precautions While Using abaloparatide It is very important that your doctor check your progress at regular visits to make sure abaloparatide is working properly. Blood and urine tests may be needed to check for unwanted effects. abaloparatide may increase your risk of having osteosarcoma (bone cancer). This is more likely to occur if you have a history of radiation treatment involving your bones. Check with your doctor right away if you have bone pain that does not go away or a new soft tissue mass that is tender to palpation. abaloparatide may cause some people to become dizzy or drowsy. Make sure you know how you react to abaloparatide before you drive, use machines, or do anything else that could be dangerous if you are not alert . Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor. abaloparatide may increase levels of calcium in the blood and urine. High calcium in the urine may cause kidney stones. Call your doctor right away if you have blood in the urine, confusion, constipation, dry mouth, metallic taste, muscle weakness, nausea or vomiting, pain in the side, back, or abdomen, or weight loss. abaloparatide Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: More common Blood in urine constipation depression loss of appetite loss of weight muscle weakness nausea or vomiting pain in the side, back, or stomach thirst unusual tiredness or weakness Less common Fast, irregular, pounding, or racing heartbeat or pulse Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: More common Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site dizziness headache Less common Feeling of constant movement of self or surroundings sensation of spinning Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Print this page The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products. Copyright 2017 Truven Health Analytics, Inc. All Rights Reserved.} Recently Approved Lonhala Magnair Lonhala Magnair (glycopyrrolate) is a long-acting muscarinic antagonist (LAMA) bronchodilator for... Ozempic Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) analog administered once-weekly for the... Ogivri Ogivri (trastuzumab-dkst) is a HER2 / neu receptor antagonist biosimilar to Herceptin indicated for... Sublocade Sublocade (buprenorphine) is a once-monthly injectable partial opioid agonist formulation for the... More Help and Support Looking for answers? 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for instance abaloparatide Generic Name: abaloparatide (a BAL oh PAR a tide) Brand Name: Tymlos Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A What is abaloparatide? Abaloparatide is a man-made form of parathyroid hormone that exists naturally in the body. Abaloparatide increases bone mineral density and bone strength, which may prevent fractures. Abaloparatide is used to treat osteoporosis in postmenopausal women who have a high risk of bone fracture. Abaloparatide may also be used for purposes not listed in this medication guide. Slideshow Ladies A Moment: 10 Health Screenings That All Women Need What is the most important information I should know about abaloparatide? Abaloparatide has caused bone cancer (osteosarcoma) in animals but it is not known whether this would occur in people using this medicine. Talk with your doctor about your own risk. Call your doctor at once if you have bone pain, unusual body aches, or a lump or swelling under your skin. Avoid smoking cigarettes or drinking alcohol. Smoking or heavy drinking can reduce your bone mineral density, making fractures more likely. What should I discuss with my healthcare provider before using abaloparatide? You should not use abaloparatide if you are allergic to it. Abaloparatide is not for use in children or young adults whose bones are still growing. To make sure abaloparatide is safe for you, tell your doctor if you have ever had: Paget's disease or a bone disease other than osteoporosis; high blood levels of calcium or alkaline phosphatase; overactive parathyroid glands; bone cancer or radiation treatment involving your bones; or a kidney stone. Abaloparatide has caused bone cancer (osteosarcoma) in animals but it is not known whether this would occur in people using this medicine. Talk with your doctor about your own risk. Abaloparatide is for use only in women who can no longer get pregnant. It is not known whether abaloparatide will harm an unborn baby. Tell your doctor if you think you may be pregnant. It is not known whether abaloparatide passes into breast milk or if it could harm a nursing baby. How should I use abaloparatide? Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended. Abaloparatide is injected under the skin. You may be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes. Abaloparatide is usually given once per day. Use the medicine at the same time each day. Your care provider will show you the best places on your body to inject abaloparatide. Use a different place each time you give an injection. Do not inject into the same place two times in a row. Use only the injection pen provided with abaloparatide. Do not transfer the medicine to a syringe or other injection device or you could get an overdose. Abaloparatide can cause you to feel dizzy or light-headed. Always give your injection at a time and place where you can sit or lie down for a short time afterward. Abaloparatide should be clear and colorless. Do not use the medicine if it has changed colors, looks cloudy, or has particles in it. Call your pharmacist for new medicine. Use a disposable needle only once. Follow any state or local laws about throwing away used needles. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. Abaloparatide may be only part of a complete program of treatment that also includes diet changes, exercise, taking vitamin or mineral supplements, and changing certain behaviors. Follow your doctor's instructions very closely. Store unopened injection pens in the refrigerator, do not freeze. Once you start using the injection pen, store it at room temperature away from moisture and heat. After each use, remove the needle and cover the pen with the outer needle cap. Do not store the pen with a needle attached. Each prefilled injection pen contains enough abaloparatide for 30 separate injections. Throw the pen away after 30 injections, even if there is still medicine left inside. Your doctor will determine how long to treat you with this medicine. Abaloparatide is often given for only 2 years. What happens if I miss a dose? Use the missed dose on the same day you remember it. Use your next dose at the regular time and stay on your once-daily schedule. Do not use 2 doses in one day. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include headache, dizziness, vomiting, rapid heartbeats, feeling light-headed, or fainting. What should I avoid while using abaloparatide? Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall. Avoid smoking, or try to quit. Smoking can reduce your bone mineral density, making fractures more likely. Avoid drinking large amounts of alcohol. Heavy drinking can also cause bone loss. Abaloparatide side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: a light-headed feeling, like you might pass out (may occur within 4 hours after injection); bone pain; unusual body aches; a new or worsening lump or swelling under your skin; pounding heartbeats or fluttering in your chest; high levels of calcium in your blood--nausea, vomiting, constipation, weakness, tired feeling; or symptoms of a kidney stone--severe pain in your side or lower back, blood in your urine, painful urination. Common side effects may include: dizziness, spinning sensation; headache; fast heart rate; nausea, upper stomach pain; or feeling very tired. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Side Effects (complete list) Abaloparatide dosing information Usual Adult Dose for Osteoporosis: 80 mg subcutaneously once a day Comments: -Cumulative use of this drug and parathyroid hormone analogs (e.g., teriparatide) for more than 2 years during a patient's lifetime is not recommended. -Patients should receive supplemental calcium and vitamin D if dietary intake is inadequate. Use: For the treatment of postmenopausal women with osteoporosis at high risk for fracture defined as a history of osteoporotic fracture, multiple risk factors for fracture, or patients who have failed or are intolerant to other available osteoporosis therapy; in postmenopausal women with osteoporosis, this drug reduces the risk of vertebral fractures and nonvertebral fractures What other drugs will affect abaloparatide? Other drugs may interact with abaloparatide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. Next Side Effects Print this page Add to My Med List More about abaloparatide Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 0 Reviews Add your own review/rating Drug class: parathyroid hormone and analogs Consumer resources Abaloparatide Other brands: Tymlos Professional resources Abaloparatide (AHFS Monograph) Related treatment guides Osteoporosis Where can I get more information? Your pharmacist can provide more information about abaloparatide. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Last reviewed: October 25, 2017 Date modified: December 03, 2017} Drug Status Rx Availability Prescription only N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Parathyroid hormone and analogs Related Drugs Osteoporosis hydrochlorothiazide , alendronate , calcium carbonate , estradiol , Fosamax , Prolia , Caltrate , Premarin , Evista , raloxifene , Boniva , Actonel , Citracal + D , calcium / vitamin d , Reclast , ibandronate , Zometa , Caltrate 600+D , risedronate , Forteo , denosumab , zoledronic acid , Prempro , More... Abaloparatide Rating No Reviews - Be the first! No Reviews - Be the first! Not Rated - Be the first! Help and Support Looking for answers? Ask a question or go join the abaloparatide support group to connect with others who have similar interests.} } is making an attempt


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lifestyle (*this news item will not be available after 01/30/2018) Wednesday, November 1, 2017 WEDNESDAY, Nov. 1, 2017 (HealthDay News) -- Women who give birth in their teens may face hardships, and new research suggests that stress might take a toll on the heart. The study found that in a group of women over 65, those who gave birth for the first time before age 20 had a higher risk of heart disease and stroke (cardiovascular disease) later in life. "Adolescent childbirth may be an important risk marker for cardiovascular disease in women, and one that is worth more investigation and clinical consideration," said the study's senior author, Catherine Pirkle. She's an assistant professor in health policy and management at the University of Hawaii at Manoa. "Adolescent mothers may need to be more attentive to lifestyle factors that increase the risk of cardiovascular disease, including maintaining a healthy body weight and engaging in sufficient physical activity," she said. And women who gave birth in their teens may also want more frequent heart disease screening, Pirkle said. But Pirkle also emphasized that it's not clear how adolescent childrearing is related to a bigger risk of heart disease and stroke, or even if it is a cause of later heart disease and stroke risk. "Our research and several other teams document an association," she said, adding this study alone cannot "prove anything." But Pirkle and her colleagues have theories as to how giving birth at an early age might affect later heart health. For example, these women may have more unhealthy stress throughout their lifetimes. "I think they experience a cascade of adverse life experiences that over time harms their health, with cardiovascular disease being an expression of that harm," Pirkle explained. "For example, adolescent mothers are more likely to drop out of school early and therefore earn less over their lifetimes," she said. "Low educational attainment and low incomes are strongly related to poor health outcomes." Teen moms may also engage in more unhealthy and risky behaviors, such as smoking. It may also be harder for them to practice healthy behaviors, such as eating lots of fruits and vegetables or getting plenty of exercise. In addition, Pirkle said, there may be physical differences between a teen and a grown woman having a baby. Adolescence is a time of rapid change and development. "There is some evidence that adolescent mothers experience greater weight gains during pregnancy and lose less of that weight after delivery," Pirkle said. Worldwide, it's estimated that 11 percent of births occur among teens, the study authors said in background notes. Their study included more than 1,000 women between 65 and 74 from Canada, Albania, Brazil and Colombia. The researchers used a well-regarded measure of 10-year heart disease and stroke risk called the Framingham Heart Risk Score. Women who had been teen moms scored an average of 6 points higher, indicating a greater heart disease and stroke risk over the next 10 years. The researchers also found that women who had never had a child had the lowest heart risk score. Among mothers, those who gave birth for the first time between 25 and 29 had the lowest risk, the study showed. Dr. Kevin Marzo is chief of cardiology at NYU Winthrop Hospital in Mineola, N.Y. He said he wasn't surprised by the study's findings. "Having a child at a young age may lead to confounding variables, such as economic and lifestyle factors that could lead to more heart disease risk. The authors did try to adjust for all of these variables," said Marzo, who wasn't involved in the study. He suggested that women who became mothers at a young age should pay more attention to heart disease risk factors and try to modify those they can, such as smoking or obesity. Pirkle added there are important implications from the study. It shows how important sex education and access to birth control is for teen girls "to avoid adolescent childbearing in the first place." And for teens who've already had babies, Pirkle said the findings show the need to help support young mothers. The study was published Nov. 1 in the Journal of the American Heart Association . SOURCES: Catherine Pirkle, Ph.D., assistant professor, health policy and management, University of Hawaii, Manoa; Kevin Marzo, M.D., chief, cardiology, NYU Winthrop Hospital, Mineola, N.Y.; Nov. 1, 2017, Journal of the American Heart Association HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Heart Disease in Women Stroke Recent Health News end result


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final result (*this news item will not be available after 01/31/2018) By Robert Preidt Thursday, November 2, 2017 THURSDAY, Nov. 2, 2017 (HealthDay News) -- Deforestation doesn't just strip the landscape. In tropical regions, it may also lead to more disease-carrying mosquitoes, University of Florida researchers say. "Converting pristine tropical forests into areas for agriculture or other uses creates a habitat for the mosquitoes that transmit human diseases," lead study author Nathan Burkett-Cadena said in a university news release. He's an assistant professor of entomology. The scientists don't say why those mosquitoes might thrive without extensive tree coverage, but they note that deforested areas are warmer and drier than similar pristine forests. For their report, the researchers analyzed 17 studies from around the world. They found a strong link between deforestation in tropical habitats and higher concentrations of mosquitoes that carry diseases transmittable to people. Almost 57 percent of mosquito species in deforested areas were confirmed carriers of human disease, compared with about 28 percent of mosquito species in forested areas, the investigators said. They also found that mosquito species capable of carrying multiple human diseases favored deforested habitats. These include Aedes aegypti mosquitoes, which transmit the dengue, West Nile, yellow fever and Zika viruses. "The last couple of decades have seen an increase in efforts looking into the association between deforestation and specific diseases," said study co-author Dr. Amy Vittor. "Here we're taking a global view, comparing the distribution of mosquito species capable of carrying disease in deforested and forested areas in the tropics," added Vittor, an assistant professor in the division of infectious diseases and global medicine. The findings were published recently in the journal Basic and Applied Ecology . SOURCE: University of Florida, news release HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Mosquito Bites Recent Health News the majority


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come across (*this news item will not be available after 01/31/2018) Thursday, November 2, 2017 THURSDAY, Nov. 2, 2017 (HealthDay News) -- If you're a fan of sodas, fruit juices and sugary sports drinks, you're probably not doing your heart any favors. A new review suggests that regularly quenching your thirst with sugar-sweetened beverages not only contributes to your risk of gaining weight, it also ups your chances of developing type 2 diabetes and metabolic syndrome, a cluster of conditions that raises your risk of heart disease. "Some studies found that consuming as few as two servings of sugar-sweetened beverages a week was linked to [an increased risk of metabolic syndrome, diabetes and heart disease and stroke]," said study senior author Faadiel Essop, a professor at Stellenbosch University in South Africa. "Others found that drinking at least one sugar-sweetened beverage per day was associated with elevated blood pressure," he said, and added that even more alarmingly, some studies found that sugary drinks could raise blood pressure in teenagers. Metabolic syndrome occurs when you have three or more of the following risk factors for heart disease: abdominal obesity, high levels of triglycerides (a type of blood fat), reduced levels of HDL (the good) cholesterol, elevated blood sugar, and higher than normal fasting blood sugar levels (but not yet high enough to be considered diabetes), according to the American Heart Association. The review included 36 studies that looked at the effects of sugary drinks on heart and metabolic health. The studies were done within the past 10 years. The studies had varied findings, according to the researchers. But most suggested an association between drinks containing sugar and the development of metabolic syndrome. The majority of the studies also looked at people who had more than five sugary drinks a week. It's not clear exactly how these drinks increase the odds of metabolic syndrome, Essop said. But certainly excess consumption of sugary drinks is linked to a higher waist circumference -- a factor in metabolic syndrome -- and weight gain. Such drinks have also been tied to decreased insulin sensitivity (a risk for diabetes), inflammation, abnormal cholesterol and high blood pressure, he said. "Those consuming sugary drinks do not feel as full as those who ate solid foods, even though they had the same amount of calories," Essop noted, and that lack of satiety may then cause people to eat or drink more. Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, said that fruit offers a good example. "If you eat an apple, you get full much easier. In addition to sugar, an apple has a lot of fiber and the satiety is much better. But when you have a glass of apple juice, you're getting the sugar from three to four apples and no fiber. That's a much more concentrated dose of sugar that will spike the blood sugar level," he explained. Dr. William Cefalu, chief scientific, medical and mission officer from the American Diabetes Association, said the studies included in this review were observational studies, which are a good starting point when looking at medical problems, but they cannot prove a cause-and-effect relationship. "What we can be sure of, however, is that sugar-sweetened beverages provide a substantial amount of excess calories with no nutritional benefit, and excess calories beyond what is normally needed by the body to maintain normal activities, in turn, does lead to weight gain," Cefalu said. And excess weight is a significant risk factor for type 2 diabetes, as well as many heart disease risk factors. "At the end of the day, drinking water is the best form of hydration for all people -- with or without diabetes," he said. One important exception, Cefalu noted, is anyone with diabetes -- particularly those treated with insulin -- whose blood sugar is low. In that case, it's crucial to quickly raise blood sugar levels to prevent serious complications. A sugar-sweetened beverage such as juice or soda can do that quite well. The study was published Nov. 2 in the Journal of the Endocrine Society . SOURCES: M. Faadiel Essop, Ph.D., professor, Stellenbosch University, South Africa; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center, New York City; William Cefalu, M.D., chief scientific, medical and mission officer, American Diabetes Association; Nov. 2, 2017, Journal of the Endocrine Society HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Carbohydrates How to Prevent Heart Disease Metabolic Syndrome Recent Health News most valuable


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twiddling with (*this news item will not be available after 01/31/2018) By Robert Preidt Thursday, November 2, 2017 THURSDAY, Nov. 2, 2017 (HealthDay News) -- Certain pieces of brain structure may make some people less likely to develop Alzheimer's disease. That's the conclusion of a new study that could lead to new ways to prevent or slow the memory-destroying disease, researchers said. For the study, the researchers analyzed brain samples from patients at memory clinics and found that the presence of healthy dendritic spines (connections between neurons) provide protection against Alzheimer's in people whose brains have proteins associated with the disease. The findings, published recently in the Annals of Neurology , are the first of their kind, the study authors said. "One of the precursors of Alzheimer's is the development in the brain of proteins called amyloid and tau, which we refer to as the pathology of Alzheimer's," said the study's lead author, Jeremy Herskowitz. He's an assistant professor with the University of Alabama at Birmingham School of Medicine's department of neurology. "However, about 30 percent of the aging population have amyloid and tau buildup but never develop dementia. Our study showed that these individuals had larger, more numerous dendritic spines than those with dementia, indicating that spine health plays a major role in the onset of disease," Herskowitz said in a university news release. Neurons, which are brain cells, are constantly sending out dendritic spines in search of other neurons. When they connect, a synapse -- an exchange of information -- occurs between neurons. This is the basis for memory and learning, the researchers explained. "One obvious culprit in Alzheimer's disease is the loss of dendritic spines and thus the loss of synapses," Herskowitz said. "This would impair the ability to think, so the assumption has been that those without dementia had healthy [dendritic] spines and those with dementia did not. But no one had gone in to see if that was true," he noted. Healthy dendritic spines could be genetic, or the result of beneficial lifestyle habits -- such as good diet and exercise -- which are known to reduce the risk of dementia, Herskowitz said. The new findings provide "a target for drugs that would be designed to support and maintain dendritic spine health in an effort to rebuild neurons or prevent their loss," he added. "This data suggests that rebuilding neurons is possible. And as we are better able to identify the increase of amyloid and tau early in the progression of the disease, even before symptoms arise, we might be able to one day offer a medication that can contribute to maintaining healthy dendritic spines in those with the Alzheimer's pathology," he concluded. SOURCE: University of Alabama at Birmingham, news release, Oct. 24, 2017 HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Alzheimer's Disease Recent Health News newest


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taking advantage of (*this news item will not be available after 01/31/2018) By Margaret Farley Steele Thursday, November 2, 2017 THURSDAY, Nov. 2, 2017 (HealthDay News) -- While diabetes cases continue to rise in the United States, one potential outcome -- kidney failure -- has decreased by one-third, health officials report. The rate of kidney failure requiring dialysis or transplantation among people with diabetes fell 33 percent from 2000 to 2014, a new report from the U.S. Centers for Disease Control and Prevention shows. This continued a trend begun in the 1990s. "Continued awareness of risk factors for kidney failure and interventions to improve diabetes care might sustain and improve these trends," wrote researchers led by Nilka Rios Burrows. She's an epidemiologist in the CDC's division of diabetes translation. The survey data reflects all 50 states, the District of Columbia and Puerto Rico. It's likely that people with diabetes have better control of blood pressure and blood sugar, two risk factors for kidney failure, the researchers suggested. For example, treatment with so-called ACE inhibitors or angiotensin-receptor blockers can slow the decline in kidney function while lowering blood pressure, they noted. Dr. Maria DeVita, a nephrologist at Lenox Hill Hospital in New York City, agreed. "We can conclude that the measures that physicians take to delay progression is working to some degree," she said. However, "we have to be cautious about the data as some of it was from self-reporting," DeVita added. "In addition, there has been a significant increase in those patients undergoing preemptive kidney transplant, thus not technically reaching [end-stage kidney failure] and therefore not being captured on federal forms." According to the report, about 1 in 3 adults with diabetes has kidney damage or reduced kidney function. But most are unaware of it. The researchers said earlier screening for kidney disease in people with diabetes is important. And better treatment can prevent complications, they noted. More than 9 percent of Americans are estimated to have diabetes, according to recent CDC figures. The overwhelming majority have type 2, which is linked to overeating and a sedentary lifestyle. Preventing type 2 diabetes is one way to lower the odds of chronic kidney disease, the CDC says. Lifestyle changes, including healthy eating and weight management, can help in that regard. Despite improving numbers with regard to kidney failure, doctors and patients with diabetes should not become complacent, experts said. "Diabetic kidney disease remains a major health concern and certainly more work needs to be done," DeVita said. The study findings appear in the CDC's Nov. 3 Mortality and Morbidity Weekly Report . SOURCE: U.S. Centers for Disease Control and Prevention, Nov. 3, 2017, Mortality and Morbidity Weekly Report HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Kidney Failure Recent Health News for reinforcing


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high-quality (*this news item will not be available after 01/31/2018) Thursday, November 2, 2017 THURSDAY, Nov. 2, 2017 (HealthDay News) -- The type of bacteria that cancer patients harbor in the gut might affect their odds of responding to certain treatments, two early studies hint. The research, in humans and mice, adds to evidence that gut bacteria play a key role in the immune system. But experts stressed it's too soon to make recommendations to cancer patients -- including whether they should take "probiotic" supplements. Both studies looked at whether there's a link between patients' gut bacteria and their responses to newer cancer drugs called PD-1 inhibitors. The drugs, which include Keytruda (pembrolizumab) and Opdivo (nivolumab), work by freeing up the immune system to attack cancer cells. The drugs are approved for several cancers, including advanced cases of melanoma, lung, bladder and stomach cancers. In one study, researchers focused on 112 patients with advanced melanoma, the deadliest form of skin cancer. The investigators found that those who'd responded to PD-1 therapy tended to have a gut "microbiome" that was distinct from those of patients who did not respond. Those who'd responded generally had more diversity in their bacteria, plus higher concentrations of common bacteria called Ruminococcus and Faecalibacterium . Still, the researchers said the findings do not prove that those bacteria improve the odds of doing well on PD-1 therapy. "Only a clinical trial can show that. This needs to be tested," said senior researcher Dr. Jennifer Wargo, an associate professor at University of Texas M.D. Anderson Cancer Center in Houston. However, the findings build on evidence of a "clear link between the gut microbiome and immune function," she said. The "microbiome" refers to the trillions of bacteria and other microbes that dwell in the human body. Studies have found that the diversity of those bugs -- particularly in the gut -- is linked to the risks of various health conditions, including those related to immune function. In general, studies have found, the more diversity in the gut microbiome, the better. Wargo's study involved a group of melanoma patients who'd responded to a PD-1 inhibitor -- meaning their cancer had stabilized or regressed for at least six months -- and a group that did not respond. Overall, the responders showed an "abundance" of Ruminococcus and Faecalibacterium . In contrast, the non-responders had a high concentration of Bacteroidales bacteria. To test whether the microbes might have a direct influence on treatment response, the researchers transplanted gut bacteria from the patients into lab mice. Those animals also responded better to PD-1 therapy, versus mice that had transplants from non-responding patients, according to the report. In the second study, French researchers focused on 249 patients treated with a PD-1 inhibitor for lung, kidney or urinary tract cancers. Just over one-quarter had taken antibiotics to treat an infection shortly before or after starting PD-1 treatment. (Antibiotics are drugs that kill bacteria). Overall, those antibiotic patients had lower survival odds. Plus, 69 percent of patients who responded to PD-1 treatment had detectable amounts of bacteria called Akkermansia muciniphila , versus 34 percent of patients who did not respond. It all raises "exciting possibilities," Wargo said. Namely, could manipulating the gut microbiome improve the chances of responding to cancer treatment? But there are plenty of unanswered questions. For one, "We don't really know what constitutes a 'favorable' microbiome," Wargo noted. So there is no way to tell cancer patients whether any probiotic might benefit them. In fact, she said, if patients were to take a random supplement, it might end up causing harm. In addition, there also needs to be more research into gut bacteria and responses to other cancer therapies, Wargo added. Dr. Nikhil Khushalani specializes in treating skin cancer at Moffitt Cancer Center, in Tampa, Fla. He cautioned that the study findings are a "first step," but also a "very intriguing" one. Khushalani said the findings raise the possibility of testing patients' stool samples to see who has a greater likelihood of responding to PD-1 therapy. "That could help us in truly tailoring treatment," he suggested. Then there's the possibility of actually altering patients' microbiomes -- whether through probiotics or even fecal transplants, Khushalani added. Like Wargo, he cautioned patients against self-treating with probiotics, given the unknowns. "But that could be where we're heading," Khushalani said. "Hopefully, this will open the door to even more research in this arena." The new research appears in the Nov. 3 issue of Science . SOURCES: Jennifer Wargo, M.D., associate professor, surgical oncology, University of Texas M.D. Anderson Cancer Center, Houston; Nikhil Khushalani, M.D., vice-chair, department of cutaneous oncology, Moffitt Cancer Center, Tampa, Fla.; Nov. 3, 2017, Science , online HealthDay Copyright (c) 2017 HealthDay . All rights reserved. News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services. More Health News on Cancer Cancer Immunotherapy Recent Health News no need


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