New Jersey saw a 22 percent decrease in opioid prescriptions given out after a new law went into effect. The law limits prescriptions of opioids such as oxycodone to a five-day supply on new orders. An alert notifies those filling the prescriptions if the limit has been reached.

Prescriptions Decline in New Jersey

The study is the first of its kind in reviewing the impact of such a state law and the effects of an electronic medical record on reporting. According to the study, no evidence has been found to suggest that pain control declined.

The study monitored phone calls and hospital visits to determine if the reduction in pain medication had an impact on pain or recovery. None were found from the research done after the law went into effect. The law was passed in May 2017 for any patients who had not been on opioid medications for more than a year. In total, 33 states have implemented some types of limits or restrictions for new prescriptions. Pennsylvania has a seven-day limit for specific situations.

Medicare and some private insurance providers have also implemented limits, which doctors must be aware of when prescribing these medications. These requirements are in addition to any state laws.

A Study of the Impact of Alerts and Legislation on Opioid Use

The study required two years of research before and after the new law went into effect. In New Jersey, during the time of the study, 668 new prescriptions were written and 4368 in Pennsylvania. These scripts included the best-known opioids, such as hydrocodone, oxycodone, morphine, codeine, tramadol, and hydromorphone.

The average dosage before the law went into effect as 225 MME in New Jersey and 150 MME in Pennsylvania. Generally, 30 tablets were prescribed. After the law passed, the MME went down from 225 to 150 and the number of tablets decreased from 30 to 20. No change was noted in Pennsylvania, which is interesting since it didn’t have an electronic medical record system to provide alerts. The decrease in number of prescriptions went down 22 percent in New Jersey compared to eight percent in Pennsylvania.

What the results of the study show is that the law may not have as much effect as the electronic alerts. Targeted interventions may be the best tools to see change with opioid prescriptions. The goal with these resources is to provide flexibility to doctors while encouraging them to make prescriptions safer for the patient.

Opioid prescriptions may lead to dependency when given over the long-term. They can also lead to illicit drug abuse when the person is no longer able to obtain the prescription drug. With the rise in opioid overdoses and the indication that many of the situations began with prescriptions, public concern has led to new rules and regulations to limit the opioid drugs getting into the hands of patients while still providing the quality of care necessary to treat acute and chronic pain and other medical conditions. In time, the information may show which tools are providing the best results.

Elmiron, also known as pentosan polysulfate sodium, is a medication prescribed to treat a bladder condition. Even though it has been around for several decades, new information links it to an eye condition, which can lead to vision loss.

An initial report in 2018 linked Elmiron to retinal damage. After this report was released, three ophthalmologists reviewed patients who had been given this prescription. They discovered that about one-third of those who took Elmiron had indications of damage to the eye. It could also cause macular degeneration and other eye conditions.

What Does Elmiron Do?

Elmiron is prescribed by doctors to treat interstitial cystitis. It is a condition which leads to chronic pain in the pelvic area and in the bladder. Patients diagnosed with the condition are mostly women, but more than one million people are estimated to have it. Elmiron is prescribed to treat the pain and is the only pill approved by the FDA for this condition.

A medical doctor reported that six of his patients had unusual changes in the retina. They had been taking the medication for over 15 years, which led the doctor to believe that long-term use of Elmiron could cause damage to the eye, specifically the retina. No other information in the patients’ medical histories indicated other causes for the change in vision.

Three ophthalmologists at Kaiser Permanents reviewed all 4.3 million patients in the database. They discovered 140 patients who had long-term use of Elmiron with more than 5,000 pills taken in the last 15 years. A total of 91 patients were willing to come in for an eye exam.

Of the 91, 22 showed definite signs of toxicity to the drug. The more of the drug taken, the more patients who had eye problems. It appears that the longer the person took the medication, the more likely they were to experience a severe eye condition. Doctors recommend that patients who take this drug get screened for damage once a year. If tests indicate damage, the person should talk to their doctor about stopping the prescription.

If the eye damage is found early, damage may be stopped as long as the person stops taking the medication. If the damage is in the late stages, it could lead to loss of vision which is permanent.

What is Interstitial Cystitis?

Interstitial cystitis is a chronic illness which causes pain and pressure in the bladder. It can be severe or just uncomfortable. Many times, the person can be misdiagnosed with a urinary tract infection. A person with this condition will feel the need to go to the bathroom more often while having lower output. In fact, they may feel the need to urinate up to 60 times in a day. There is no cure for interstitial cystitis.

Anyone diagnosed with this condition should be aware of the risks of taking Elmiron and remain under a doctor’s care. If they notice any changes with their sight, they should alert their doctor.

The new drug from Gilead Sciences Inc., Descovy, has been approved by the US Food and Drug Administration for the use to reduce the risk of HIV infection. It has already been in use to treat chronic HIV.

Descovy is a combination of tenofovir alafenamide and emtricitabine. The drug is now approved for use in patients to prevent transmission of HIV from sexual activity. It has specifically been approved for use with men and transgender women who are sexually active with men.

What is Descovy?

The two active ingredients in Descovy are antiviral medications. They work by preventing HIV from multiplying. While it’s not a cure for AIDS, it can treat HIV, which is the virus that causes AIDS.

This medication isn’t designed to be used with other drugs that contain the same or similar active ingredients, including tenofovir, emtricitabine, lamivudine and adefovir. The medication could cause you to have a build-up of lactic acid in the bloodstream. This condition is known as lactic acidosis. They symptoms include muscle pain, difficulty breathing, dizziness, pain in the stomach, feeling cold and tired or weak.

Risks of Descovy

Another risk for this medication is that it can make hepatitis B worse after stopping it if someone has been diagnosed with the condition. It’s also important to let the doctor know if you have been diagnosed with osteopenia which is low bone mineral density or if you have had kidney disease. The doctor may prescribe regular tests for liver function while you are on this medication.

The doctor should be notified if the patient shows any signs of a new HIV infection, has unusual pain in the bones or kidney problems as well as any symptoms that indicate liver issues, such as jaundice, nausea and swelling around your abdomen.

A person may experience side effects even after they stop taking the medication, including trouble speaking, issues with eye movement, weakness, signs of a new infection and swelling in the neck or throat.

Common and Serious Side Effects

Common side effects from Descovy include nausea and stomach pain, weight loss, headache, dizziness, depressions, rash, difficulty sleeping or strange dreams.

Damage to the kidneys increases if you take Descovy with other medicines for cancer, infection, osteoporosis and arthritis. It’s important to let the doctor know all medications a person has been taking, including vitamins and minerals and herbal supplements.

This isn’t the first drug Gilead has produced for treating HIV. The manufacturer has developed other drugs, such as Truvada, Atripla, Complera and others. All of these TDF drugs carry a risk of serious side effects, including bone loss and kidney damage. While these drugs can help treat HIV and improve the quality of life for the person with the disease, it’s important that they understand the risks involved with these drugs. Once they are aware of the possible complications, they can make an informed decision about whether the risk is worth the potential benefits for treating HIV. They can also determine with their doctor’s advice if they are a good candidate for the medication.