According to a report from Reuters, taking ginkgo biloba, St. John’s wort and several other widely used herbal medications may impede the potency of prescription drugs, making them more or less effective.

Experts at the Journal of the American College of Cardiology found that mixing herbs and drugs also may cause serious heart rhythm problems and bleeding.

“We can see the effect of some of these herb-drug interactions — some of which can be life-threatening — on tests for blood clotting, liver enzymes and, with some medications, on electrocardiogram,” Dr. Arshad Jahangir of the Mayo Clinic in Arizona said in a telephone interview.

Many patients fail to disclose their use of herbal remedies so healthcare providers should be more probing, Jahangir said in a telephone interview.

“We need to be actively ask about alternative or complementary medicine patients may be seeking on their own to assess these potential interactions or side affects,” said Jahangir, a cardiologist.

“They don’t even consider that herbs could have a negative effect,” he said. “Their impression is that ‘natural’ is safe,”

So whether you use an ACE inhibitor like Vasotec or Monopril, alpha agonists like Zanaflex, or angiotensin II receptor blockers like Avapro or Atacand, it is a good idea to check with you doctor and make sure there won’t be an interaction with any of the additional supplements you may be taking.

Remember, whenever dealing with potential interactions between medicines and supplements, it is always better to error on the side of caution.

Better safe than sorry.

Earlier this month, a closely-watched trial over the osteoporosis drug Fosamax ended in mistrial, to the frustration of nearly everyone involved. The trial was marked by great tension, with a deadlocked jury, reports of threats of physical violence, and a judge-ordered cooling-down period.

What could cause such intense drama? Well, this was just one of approximately 900 state and federal cases pending against Fosamax, alleging that that medication causes osteonecrosis of the jaw (the death of jawbone tissue). In large part, the tension in the Manhattan courtroom was that this trial — the first — was supposed to be an indicator of how these hundreds of similar cases might proceed. The other major factor is that it is notoriously difficult to “prove” drug-related injuries, and this difficulty was definitely shown in the frustration and tension among jury members.

Millions of women have taken Fosamax (alendronate), a Merck drug that was approved in 1995 to treat osteoporosis associated with menopause, and in 1997 to prevent osteoporosis itself. Until the recent introduction of some competing medications, it was one of the most popular drugs in the U.S. It is still prescribed millions of times per year to women suffering from bone loss.

In short, Merck’s defense on this topic is that there is no definitive evidence that Fosamax causes the death of jaw tissue, while plaintiffs and their lawyers insist that Merck overpromoted Fosamax without warning doctors about the potential for jaw injury. Obviously, no conclusions were reached.

Of course, this is of great interest to women who may have taken, or are considering taking, Fosamax. Only your doctor can decide what is the right choice for you, but we thought we would enumerate the other medications available for treating osteoporosis for those doing research on Fosamax alternatives. One very important thing to be aware of it is that Fosamax is not the only osteoporosis drug in this class (the bisphosphonates), which all have a similar mode of action. Fosamax is being talked about most in the media, but all are associated with some amount of risk of damaging the jaw.

If you do choose to take a bisphophonate, know these facts:

• A high proportion of jaw injuries occur following high-dose intravenous administration, so that is a particularly risky way to take the medication.
• As many as 60% of the cases are preceded by a dental surgical procedure involving the jaw. In short, women who are expecting major dental work should consider delaying treatment with Fosamax, Boniva, Actonel or similar drugs until after their dental surgery.

Here are the main alternatives on the market for Fosamax:

1. Actonel (risedronate) is a bisphosphonate manufactured and marketed by Procter & Gamble and Sanofi-Aventis. It belongs to the same family of drugs as Fosamax, and may be associated with the same jaw side effects.
2. Boniva (ibandronate) is also a bisphosphonate, manufactured and marketed by GlaxoSmithKline and Roche Laboratories. It is a competitor to Fosamax, and may also affect the jaw tissue.
3. Evista (raloxifene) is NOT a bisphosphonate , but rather an oral selective estrogen receptor modulator from Eli Lilly and Company that affects bones through estrogen. Evista may be an interesting alternative for women concerned about their jaw health or planning oral surgery.

Also this month, The Wall Street Journal published an article called “From the Osteoporosis Front, Updates on Potential New Drugs.” These are the up-and-comers in clinical trials and going before the FDA. The story covers the latest news about Wyeth’s Viviant, Pfizer’s Fablyn, Amgen’s denosumab, and other upcoming treatments for osteoporosis.

If you are interested in following the Fosamax case that ended in a mistrial, it is expected to be re-tried in the spring. The name of the case is “In re Fosamax Products Liability Litigation, U.S. District Court, Southern District of New York (Manhattan), No. 06-1789.”

It hadn’t really occurred to me, until I read a great rant by Jen Huntley in the Reno News & Review the other day, just how completely the web of Big Pharma envelops our lives.

In other words, Big Pharma doesn’t just provide us drugs when we get sick. Big Pharma also helps us get sick in the first place. It’s the perfect racket: they’ve got us coming and going.

As Jen writes:

While those of us with adequate or good health insurance looked the other way, health care became a giant profit-making machine for insurance companies and hospitals—but the pharmaceutical industry really takes the cake.

Not only have they bought the government with profits built on taxpayer subsidies, but other reports also reveal the enormous role of drug companies on our food supply. Seventy percent of all antibiotics are fed to livestock to keep them alive long enough to reach market weight in crammed feeding lots. As Prevention magazine reported last month, the superbug MRSA—a deadly, drug-resistant form of staph—is now present in our food supply.

Great. Taxpayer-subsidized drugs in our food make us sick—we go to the hospital and get fed more drugs. With its vast and powerful lobbying system, the pharmaceutical industry writes both agricultural and medical policy to feed its own bottom line. [emphasis added]

Just how serious is the MRSA threat created by the overuse of antibiotics in pigs and other livestock? Chances are, we won’t find out until it’s too late. Here’s an excerpt from an MSNBC.com report:

Until recently, the CDC has acknowledged the presence of MRSA in meat but downplayed the danger … One reason the CDC and the National Pork Board must guess about transmission rates — and why we don’t know exactly how many MRSA-related infections occur — is that the federal government doesn’t collect data on MRSA outbreaks, says Karen Steuer, director of government operations for the Pew Environment Group. According to the US Government Accountability Office, there’s no testing for MRSA on farms. And the National Antimicrobial Resistance Monitoring System tests just 400 retail cuts of meat each month for four drug-resistant bacteria — which don’t include MRSA.

And yet, according to Food Poison Journal, recently published research shows MRSA was present in nearly half of pigs in a study of U.S. pig farms.

Fortunately, Congress finally appears to be taking action against the overuse of antibiotics in farm animals. The FDA is recommending the following actions, which have been endorsed by the AMA (but opposed by the National Pork Producers Council, among others) –

Phasing out and banning the use of antimicrobials for non-therapeutic (i.e. growth promoting) use in food animals.

Immediately banning any new approvals of antimicrobials for non-therapeutic uses in food animals and retroactively investigating antimicrobials previously approved.

Strengthening recommendations in FDA Guidance #152 which requires the FDA determine that the drug is safe and effective for its intended use in the animal prior to approving an antimicrobial for a new animal drug application.

Facilitating the reduction in industrial farm animal production use of antibiotics and educating producers on how to raise food animals without using non-therapeutic antibiotics.

We’ll see if this recommendation goes through … or if it dies on the vine like Canadian drug reimportation and other measures popular with the public, but unpopular with powerful vested interests.

Think about what will happen if MRSA continues to spread from hospitals — where it currently is at dangerous levels — into the general population. It will actually solve some big problems for Big Pharma.

As we’ve reported here before, a number of supermarket chains and other retailers are now giving away common antibiotics for free. The reason is that patents on these drugs have long since expired, so the prices for these drugs are very low. It’s worth it to the retailers to give them away in order to get you into their stores.

I have a friend who recently acquired an infection caused by MRSA, which as we know is not treatable by those “free antibiotics.”

He had to purchase a special antibiotic called Zyvox (linezolid) to treat it. The price for Zyvox at his corner drug store was $1,400. Even after insurance, he still had to pay $400 — for a 10-day supply.

If you’re Big Pharma, that sure beats free, doesn’t it?

PharmacyChecker.com is the leading verification authority for online pharmacies in the United States and Canada. Over the past six years, PharmacyChecker arguably has done more than any other organization to help Americans make safe choices when buying prescription drugs from Canada. Google requires all pharmacies in its ad network to receive PharmacyChecker verification, and eDrugSearch.com requires all member pharmacies to have PharmacyChecker verification as well.

Unfortunately, PharmacyChecker.com has been under attack from Big Pharma and its proxies in recents months. Last year, Big Pharma launched a disinformation campaign, advanced by the NABP and other organizations, to link licensed, legitimate Canadian pharmacies with dangerous rogue pharmacies. This despite the fact that no American has ever been reported injured by a drug purchased from a licensed Canadian pharmacy.

We chatted recently with PharmacyChecker.com Vice President Gabriel Levitt about his organization’s mission, Big Pharma propaganda, and the drug reimportation legislation recently put before Congress.

Q: When and why was PharmacyChecker.com created?

A: PharmacyChecker.com opened its “virtual doors” in April of 2003 to help Americans identify licensed pharmacies operating online that offered the best prices. The earliest origins of the company began with requests to ConsumerLab.com’s president, Tod Cooperman, M.D., about how to find safe Canadian online pharmacies and Dr. Cooperman’s subsequent decision to start such a service focusing on pharmacies both in and outside the United States.

Q: How did your relationship with Google come about? How does it work?

A: In 2006, the search engines needed a new company to help them qualify and monitor online pharmacies to prevent “rogue” online pharmacies from advertising in their search marketing spaces. PharmacyChecker.com was already involved in precisely these efforts for three years and was the natural company to go with.

Q: In the past year, the pharmaceutical industry, the NABP and others have mounted a campaign to convince people that Canadian pharmacies aren’t safe. What are your thoughts about the industry’s arguments and tactics?

A: These groups have cleverly taken genuine concerns over counterfeiting and unethical pharmacy practices by truly rogue websites and associated those fears with safe, licensed non-U.S. online pharmacies that operate ethically. They do this by publishing “not approved” lists that include safe, Canadian-based online pharmacies AND dangerous, rogue websites, attempting to brand them as one and the same.

With funding by Pfizer, for example, the NABP created such a list of “not approved” pharmacies. The pharmaceutical trade group, PhRMA, created a website that directs people to this list. Other groups that appear to receive funding or revenue from pharmaceutical companies have used similar schemes to brand licensed non-U.S. pharmacies as rogue, illegal, illegitimate, or not approved.

Why are pharmaceutical companies doing this? Most likely because safe, Canadian-based online pharmacies are putting a dent in their profits by allowing Americans to buy their drugs at lower prices.

The fact is that non-U.S. websites that are verified by PharmacyChecker.com require an original prescription, fill orders with licensed pharmacies and meet other important safety standards of online pharmacy practice. These sites help Americans who can’t afford the drug prices here at home. In complete contrast, rogue online pharmacies are dangerous, unethical, and often take advantage of the American consumer. It seems wrong that NABP, the pharmaceutical industry, and related parties are trying to lead Americans to believe that these two very different types of websites are one and the same.

Recently, we have learned that these groups are using similar tactics to scare search engines from permitting low cost pharmacies in Canada and elsewhere from advertising. It seems particularly galling for them to do this now, at a time when millions of Americans are already skipping medication due to cost.

Q: One of the industry’s main arguments against reimportation is that the drugs that licensed Canadian pharmacies sell to Americans do not meet the same safety standards as the drugs sold to Canadians. What is your response to this?

A: Regulated drug products manufactured under Good Manufactured Practices (GMP) and sold in Canada and many other countries are just as safe as those approved in the United States. If the head of the NABP or even the Pharmaceutical Researchers and Manufacturers of American were travelling in Winnipeg and needed medication due to a sudden illness would they trust a Canadian pharmacy? Of course they would. Drug products approved in Canada are just as safe as those in the U.S.

Q: We know that the industry has been planting stories in the news media, including attacks on Google and PharmacyChecker. Are you concerned about these attempts to discredit you? How are you responding to them?

A: Such stories do appear to be stimulated by the pharmaceutical industry or those supported by the industry. While some contain legitimate concerns, they typically build on the strategy of mixing issues, trying to mislead and unnecessarily scare consumers and other parties. On several occasions we have been contacted by journalists who claim that a dangerous drug can be purchased without a prescription from a site approved by us. We have proven this to be incorrect, as in the case above. We are proactive in contacting and correcting those sites that publish incorrect or misleading information.

Q: Do you believe that the Pharmaceutical Market Access and Drug Safety Act of 2009, allowing American consumers to purchase drugs from Canadian pharmacies, will be made law this year? Why or why not?

A: That bill was voted down in committee. Right now an amendment has passed in the Senate that would help Americans continue to purchase safe medication from Canada, by not allowing newly allocated funds to be used to confiscate such shipments; although confiscations have been rare in recent years anyhow. It’s uncertain if this amendment will become law.

I really don’t know what will happen in Congress but I hope our government doesn’t rely on promises from the pharmaceutical companies about lowering drug prices in the future as a reason to stop Americans from getting their medications now. The recent announcement that pharmaceutical companies will provide a discount to seniors during the “gap” in Medicare Part D drug programs is not much of a concession and of no value to the vast majority of Americans.

Q: Anything else you’d like to share with our audience?

A: Americans need to be mindful of the intent of pharmaceutical companies to scare them away from lower-cost, licensed pharmacies abroad. They should question information that suggests dangers with such pharmacies and use PharmacyChecker.com’s free verification research and drug price information to help them. Also, our website provides drug price comparisons of non-U.S. pharmacy prices and U.S. pharmacy prices. Americans should know that many generic drugs are cheaper in the United States and should take advantage of those low prices.

I read the following disturbing Q&A in Joe and Teresa Graedon’s People’s Pharmacy column this morning:

Q: I once worked for a pharmaceutical company that ordered a raw ingredient, diphen-hydramine, from China. I was a quality-assurance inspector and had to inspect incoming material.

That ingredient was trashy, with what looked like a lot of floor sweepings and black blobs of something I could not identify. I placed all of that shipment on reject. I came in to work the next day and was told by the boss that he had authorized the release of that ingredient to be used in production!

When I left work later that day, I called the Food and Drug Administration and reported the whole thing. I called in the next day and quit my job.

A: We forwarded your shocking story to the FDA but have not received a response. Diphenhydramine is an antihistamine found in dozens of allergy medicines as well as sleep aids and nighttime pain pills.

Past experience with adulterated heparin and milk products, as well as pet food, suggests that Chinese ingredients require monitoring. A recent report from the Institute for Safe Medication Practices concludes, “It is increasingly clear that the nation is experiencing serious problems in ensuring that generic drugs are manufactured with adequate quality control.”

By now, we’ve all heard horrors stories about unsafe drugs, food, toys and other products imported from China. But I’m still amazed that the American public hasn’t been calling for the heads of government officials over this problem; it’s a basic responsibility of our government to keep its citizens safe.

In a report issued earlier this month, the Institute for Safe Medication Practices (ISMP) argues that one reason the public has not been more outraged is that the FDA has been less than forthcoming in sharing information. While the public knows that there have been recalls, the ISMP says, it doesn’t know just how serious the problem is.

As the ISMP summarizes the issue:

Concerns continue regarding serious problems our nation seems to be facing to ensure generic drugs are manufactured with adequate quality control.

In the first quarter of 2008, there were urgent recalls of most of the nation’s supply of one form of generic heparin and millions of fentanyl patches from several generic drug manufacturers. In the second quarter, about 50% of the nation’s supply of generic digoxin was recalled because over-strength tablets may have been manufactured and distributed. An additional generic digoxin recall was announced in March 2009.

In the third and fourth quarters of 2008, urgent recalls were announced for generic versions of morphine sulfate, propafenone, and isosorbide. All involved over- or under-strength tablets that could have significant health consequences. In addition, two NJ plants of the Actavis Group were closed and all products manufactured there were recalled due to manufacturing concerns. In December 2008, KV Pharmaceuticals’ plants were closed to resolve quality control problems.

The concern regarding the manufacture of generic drugs has received little public and official notice in part because FDA does not require disclosure of the size and impact of a product recall. To cite one example, neither Caraco Pharmaceutical Laboratories nor FDA would reveal how many digoxin tablets were involved in its March 31, 2009, recall notice.

Based on these findings, it seems apparent that FDA’s current system for inspecting plants, dealing with violations, and managing product recall notices requires systematic independent review.

While we’re not sure (yet) that an independent review of FDA practices is necessary — we may see significant change with the new leadership President Obama has put in place — we agree strongly that the FDA should share more information about the risks and dangers it is encountering in our drug supply.

That’s only fair to the public. It’s a step Obama’s FDA should take immediately.

Here’s a well-produced report on the dangers of remote-consultation Internet pharmacies from the Pensacola, Fla., Fox affiliate. Since this piece originally aired last year, Hogan’s Pharmacy, one of the pharmacies exposed in the story, has been shut down and the pharmacist indicted.

Researchers from the University of Chicago Medical Center report in the Dec. 24/31, 2008 issue of JAMA that more than half of older Americans take five or more prescription medications — and that an alarming number of these seniors risk harmful drug interactions.

We’ve warned of drug interactions here before — and have recommended sites like DoubleCheckMD.com to make sure your drug regimen is safe.  This latest study reinforces the importance of such precautions.

According to the researchers, at least one in 25 older adults take multiple drugs in combinations that can produce a harmful drug interaction.  That’s 2.2 million seniors in the United States.

Nearly half of the drug interactions identified in the study put seniors at risk for bleeding problems. One of the most common was taking warfarin, a medication to prevent blood clots, along with an over-the-counter drug such as aspirin, which also interferes with clotting.

Dr. Nancy Snyderman of the Today Show reported this morning on the growing number of Americans who use prescription drugs, and in many cases several prescription drugs, to treat chronic illnesses.

One of the issues the report raises is the importance of being aware of potential drug interactions; be sure to talk with your doctor and pharmacist, and to use online tools like DoubleCheckMD, to ensure that your drug regimen is safe.

A group of students at California Northstate College of Pharmacy put together this short video on the dangers of sharing prescription drugs like penicillin and Adderall. (Remember, they’re training to be pharmacists — not actors.)

The Day of New London, Conn., has a nice article on Dr. Peter Rost’s bid for FDA commissioner. Here’s an excerpt referencing our interview with Peter:

If Pfizer Inc. were to describe its worst nightmare, it might very well be seeing former company whistleblower Peter Rost become commissioner of the U.S. Food and Drug Administration.

So guess who is actively seeking the FDA’s top post?…

Rost said he is looking for a shakeup of the FDA, including a reorienting of the agency’s priorities from serving the drug industry to helping American citizens.

”That means the agency would focus not only on the fastest and most efficient processing of new drug applications, but would also ensure that unsafe drugs are taken off the market or labeling (is) revised in a more timely manner,” Rost said in an interview this week with eDrugSearch. com, which endorsed his candidacy.

Some of Rost’s most controversial stances include his views on reimportation of drugs from Canada, which he approves, and his opposition to direct-to-consumer advertising.

”DTC advertising is not part of a ‘free market’ – it is part of manipulation of consumers who don’t know better and doctors who give the patient whatever they ask for,” Rost said.