The long lists of side effects that are listed for each drug by the FDA

in Welcome to the Forum ! Tue Nov 14, 2017 7:00 am
by eggles • 924 Posts

The prostaglandin travoprost is available with the same preservative as latanoprost, or with a different preservative as Travatan Z. For any drug, the vehicle has several parts: the drug, the preservative to keep bacteria from growing in the bottle, and chemicals added to prolong the drug life, keep it at the right acidity, and make it more comfortable on the eye. We pay attention to the preservative because there is a lot of evidence that patients sometimes stop being able to tolerate drops because of irritation or allergy caused by the preservative, not the drug in the bottle. For many years, most eye drops used a preservative called benzalkonium chloride, which kills bacteria well, and even helps to get the drop into the eye better. But, if you became allergic to benzalkonium, you were in trouble, as most of the drops had itóso you couldnít take any of them. More recently, each class of glaucoma drug has an alternative with either a different preservative or a form that is preservative-free. These cost significantly more.

The side effects from a drug can be listed in various ways. In this section, Iím going to distinguish between what I call the possible side effects and all the others that are listed by the FDA paper that comes with drugs or the lists that are handed out by drug stores, chains, and prescription plans. The possible side effects are things that happen often enough that you might actually have them happen to you. They are side effects that are clearly associated with taking the drop type based on good evidence. These go away when the drug is stopped and come back if it is restarted. This doesnít mean that a unique side effect couldnít happen just to you and not to anyone else. Our approach at the Glaucoma Center of Excellence is always to stop a drop when a patient thinks something bad is due to the medicine. We like to see if the side effect comes back when the drug is restarted, too. While it is reasonable to always suspect the drug, itís easy to test whether the drug is the cause by this type of stop trial. Many times, whatever happened is just incidentally occurring and isn't due to the drops.

The long lists of side effects that are listed for each drug by the FDA, and sometimes handed out by drug stores, contain side effects that are rare, most of which arenít even related to the drug. Drugs are tested for effectiveness by comparing the response of people treated with the drug to people who took drops that haven't got any drug in them. These dummy drops are called placebos, and we use them to show that the drug has a real effect that wouldn't be seen by chance. The FDA listing includes as a side effect anything that happened to 1 in 100 (1%) or more persons in the year-long studies done to get the drug approved. However, they include things that happened 1% of the time whether they happened in the drug-treated group or the placebo group. So, prostaglandin eye drops are said to be more likely to cause upper respiratory infections, probably because there were a lot of colds in everyone in the final study trial. Prostaglandin eye drops have a tiny amount of chemical per drop. The amount is measured in micrograms, or millionths of a gram. Most of it winds up staying in the eye, or it is broken down before it gets into the blood stream. In fact, I have been told you canít measure any prostaglandin drug in the blood after standard doses. So how could it cause systemic things like a cold? Some of the things Iíve seen on drug store side effect lists have never happened during my 40 yearsí experience seeing glaucoma patients every week. The best approach is to ask your doctor about side effects you are worried about.cheap lumigan eye drops
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