NMA: Nonprescription Medicines Academy

Quick Takes

August 1st, 2012

  • Data from the Right from the Start study indicate that use of nonprescription nonsteroidal anti-inflammatory drugs (NSAIDs) in early pregnancy does not put women at increased risk of spontaneous abortion. Among 2,780 pregnancies, 1,185 women (43%) reported NSAID exposure, and 367 women (13%) experienced a spontaneous abortion. NSAID exposure was not associated with spontaneous abortion risk in unadjusted models (HR, 1.01; 95% CI, 0.82–1.24) or models adjusted for maternal age (adjusted HR, 1.00; 95% CI, 0.81–1.23). {Obstet Gynecol. 2012;120:113–22.}
  • In a population-based, case-control study conducted in northern Denmark, use of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with a decreased risk of squamous cell carcinoma (IRR, 0.85; 95% CI, 0.76–0.94) and malignant melanoma (IRR, 0.87; 95% CI, 0.80–0.95), especially for long-term use (≥7 years) and high-intensity use (>25% prescription coverage during the total duration of use). NSAID use was not associated with a reduced risk of basal cell carcinoma overall (IRR, 0.97; 95% CI, 0.93–1.01). All estimates of reduced risk were driven primarily by the use of nonselective NSAIDs and older COX-2 inhibitors (diclofenac, etodolac, and meloxicam). {Cancer. 2012 May 29. [Epub ahead of print]}
  • The integrative medicine international research collaboration Natural Standard (www.naturalstandard.com) recently launched Adverse Effects Checker, a point-of-care, decision-support tool that allows clinicians to search for potential causes of reported adverse effects alphabetically or by category. Users can click on specific adverse effects (such as abdominal cramps or hair loss) to see which integrative therapies may have these effects. The checker results are based on evidence from laboratory and animal studies and human case reports and trials; they also incorporate expert opinion and anecdote.
  • The May-June 2012 issue of Journal of the American Pharmacists Association includes a review of the pharmacist's role in identifying and treating constipation, including clinical evidence for the efficacy, safety, and tolerability of the nonprescription laxative polyethylene glycol (PEG) 3350 (MiraLAX). {J Am Pharm Assoc. 2012;52:372-380.}
  • Results of the 2012 Harris Poll EquiTrend survey show that Americans “still cling to classics such as Vicks, Tums, and Phillips Milk of Magnesia to cure what ails them,” according to Harris Interactive. EquiTrend is an annual survey that measures and tracks consumer perception of brand equity for more than 1,500 leading brands; among the product categories included in the study are cold and allergy, pain relief, digestive aids, fiber, laxatives, and sleep aids. Based on the 2012 survey results, prescription medications that have made the switch to nonprescription status are fighting for consumer brand equity, with many falling below the category averages in their respective categories. A summary of results is available at http://www.harrisinteractive.com/vault/OTC Formatted FINAL.pdf.
  • Immediately vaccinating immunocompetent patients who have had a recent episode of herpes zoster may not be necessary, according to a matched cohort study conducted by Kaiser Permanente Southern California. The study included 1,036 vaccinated and 5,180 unvaccinated older men and women (≥60 years of age) with a recent herpes zoster episode. The incidence of recurrent herpes zoster among persons younger than 70 years was 0.99 (95% CI, 0.02–5.54) and 2.20 (95% CI, 1.10–3.93) cases per 1,000 person-years in the vaccinated and unvaccinated cohorts, respectively. The adjusted hazard ratio was 0.39 (95% CI, 0.05–4.45) among persons younger than 70 years of age and 1.05 (95% CI, 0.30–3.69) among persons 70 years of age or older. {J Infect Dis. 2012;206:190-6.}
  • The presence of active thyroid hormone in readily available dietary supplements is of great concern, according to an editorial published in the May 2012 issue of Expert Review of Endocrinology & Metabolism. The article provides an overview of plants that have an effect on thyroid economy or thyroid hormone metabolism and summarizes published information about the presence of triiodothyronine (T3) and thyroxine (T4) in generally available natural hormone preparations. The full text article is available at http://www.expert-reviews.com/doi/full/10.1586/eem.12.16. {Expert Rev Endocrinol Metab. 2012;7:247-9.}
  • A study published in the June 2012 issue of Clinical Biochemistry establishes commonly used baby wash products as potential causes of false positive cannabinoid (THC) screening results. The authors mixed drug-free urine with various commercial soap and wash products used for newborn and infant care. All products except for hospital foaming hand soap caused some level of reactivity with the THC assay; four products—Johnson & Johnson's Bedtime Bath, CVS Night-Time Baby Bath, Aveeno Soothing Relief Creamy Wash, and Aveeno Wash Shampoo—caused assay interference sufficient to yield a positive screen result. {Clin Biochem. 2012;45:605-9.}