OTC to Rx Seems Like the Wrong Direction

It keeps happening. A common substance (two actually), available on drug store shelves everywhere, has been turned into a prescription drug. The current culprit is a drug called Diclegis, prescribed for morning sickness in pregnancy. You may recall that the drug has gained some notoriety because a famous person was shown on her Instagram account holding a bottle of the product and exclaiming over its benefits.

It turns out that Diclegis is nothing more than a combination of an antihistamine and a vitamin. A 30-day prescription runs around $350, while a 30-day supply of doxylamine succinate (aka Unisom) and pyridoxine hydrochloride (vitamin B6) will cost you about $25. Not only is it made from common ingredients, it’s a repeat of a drug that was on the market more than 30 years ago. The drug Bendectin was the only FDA-approved remedy for morning sickness. Many women had filed lawsuits claiming that the drug had caused birth defects in their babies. It wasn’t true, but the cost of defending the suits led the maker to pull the drug from the market in 1983. The only real side effect from Bendectin/Diclegis is sleepiness—not surprising considering that the main ingredient is an antihistamine.

There’s Gold In Them There Pills

As I mentioned in an earlier post, when a drug goes off patent protection the manufacturer often looks to take it to over-the-counter (OTC) status. But every now and then someone with a deep pocketed research grant sees a way to go the other direction. Another example of this transfer is a prescription fish oil. Lovaza contains 840 mg of omega-3 oils from fish, in 1 gram total of fish oil. The maker has run plenty of clinical trials showing that Lovaza provides benefits for your heart and brain. The claim is that Lovaza is better than ordinary off-the-shelf fish oil because it’s more concentrated, or because it’s standardized, or some such. I don’t believe a word of it. If your doctor recommends Lovaza, look for a good high-potency fish oil at your local grocery instead.

Another example is Niaspan. This is simply a time-release formulation of niacin, vitamin B3. A 90-day supply of 500-mg Niaspan will cost nearly $200, while the same amount of ordinary niacin is less than $10 at the grocery. (Or you can do what I do, and buy niacin as bulk powder from online sources such as www.PureBulk.com.) Not to mention that time-release formulas of niacin carry a higher risk of liver damage than the ordinary type.

Be a smart consumer. When your doctor recommends a prescription type of something ordinary, ask why the preference.


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