Mot

[John Gill]

I recently attended my local health centre for my annual health check, otherwise known as an MOT. As the name suggests i attend every year in May, round about my birthday. I'm sure there are members who also avail themselves of this service which, i think, is valuable in keeping an eye on things. System is to have what seems like a gallon of blood extracted for analysis for most functions of the body and a week or so later give the results, I've been having it done for about 5 years now and all seems ok, although as i am type2 diabetic( diet controlled) i have to see a podiatrist and visit the retinopathy department to have my vision checked.
Although all the above can be valuable, i sometimes wonder how many people or organisations have access to our personal health information. I see a string of practice nurses whenever I have these checks and have even been invited into the back room of my local pharmacy to discuss my medication and lifestyle, which inevitably involves me blatantly lying about my alcohol consumption.(never could understand what a unit meant). If you access any of these health websites to check something, sure enough- soon after your spam folder is full of offers for things like Blue Pills or penis enlargement. (actually, i would stay away from the latter, those weights play havoc with mobility).
Medication Medication Medication- i know it sounds like a conservative policy mantra, but i seem to take increasing amounts as i get older. My medicine cabinet of late resembles the loading bay of Glaxo Smith Kline.
Gilly

[Keith Tindell]

My chemist kept calling me in for a review of my medication,why?, surely the doctor does this for you, in my case every 6 months. So i asked the doctor if the chemist makes a charge for this, and the answer was, yes, as i deem this review a waste of money, i now decline it, regards KT

[robpage]

I asked my Doctor about hit , he did say they claimed a fee off the NHS for a service he already is paid to do .

[Louis the Amigo]

Hi shipmates, I too am a drug fiend {legal of course} But I was told after my triple bypass, My question was how long must I take the pills for? reply untill you go into your box, I thought after you had it done then you were 100% fit? good as new? and did not need any more pills? very very Wrong!!!! I have been to see my chemist many times over the last few years, she is good fun and into musicals {Hobby}and likes to sing some of her late -test part to her clients, if she is not too busy, but she took me off statins as they dont agree with me thanks to a review, so if you shipmates , or anyone you know has any nasty side effects from any drug, go to see your chemist urgently, some doctors many G.Ps are in the pockets of drug companys and the more drugs they give you , the more they make.

[Keith at Tregenna]

Louis my Amigo:

Could do with changing mine, for some reason not allowed Grapefruit ?

Spoils Brekkie:

Will check out the lady in Boots !

K.

[robpage]

The Simvastatin-Grapefruit Juice Interaction


It is thought that grapefruit products, including grapefruit juice, interfere with an enzyme that is used by the body to break down simvastatin. This means that when taken with grapefruit products, simvastatin stays in the body longer. In fact, clinical studies have shown that grapefruit juice can significantly increase the levels of simvastatin in the blood. In one clinical study, levels in the blood increased by 12-fold when the drug was taken at the same time as large quantities of grapefruit juice. Even one glass of grapefruit juice daily can significantly increase the levels of simvastatin in the blood.

Recommendations


People taking simvastatin should not drink grapefruit juice, eat grapefruit, or use grapefruit supplements, as they can increase the levels of this medication in the blood. This, in turn, can increase the chances of developing a serious muscle problem (for example, myopathy or rhabdomyolysis) that can cause the kidneys to stop working and lead to other life-threatening complications. In rare cases, this could result in loss of life.


Grapefruit contains furanocoumarins, notably bergamottin and 6',7'-dihydroxybergamottin, which inhibit the intestinal cytochrome P450 3A4 isoform. This, in turn, slows metabolization of simvastatin and a large number of other drugs, resulting in higher plasma levels of the drug. Due to the risk of toxicity, patients taking simvastatin should avoid intake of grapefruit and grapefruit-containing products.
On August 8, 2008, the FDA issued a warning of the risk of rhabdomyolysis, which can lead to kidney failure or death, when simvastatin is used with amiodarone. This interaction is dose-dependent with simvastatin doses exceeding 20 mg. This drug combination, especially with higher doses of simvastatin, should be avoided.On March 19, 2010, the FDA issued another statement regarding simvastatin, saying it increases the risk of muscle injury (myopathy) when taken at high doses (80 mg) or at lower doses in combination with other drugs. This conclusion is supported by the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) trial. The highest 80-mg dose rate causes muscle damage in 61 of every 1,000 patients, according to the research, in contrast to the lower 40-mg dose, which causes muscle damage in eight of 10,000 patients.The FDA warning, re-released on June 8, 2011, suggested that "Simvastatin 80 mg should be used only in patients who have been taking this dose for 12 months or more without evidence of muscle injury (myopathy)" and that "Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug."
Also, a 2010 FDA review of simvastatin drug-drug interactions stated patients should not take simvastatin with itraconazole, ketoconazole, erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, or nefazodone. Patients taking 10 mg of simvastatin should not take it with gemfibrozil, cyclosporine, or danazol. If taking 20 mg of simvastatin, do not take it with amiodarone or verapamil. Diltiazem should not be taken with 40 mg of simvastatin. These drugs mentioned are CYP3A4 inhibitors which decrease the metabolism of simvastatin, therefore increasing the plasma activity of simvastatin, which leads to higher risk of developing rhabdomyolysis and myopathy


Simvastatin is contraindicated with pregnancy, breast feeding and liver disease.[4] Pregnancy must be avoided while on simvastatin due to potentially severe birth defects. Patients cannot breast feed while on simvastatin due to potentially disrupting the infant's lipid metabolism.Simvastatin is also contraindicated with Amlodipine and should not exceed a dosage greater than 20mg/day when taken alongside Amlodipine.

[Keith at Tregenna]

GLAD I READ THE INSTRUCTIONS:

But did so love my grapefruit.

Cheers K

[robpage]

Death is rare Keith , but I avoid Grapefruit too , just in case I am the rare victim

[cappy]

me too

[John Gill]

never cared much for grapefruit anyway.