What is Changed or New for the RxFiles

1 What is Changed or New for the RxFiles ? Visit to get a complete free indexed compilation of all our Newsletters, Q&A's, Trial summaries & list of references. Table of Contents: 1. Chronological list of some chart changes 2. Latest Newsletter: Antibiotics & Common Infections (Stewardship & Clinical Pearls). 3. Viral Prescription Pad 4. Going Viral Clinic Posters 5. Antibiotics: Potential Harms 6. Flame (Ultibro: LABA+LAMA vs Advair: LABA+ICS in COPD). 7. Empa-Reg (Empagliflozin for CV benefit) 8. Leader (Liraglutide for CV benefit). Jun-Jul 2018 NEW guidelines: New CDN: Clopidogrel & ASA x3mon better than ASA for TIA 5 vs , ANN'18 Multiple Sclerosis- Disease Modifying tx Ceftobiprole a cephalosporin but major bleeding vs . Point AUA'18 Erectile Dysfunction Contrave for weight loss, Budesonide-formoterol combo as need vs regular dosing in mild asthma: asthma CANMAT'18 Canadian Bipolar Disorder Fasenra for eosinophilic asthma, exacerbations & ICS exposure, improves lung fx, but sx's.

2 SYGMA 1 & 2. CASL'18 Chronic Hepatitis C Management Movapo for Parkinson's, new generics: Abilify, Champix, Coversyl Plus, Inspra, Macrobid, Mavik, Siliq for psoriasis, Tamiflu, Vimovo, Zeldox Suboxone 12 /3 & 16 /4mg SL tabs Methadone no longer needs a special prescribing license Trelegy Ellipta triple therapy for COPD Dolutegravir may have increase neural tube defects during first trimester use Viibyrd for depression Sask. SPDP some changes New FDA: -Full Formulary: Celecoxib, clopidogrel & olanzapine Aimovig erenumab for migraine CGRP -EDS: Axert (for migraine 12yrs), Botox (for urinary incontinence), Andexxa Factor Xa antidote Glatech (glatiramer), Mictroyl Pediatric, Nucala, Odefesey Repatha, & Stelara Imvexxy for dyspareunia new NIHB: Lucemyra for opiate withdrawal -Full: Adderall, Basaglar, Ditropan XL, Mictoryl Pediatric Olumiant for arthritis -EDS: Adempas, Afinitor, Bosulif, Erelzi, Esbriet, Ibrance, Imbruvica, Inlyta, Retacrit generic epoetin biosimilar Invega Trinza, Jakavi, Nucala, Repatha, Stivarga, Tasigna, Uptravi, Vosevi &.

3 Xalkori. Feb-May 2018 NEW guidelines: New CDN: Sask. SPDP some changes ACG'18 Crohn's disease in Adults Addyi for female sexual desire -Full: Benztropine 1mg, Ciclopirox & Methotrexate SC inj;. ACIP'18 Adult & Child Vaccine Recommendations Adylxine for diabetes -EDS: Erelzi (generic Enbrel), Invega Trinza, Ravicti, Taltz, Uptravi & Vosevi. ACP'18 A1C targets for Nonpregnant adult Type 2 diabetes Akynzeo for nausea new NIHB: AHA/ASA'18 Acute Ischemic Stroke Mavenclad for multiple sclerosis -Full: Enstilar, Entocort 3mg, magnesium oxide 835mg & methotrexate SC inj;. APA'18 Alcohol Use Disorder Ozanex for impetigo -EDS: Entyvio, Rotigotine, Tantum, tenofovir & Xigduo. ASCO'17 Antiemetics Guideline Ozempic for diabetes Odyssey ACC'18: Alirocumab over in ACS pts all-cause death: to CADDRA'18 Canadian ADHD 4th Edition Guide Symtuza for HIV Cares: Allopurinol or febuxostat in gout+CVD pts: all-cause death with febuxostat Diabetes Canada Diabetes Guidelines'18 Trumenba for meningitis Impact: Trelegy in COPD had exacerbations but pneumonia, many on previous ICS vs (Breo or Anoro).

4 Endocrine Soc'18: Testosterone tx-male Hypogonadism Xiidra for dry eyes new generics: budesonide nebs, Coversyl Plus, hydralazine, perindopril, Hypertension Canada'18 Adult/Children & Pregnancy New FDA: Suboxone & ziprasidone. KDIGO'17 Chronic Kidney Disease-Mineral & Bone Dx Biktarvy for HIV (Lower Pan-Canadian prices: amlodipine, metformin, rabeprazole, rosuvastatin ). Jan 2018 NEW guidelines: New CDN: Sask. SPDP some changes ACC/AHA'17 Hypertension in Adults Entuzity insulin for diabetes -Full: Basaglar, Enstilar, Humalog Kwikpen 200 IU/mL, M-Ediat IR & Truvada ACC'17 Manage Bleeding on Oral Anticoagulants Foquest for ADHD. ADA'18 American Diabetes Guidelines Glatect for multiple sclerosis Tardis: triple antiplatelet therapy (ASA+clopidogrel+dipyridamole) NS vs CCS'18 Antiplatelet Therapy Focused Update Tremfya for plaque psoriasis standard (clopidogrel or ASA+dipyridamole) for stroke, but had major bleeding CTS'17 COPD Pharmacotherapy New FDA: VERO: fractures with teriparatide vs risedronate in severe PMO osteoporosis SOGC '18 Overactive Bladder Pharmacotherapy Admelog insulin for diabetes USPSTF'17 HRT Primary Prevention-Chronic Conditions Juluca for HIV new generics: metformin ER, desvenlafaxine VA/DoD'17 American Type 2 Diabetes Ozempic for diabetes (semaglutide).

5 Steglatro for diabetes (ertugliflozin). June-Dec 2017 NEW guidelines: New CDN: Sask. SPDP some changes AACE'17 for menopause Duavive for vasomotor HRT -Full: Cyklokapron, Monurol, Proglycem, Synthroid 137mcg & TactuPump Forte ACC'17 for Non-statin LDL lowering Erelzi is biosimilar etanercept -EDS: Brenzys, Campral, Grastofil, Fentanyl 37ug patch, Genvoya, Jadenu, Neupro, ACC'17 for Syncope Maviret & Vosevi for hepatitis C Revia, Salagen, Rilutek & Xigduo ACC'17 for Heart Failure Update Ocrevus for multiple sclerosis new NIHB: ACG / CAG Management of Dyspepsia Shingrix for shingles vaccine -Full: Abilify Maintena, Aptivus, Arnuity, Celebrex, Celsentri, Intelence, Isentress, ACR'17 Osteoporosis-Glucocorticoid Induced Tresbia is insulin degludec Revia, Triumeq & Zeldox ACR'17 Perioperative Management of DMARDs Viberzi for IBS-D -EDS: Breo Ellipta, Daklinza, Dicetel, Entresto, Epclusa, Foxiga, Inspra, Jentadueto, Canadian Schizophrenia Guidelines 2017 Vemlidy for hepatitis b Modulon, Myrbetriq, Prevacid Fastab, Strattera, Viread, & Zepatier CCS'17 Canadian Heart Failure New FDA: Canvas: canagliflozin CV events, but amputations (ie.)

6 Toe or metatarsal). Drugs in Pregnancy & Lactation Eleventh Edition 2017 Bevyxxa for VTE prophylaxis RE-DUAL PCI: dabigatran & clopidogrel- bleed vs triple therapy with warfarin ESC'17 Guidelines for DAPT, PAD & MI. Mavyret & Vosevi for hepatitis C Compass: Rivaroxaban bid + ASA CV but bleeding in 20 CAD prevention Trelegy Ellipta triple therapy for COPD Exscel: Exenatide 2mg SC weekly had non-significant CV benefit vs placebo cost: Dipentum & Zaditen new generics: Atripla, Avandia, caspofungin, clonidine, deferasirox, Diclectin, cost: flecainide, gliclazide, Truvada Enbrel (with Brenzys), hydralazine, phenytoin, Sporanox, Truvada & Viread Apr-May 2017 NEW guidelines: New CDN: Sask. SPDP some changes ACP'17 Low Back Pain Cinqair for asthma, -EDS: Acyclovir susp, Entresto, Entyvio, Plegridy &. ACP'17 Osteoporosis Guidelines Enstilar for psoriasis, for hepatitis (Daklinza, Epclusa, Sunvepra & Zepatier), ACP & AAFP'17 Hypertension for Adults 60yrs FIAST for diabetes (rapid insulin), Einstein-Choice: extended rivaroxaban better than ASA at recurrent VTE events AHA'17 Management of Valvular Heart Disease Glyxambi for diabetes, Fourier: evolocumab PCSK9 antibody CV events vs over , not mortality CHEP'17: Canadian Hypertension Guidelines Lancora for heart failure, Topic: after 1month of DAPT in ACS with ticagrelor or prasugrel, & ASA, switch to clopidogrel bleed CDN'17 Opioid Therapy & Chronic Noncancer Pain Mictoryl for urinary incontinence, Trinity: Triple COPD tx (beclomethasone, formoterol & glycopyrronium) > tiotropium CUA'17 Adult Overactive Bladder Odefsey for HIV, & Trust.

7 Levothyroxine no apparent benefit, older pts with subclinical hypothyroidism SOGC'17 Combined Hormonal Contraception Rexulti for schizophrenia. TT trials: testosterone improves hemoglobin & BMD, but total CV plaque new generics: cost: amlodpine, atazanavir, atorvastatin, cholestryramine, clopidogrel, Epclusa, Cellcept, Exelon patch, Olmetec, fluoxetine liquid, gliclazide MR, indomethacin, modafinil, olmesartan, Omnaris, Reyataz & Sinemet IR. pantoprazole, ramipril, rosiglitazone, simvastatin, Sunvepra & Zepatier. New FDA: Ocrevus for MS (RRMS & PPMS). cost: cabergoline Jul 2016- NEW guidelines: New CDN: Sask. SPDP some changes AASLD'16 American Chronic Hepatitis B Blexten & Rupall an antihistamine, -Full: Arnuity Ellipta, Backup Plan Onestep & Plan B, Tecta Mar 2017 ACG'17 H. pylori Brenzys (etanercept) for RA, -EDS: Cosentyx, Forxiga, Ofev, Simponi IV, Xolair, Zaxine ACP '16 Gout Brivlera for epilepsy, Descovy- HIV, ACP'16 Insomnia Copaxone for 3x per week dosing, new NIHB: ACP'17 Back Pain Epclusa & Sunvepra for hepatitis C, -Full: alendronate, ezetimibe, Fosavance, levetiracetam, risedronate, solifenacin ADA 2017: Diabetes Invega Trinza for schizophrenia, & tolterodine LA, AHA'16 Drugs that Exacerbate Heart Failure Invokamet for diabetes, -EDS: Actemra, Aptiom, Breo & Incruse Ellipta, Cosentyx, Dapagliflozin, AHA'16 Drugs that Interact with Statins Kevzara for rheumatoid arthritis, Duaklir Genuair, Inflectra, Inspiolto & Spiriva Respimat.

8 Jardiance, Orencia, AAN'16: Restless Leg Syndrome Lixiana (edoxaban) for a fib/PE, Xeljanz. ATA'16 American Hyperthyroid Natesto for andropause, Canadian Opioid DRAFT Guideline 2017 Praluent for cholesterol, LEADER: Liraglutide vs placebo in T2DM- CV events & weight, but GI events CANMAT'16 Canadian Major Depression Stelara for Crohn's disease, PEGASUS-TIMI 54: Ticagrelor vs placebo with prior MI- CV events but bleed CCS'16 Atrial Fibrillation Update Synjardy for diabetes, PRECISION: celecoxib was non-inferior to naproxen & ibuprofen for CV safety CCS'16 Canadian Dyslipidemia Taltz for plaque psoriasis, PIONEER AF-PCI: rivaroxaban 15mg OD + clopidogrel or Gold: COPD 2017 Guidelines Viberzi for IBS, riva bid + DAPT, had bleeding than warfarin + DAPT (triple therapy) tx H. Pylori Tortonto Consensus 2016 Zinbryta for multiple sclerosis. IAS-USA'16 Adult HIV new generics & cost: Baraclude, NACI'16: Prevnar for 65yrs Bezalip, Fosavance, Inflectra, SOGC'16: Nausea & Vomiting in Pregnancy levetiracetam, Meltz, Micronor, Nasacort, Nasonex, Omnairs, quetiapine, rasagiline, Seasonale, Sensipar & Tamiflu.

9 Cost: Anafranil, Aventyl. New FDA: Relistor orally, Stelara for Crohn's Mar 2016- NEW guidelines: New CDN: Sask. SPDP some changes American JAAD'16 Acne guideline Bydureon for diabetes, -EDS: For COPD: Duaklir Genuair, Incruse Ellipta, Inspiolto Respimat & Spiriva Respimat;. Jun 2016 American ACC'16 Role of Non-Statin tx in CVD Risk Lunesta for sleeping, Actemra SC, Fibristal, Inflectra, Jardiance, Lemtrada, Prezcobix, American ACC/AHA'16 Update: Heart Failure Praxbind for reversing dabigatran, Vyvanse 10mg & Xeljanz. American APA'16 Antipsychotics: agitation with Dementia Trulicity & Xiguo for diabetes, new NIHB: American AACE/ACE'16 Obesity Medical Care Zerbaxa for infection. -Full: Climara Pro, Isosrbid mononitrate, moxifloxacin & Plan B. Canadian Hypertension: CHEP'16 new generics & cost: abacavir, -EDS: Diastat, Fosrenol, Invokana & Pennsaid. Canadian CDA'16 Diabetes Update: Flozins etc.

10 Alfuzosin, Clindoxyl, duloxetine, FLAME: LAMA+LABA Ultibro less AECOPD than LABA+ICS Advair in COPD. CDC'16 Prescribing Opioids for Chronic Pain efavirenz, Estrace, Kivexa & Valcyte. IRIS: Pioglitazone post TIA/stroke ( stroke/diabetes but weight/edema/fractures). Chest'16 VTE guideline-DOAC's option New FDA: Socrates: Ticagrelor in acute ischemic stroke/TIA: not superior to ASA to stroke USPSTF'16 ASA Primary Prevention CVD/Cancer Descovy & Odefsey for HIV. Summit: Fluticasone + vilanterol in high CV risk COPD pts, did not mortality Nuplazid for psychosis with Parkinsons Over the Counter OTC Advil 12hr, Flonase & Nexium Zinbryta for MS. Jun 2015- NEW guidelines: New CDN: Sask. SPDP some changes ACIP'16 USA Adult & Pediatric Vaccine Guides Arnuity Ellipta for asthma, -EDS: Abilify Maintena for Schizophrenia, Anoro Ellipta for COPD, Feb-2016 ACOG'15 Emergency Contraception Basaglar insulin for diabetes, Aptiom for seizures, ACOG'15 Nausea and Vomiting of Pregnancy Entyvio for ulcerative colitis, Diacomit for seizures, Eliquis for PE/DVT, Holkira Pak for hepatitis C, American Diabetes Association Update 2016 Daklinza for hepatitis C, Inspra for heart failure, Invokana for diabetes, Latuda for Schizophrenia, American Geriatrics Society 2015 Beers Update Duaklir & Inspiolto for COPD, Myrbetriq for overactive bladder, American ACR'15: Rheumatoid Arthritis Ella for emergency contraception, Tivicay & Triumeq for HIV & Ultibro Breezhaler for COPD.