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 &.

7 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: levothyroxine no apparent benefit, older pts with subclinical hypothyroidism SOGC'17 Combined Hormonal Contraception Rexulti for schizophrenia.

8 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.

9 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.

10 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. 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.