No abstract

Case reports in AERS are suggestive that interactions between valacyclovir and loxoprofen resulting in AKI may occur, while this association needs to be analysed by other methods in more detail in order to determine the real strength of the relationship.

This study investigated the relationships between antipsychotic drug use patterns and direct costs for 3,321 Medi-Cal patients with schizophrenia. Ordinary least-squares regression models were used to estimate the impact on costs of receiving antipsychotic drug treatment, delays in treatment, changes in therapy, and continuous therapy. Average costs were $25,940 per year per patient. Having used an antipsychotic drug was correlated with lower psychiatric hospital costs ($2,846 less) but higher nursing home costs. Completing one year of uninterrupted drug therapy was correlated with higher nursing home costs. Delayed drug treatment and changes in therapy increased the cost by $9,418 and $9,719, respectively.

No abstract

Whereas nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for the treatment of acute or chronic conditions where pain and inflammation are present. Due to the current use profile of NSAIDs, either as prescription or OTC drugs, NSAIDs are likely to be used concomitantly with acyclovir or valacyclovir in clinical practice such as rheumatoid arthritis and herpes zoster virus infection, while the study on the safety of such combinations was hardly reported.It is known that both oral acyclovir (or valacyclovir) and NSAIDs have the potential to affect kidney function, and in rare instances these drugs may cause more severe renal conditions such as acute kidney injury (AKI).3,4) Our previous research has revealed that the concomitant use of loxoprofen (a non-selective NSAID) and valacyclovir might lead to an increase in reports of AKI.5) However, it is not known whether the combination therapy of other NSAIDs with acyclovir or valacyclovir is associated with increased risk of AKI, and we also need to know the differences of drug interactions between acyclovir and valacyclovir.In the present study, we examined the United States Food and Drug Administration (FDA) database to determine the frequency of AKI adverse events in patients taking both acyclovir or valacyclovir and an NSAID, and the differences of drug interactions between acyclovir and valacyclovir. METHODSWe used the public release of the FDA's Adverse Event Reporting System (AERS) database 6) which covers the period from January 2004 to June 2012. The AERS contains reports of adverse drug events spontaneously submitted by physicians, pharmacists, other health care professionals, manufacturers, and consumers from the U.S. and other countries. From the first quarter (Q1) of 2004 through the second quarter (Q2) of 2012, tables including demographic information-DEMO file; drug information-DRUG file and adverse events coded according to the Medical Dictionary for Regulatory Activities (MedDRA) terminology-REAC file for the reported drugs were considered. A unique ISR number allows linking all information from different tables. As the AERS database has some duplicate reports, we removed the older ones from duplicate reports by sorting case identification numbers. 7)