Common side effects include headache, sleep disturbance, dizziness and muscle pain. Rare side effects can include memory loss, allergic reaction, liver failure and nerve damage. The use of statins, including Lipitor, is associated with an increased risk of new-onset diabetes. The drug is not recommended for children, or for women who are breastfeeding or planning on becoming pregnant. Interesting fact: Patients taking Lipitor are advised not to drink grapefruit juice as it can increase the amount of the drug in their bloodstream, and therefore increase their chance of experiencing side effects.
Lipitor is covered by the Pharmaceutical Benefits Scheme. This means the federal government covers most of the cost. The price a patient pays in the pharmacy will depend on the dose their doctor has prescribed. Clinical information provided in this article is based primarily on the Australian Medicines Handbook In , the same Circulation medical journal showed a connection between treatment with Lipitor and unregulated blood sugar levels.
In , another medical journal, The Lancet, published a study illustrating the risk of type 2 diabetes in women taking Lipitor. Another study in , published in the Journal of the American College of Cardiology, furthered the case by illustrating a prevalence of the diabetic condition in conjunction with Lipitor use.
It's millions of dollars. But senior management was persuaded in to at least fund the initial round of testing on a couple dozen employee volunteers. So Warner-Lambert partnered with much-larger Pfizer, considered the industry's top marketer, first to help fund the expensive late-stage testing of the drug in people and then to promote Lipitor after it was launched.
Pfizer bought out Warner-Lambert in to block two other companies trying to acquire it and get control of Lipitor. Pfizer benefited from some lucky timing: Lipitor went on sale in , the year the Food and Drug Administration first allowed drug ads targeting consumers.
So Pfizer spent tens of millions on ads, including on the popular drama "ER," first urging patients to "Know Your Numbers" and then showing patients discuss how Lipitor helped them get their cholesterol numbers below guideline goals. Meanwhile, health groups kept lowering the cholesterol targets in national guidelines, making millions more patients good candidates for statin treatment, as new research showed the link between cholesterol levels and consequences such as heart attacks.
All those new patients boosted sales for the whole statin class, particularly Lipitor. The Lipitor promotion team set new standards for a marketing campaign.
They repeatedly visited family doctors as well as cardiologists, and blanketed patients with data showing that Lipitor was best at lowering cholesterol. They stressed to doctors nervous about safety that Lipitor's lowest dose worked as well as rivals' highest doses. They gave free samples of the white pills and sometimes bought lunch for the office staff. The studies have shown how Lipitor helped patients with heart problems, diabetes, stroke risk and other conditions, by preventing heart attacks and strokes and reducing plaque buildup in arteries.
Book focuses on mathematical problems about the Einstein equations and their sources. The first five chapters are an exposition of the classical foundations of general relativity and Einstein's equations. They can form the text of a major undergraduate or first-year course. They are mathematically precise, but they require only calculus-level knowledge in mathematics.
They include the links with physics and astronomy that make general relativity such an interesting subject. The chapters that follow are more advanced. Book presents what the authors call a revolutionary new hypothesis: Our genome is out of equilibrium, both with itself and its environment.
Simply put, our genes and our cultures are not at peace. The book explains the latest results emerging from the Human Genome Project. This all changed with the advent of statins, which first reached the market in Li justifiably gives a great deal of credit to the father of this field, biochemist Akira Endo, who isolated the first statin, mevastatin, from fermentation broths while at Sankyo, a Japanese pharmaceutical company.
Endo was searching for inhibitors of the enzyme HMG-CoA reductase, a key to the biosynthesis of cholesterol, as it was envisioned that blocking the synthesis of cholesterol would result in lower cholesterol levels in plasma.
In yet another example of a compound being used to elucidate biological processes, Michael S. Brown and Joseph L. Brown and Goldstein won the Nobel Prize in for this work. Ironically, Sankyo never developed statins commercially. Li devotes an entire chapter to Merck, the company that did in fact develop the first two statins Mevacor and Zocor to reach the market.
The reader gets a clear sense of the tremendous admiration that the author has for Merck. This respect is not unfounded. Merck in the late s and early '90s was the world's most admired company according to Fortune. In fact, Merck shut down the statin program when it saw toxicity in long-term animal studies. One of the failings of this chapter is the lack of detail and credit given to the subsequent studies that Merck toxicologists did to resurrect this class of compounds.
Merck toxicologists had also accomplished a similar feat with a class of agents used to treat ulcers called proton-pump inhibitors—again rescuing a very valuable franchise from initial adverse animal toxicology findings. The commitment of Merck's P. Roy Vagelos to this field is what made these wonderful medicines a reality. But the best part of this book is the account of the discovery and development of the most successful drug product of all time, Lipitor.
Li's access to both Parke-Davis and Pfizer scientists provides an insider's view of how this compound was discovered—and almost not developed. It outlines the years of struggle that Parke-Davis endured in trying to discover its own statin. It also tells of the serendipity involved in discovering a new molecule as revealed by the lead chemist, Bruce Roth, who made the core pyrrole piece of the Lipitor molecule.
Roth didn't have any initial insight; rather, he made this analog simply because he knew how to make pyrroles as a result of his Ph. The most memorable part of this story, however, involves how Parke-Davis management at a key internal meeting was getting ready to stop development of atorvastatin generic name of Lipitor because they believed that at best it would be the fifth statin to market and would be difficult to market against existing agents.
What saved the day was the head biologist for the program, Roger Newton, getting on one knee and crooning to the tune of Al Jolson's "You Made Me Love You": "You've got to let us do the human tests. I know it's the right thing to do, and I'm begging you to do it. It also helped Newton's cause that the Parke-Davis pipeline was pretty bare at the time.
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