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Considerations for Phenazopyridine Use in Hospice Patients

Phenazopyridine (Pyridium) is a urinary analgesic that’s been around for over 100 years.1-3 In fact, the Food and Drug Administration (FDA) considers it a “grandfathered” drug, so safety and efficacy data from clinical trials is limited and its therapeutic role is based primarily on clinical observations.1,2 It’s solely a urinary analgesic (through an unknown mechanism) […]

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Guidance on Converting from Divalproex Sodium (Depakote) to Valproic Acid

As hospices operate with limited funds, minimizing drug costs is important. Therapeutic substitution, where one drug is replaced with a less expensive drug, is one tool to help with this. One substitution we’re occasionally asked about is using valproic acid (VPA) (Depakene) in place of divalproex sodium (Depakote). VPA costs about half as much as […]

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How do I convert from brexpiprazole to aripiprazole?

Earlier this year, the FDA expanded the list of approved indications for brexpiprazole (Rexulti®) to include the treatment of dementia-related agitation due to Alzheimer’s disease, making it the first antipsychotic (or any drug class for that matter) to gain FDA approval for treating agitation in patients with any type of dementia. Despite its new approval, […]

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SGLT2 Inhibitors: More than Diabetes Drugs

Known for their role in managing diabetes, sodium-glucose cotransporter 2 (SGLT2) inhibitors like Farxiga (dapagliflozin) and Jardiance (empagliflozin) also improve symptoms, function, and quality of life in patients with heart failure (HF).1 So it’s no surprise that they were added to the latest HF guidelines, even for patients without diabetes.1 The 2022 American Heart Association […]

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A Review of Loop Diuretics: Considerations for Drug Selection

Loop diuretics are essential medications for managing fluid overload and edema caused by conditions like heart failure, liver disease, or chronic kidney disease.1-4 They work by decreasing renal sodium and chloride reabsorption with the end result being  water excretion through urination (diuresis).1-3 You can learn more about loop diuretic pharmacology here. By far, furosemide is […]

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