1. The FDA approved a combination product of azelastine (Astelin or Astepro) and fluticasone (Flonase) named Dymista. Both ingredients are available individually. There is no data supporting synergy. This product could be convenient. The Allergy Dude predicts that Dymista's success will hinge on the same factor as most other products, which is its price. This is not known yet. The product is slated to be launched during August.
2. Omnaris (AQ) production continues to be too low, resulting in shortages. There is no end in sight. So if you want to fill a prescription, be prepared with an alternative.
3. A new eyedrop for eye allergies called Lastacaft is being marketed. There is no comparative data showing it is superior to other available products.
4. TEVA has been sampling its "new" nasal steroid product: Qnasl. The more things change, the more they remain the same. This is just like the no-longer-available Beconase and Vancenase sprays, except for two important differences. First, each spray produces 80 mcg, not 42, of beclomethasone dipropionate. Hence the dosing is 2 puffs once per day, not twice per day. Second, the propellent is the same HFA is in the inhalers for asthma. The Allergy Dude predicts that this product will have a niche in those patients who do not like the current aqueous formulations of corticosteroid sprays. The only problems are the potential cost and the competition below.
5. Omnaris HFA (Zetonna) is ciclesonide nasal steroid spray using HFA propellent. Interestingly, no information can be found on Sunovion's nor the FDA website about the approval date. There have been ads in allergy journals for months. No word on the launch date.
6. To the best of The Allergy Dude's research, Singulair will not be available OTC after 8/3/12, but will be going generic.
7. When the diagnosis of asthma remains in question after a careful history, physical exam, labs and spirometry, then a mannitol (Aridol) challenge would the next and definitive test.
8. Studies by Merck for its sublingual (under-the-tongue) immunotherapy are closing and will be submitted for approval soon. This means it is not available now and will not be available for 1-3 years more depending on the FDA's review, approval, and product manufacture.
9. Daliresp is a new oral medication that may reduce the number of exacerbations of COPD in patients with severe COPD.
1. Concerning medications, Insurance companies are slowly increasing copays for medications, requiring prior authorizations, and issuing denials. Keep track of which medications you have tried already.
2. At your doctor's office, ask for any coupons or rebates. Within my office, The Allergy Dude is also known as The Coupon King, because I distribute so many coupons to patients. Don't forget to use them, or you may be leaving money on the table. If your medication is tier 2 or 3, you should seriously be searching for a coupon. They are available more than you think.