Thursday, July 26, 2012

The Polypill, Is it a good idea ?

Polypill , is it a good idea ?

A recent study evaluated the potential benefit of taking one pill containing 4 different medications, Amilodipine 2.5 mg ,Losartan 25 mg , Hydrochorothiazide 12.5 mg and Simvastatin 40 mg in individuals 50 plus years old without any history of heart disease compared to a placebo.

Results :
    The group receiving the polypill results;
    systolic blood pressure  - reduced 17.9mmhg
    diastolic blood pressure - reduced 9.8 mmhg
    LDL cholesterol            - reduced 44.8 mg/dl ( 1.4 mm/l )

   Side effects
   7 % of people in the study had side effects to one or more of the drugs in the pill but only 3% stopped
   treatment because of the pill.

My thoughts on the polypill

1 pill vs 4 pills a day is not a bad idea and would probable increase taking medication compliance. My primary objection would be dealing with a serious side effect  and trying to decide which medication caused the problem.

Making the polypill available over the counter without a prescription is another idea discussed in the article.  Providing unsupervised use of 4 potent  prescription only medications is an accident waiting to happen.

 A few potential problems to consider.
Hydrocholothiazde can depletes  body stores of potassium causing muscle weakness, heart problems . Loss of fluid can cause dizziness , low blood pressure and risk of falling
Losartan can be associated with difficult to detect angioedema and high potassium levels
Simvastatin can be associated with muscle and liver problems
 I think I will stick with 4 pills a day 

more on angioedema  see the april 19 blog

Have fun , be Smart and remember all medications have side effects
David Calder,MD

David S. WaldJoan K. MorrisNicholas J. Wald*
Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom

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Your comments and questions are appreciated. David Calder,MD