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Coming soon: many drugs in one pill

Multidrug combinations may make medicines easier to swallow.

A new study provides strong support for the concept of a single pill that contains multiple medications used to fight heart disease. The idea stems from the decades-old practice of bundling two or three medications into one pill to treat a single disease, such as high blood pressure. The new combination pills put even more medicines into one pill. These medicines fight heart disease directly as well as indirectly by lowering blood pressure and cholesterol. Many doctors have been skeptical of packaging multiple medications into one pill, yet two prior studies have provided support for the concept in reducing heart disease.

The newest study, presented at the annual meeting of the American Heart Association in November 2012, may help change some minds. The Use of a Multidrug Pill in Reducing Cardiovascular Events (UMPIRE) trial found that people who took a pill containing two blood pressure medications, a cholesterol-lowering statin, and aspirin were 33% more likely to take their medications every day than those prescribed the same drugs in separate pills. As a result, their blood pressure and cholesterol were better controlled.

Combination pill tested

Combination pill tested

hydrochlorothiazide (12.5 mg) and lisinopril (10 mg)

Improving compliance

When people with heart disease—or at risk for it—fail to take medications with proven benefits, they put themselves in danger of suffering a heart attack or stroke.

The reasons they don’t comply with their doctor’s recommendations vary, but include not being able to pay for the medications, forgetting or not wanting to take them, not understanding the importance of taking them, or being confused by taking some pills once a day, some twice, and others three times. Putting several common heart medications into a single pill has the potential to make pill-taking a lot easier.

“There is plenty of evidence that a simpler regimen can improve compliance,” says Dr. J. Michael Gaziano, chief of the Division of Aging at Harvard-affiliated Brigham and Women’s Hospital.

Ideal for some, but not all

Multidrug combinations may prove to be convenient for people on fixed doses, but when the dose of any component needs to be raised gradually over time, multidrug pills might not be a good choice.

Since compliance with potentially lifesaving medications is a major concern, doctors are hoping that multidrug combinations will make pill-swallowing a lot more appealing. The question is, which drugs should be included? UMPIRE tested one common combination of heart medications, but other combinations might also be useful. “What about a single pill containing aspirin, a statin, and two different blood pressure medications?” asks Dr. Gaziano.

Posted by: Dr.Health

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