Heart(y) News, April 16

Approval, phase out and drug-drug interactions. These are the updates we are bringing you today.

FDA Approves First Biodegradable Sealant Patch for Cardiovascular Surgery
TachoSil is the first absorbable fibrin sealant patch for use in cardiovascular surgery and was approved by the US FDA earlier this month. TachoSil is indicated to prevent mild and moderate bleeding from small blood vessels, when standard surgical techniques are ineffective or not feasible. TachoSil is made of dry collagen sponge from horse tendons, and coated with fibrinogen and thrombin from strictly screened blood donors.  Fibrinogen and thrombin reacts in the wound to produce fibrin which facilitates blood clotting. The patch breaks down and is absorbed into the body within four to six months.

Asthma and COPD Inhalers That Contain Ozone-depleting CFCs to be Phased Out; Alternative Treatments Available
You may not be ware of it, but your inhaler might also contain chlorofluorocarbons (CFCs) that deplete the ozone layer. The US FDA has recently announced the gradual phasing out of these inhalers from the US market. The phase out will especially affect seven metered-dose inhalers (MDI) used to treat asthma and chronic obstructive pulmonary disease (COPD). The phase out is in accordance with longstanding U.S. obligations under the Montreal Protocol on Substances that Deplete the Ozone Layer. However, alternative medications that do not contain CFCs are available.

Cotrimoxazole ups bleeding risk in warfarin patients
Cotrimoxazole is an antibiotic commonly prescribed for urinary tract infections (UTI). However, it seems that can interact with warfarin to increase the risk for bleeding, according to a study by researchers at the University of Toronto. Warfarin is an anticoagulation commonly prescribed for patients with cardiovascular disease (CVD) to prevent heart attack and stroke. Since UTI and CVD can co-occur especially in elderly patients, doctors are advised to use alternative antibiotics when treating UTI in patients taking warfarin to avoid hemorrhage.

Still no answers in largest review on clopidogrel/PPIs
On the other hand, the possible interaction between the antiplatelet agent clopidogrel and proton-pump inhibitors (PPIs) is still not clear, according to a meta-analysis by researchers at the University of East Anglia, Norfolk, UK. According to German cardiologist Dr Dirk Sibbing of German Heart Center in Munich (he was not part of the study):

“From a pharmacological point of view, this interaction is real, no doubt about that. From a clinical point of view, it’s still a matter of debate. The clue might be found in specific subgroups of patients. For some selected subgroups, coadministered PPIs may be harmful; for the majority of patients, however, this may not be the case.”