Populations symptoms and conditions

Joint pain in fingers, joint pain in knuckles, wrist weakness after a week on 10 mg daily dose of Zetia. Amazing reduction in bad cholesterol and triglycerides when used with daily maximum 80 mg dose. Zetia was discontinued because of these painful side effects. 68 year old male.

Except for having high cholesterol (310), I'm a 29 yr old healthy active female, very petite and weigh 98lbs. My mother has had a quadruple bypass and 4 stents at the age of 54, high cholesterol is just hereditary in my family. My doctor put me on 40 mg of zocor. The first week taking zocor I started feeling strange, a little soar here and there and very tired at times, also I have become very forgetful. It's been almost 2 months now and I have severe pain in my legs. First it was the right leg and now both legs, the pain starts at my lower back all the way down to my cav. I have a burning painful feeling sometimes numbing feeling, its driving me crazy!!!! I can't stand for too long cause I feel tons of pressure on my lower back pushing down my legs, It feels like my sciatic nerve. I went to my doctor and he said he is 95% sure that this is from the zocor medication, he told me to stop it right away. This is my first day without it, I know I need to do something to prevent what happen to my mother, I'm on a strict healthy diet, staying away from all fatty cholesterol filled foods, but there has to be a better way then taking statin drugs! If anyone has some ideas of what kind of alternative meds I can take, please help.

What a rotten drug. The past seven months have been hell for me. I am 42 years of age and put on this crap last November. I have suffered from bad headaches, leg cramps, Insomnia, Plantar Fasciitis, mood swings and the list goes on. After seeing this site and all your responses I believe the best thing to do is get of the crap. I will write in 2 weeks to give an update.
cheers from Down Under

I must be living in a vacuum without knowing it. I have been on Lipitor for a few years now. I do slur words on occasion... the cramps are occasionally unbearable. I get cramps in my rib cage, legs, feet and have to watch myself making move like reaching for something that requires anything other than a normal move or twist.. or I get a cramp. I also get cramps in my hands, muscles knotting up with horrible pain... I have to watch how grasp things my fingers.... occasional just cutting a steak holding the knife or fork and applying pressure... I had a discussion with a complete stranger today who said he had similar side effects with Lipitor... I thought it was old age (I'm 62).... and not very physically active. I looked it up on the internet and found this very informative site.

Below is the latest ADR report on Singulair from the United Kingdom. I deleted side effects reports by very small numbers of patients in order to keep the post briefer. This shows the total number of reports since Singulair was approved in the UK.

I don't know the total number of prescriptions for Singulair in the UK. It is considered expensive.

Drug Analysis Print
Drug name: MONTELUKAST
Drug name: MONTELUKAST Report type: Spontaneous
Report run date: 13-May-2008 Report origin: UNITED KINGDOM
Data lock date: 09-May-2008 08:00:02 PM Route of admin: ALL
Period covered: 01-Jul-1963 to 09-May-2008 Reporter type: ALL
Earliest reaction date: 01-Jan-1997 Reaction: ALL

Cardiac disorders-TOTAL 64
Palpitations 29
Myocardial infarction 6
Tachycardia 6
Diarrhoea 84
Dyspepsia 24
Abdominal pain 98
Abdominal pain upper 22
Nausea 84
Vomiting 52
Dry mouth 15
Asthenia 13
Fatigue 45
Malaise 32
Sudden death 1
Pyrexia 10
Chest discomfort 12
Feeling abnormal 16
Influenza like illness 17
Irritability 18
Drug interaction 13
Chest pain 13
Arthralgia 59
Myalgia 38
Muscle spasms 24
Pain in extremity 14
Balance disorder 10
Lethargy 16
Somnolence 23
Psychomotor hyperactivity 25
Headache 221
Dizziness 68
Neuropathy peripheral 7
Convulsion 6
Epilepsy 7
Dysgeusia 7
Hypoaesthesia 6
Tremor 18
Nervous system disorders TOTAL 526
Abnormal behaviour 13
Agitation 12
Anxiety 18
Aggression 30
Depression 23
Insomnia 58
Abnormal dreams 12
Nightmare 49
Hallucination 21
Sleep disorder 15
Psychiatric disorders TOTAL 364
Asthma 36
Allergic granulomatous angiitis 43
Angioedema 12
Swelling face 12
Erythema 13
Pruritus 32
Rash pruritic 17
Rash 55
Urticaria 33

TOTAL NUMBER OF REACTIONS 2841
TOTAL NUMBER OF FATAL ADR REPORTS* 19
TOTAL NUMBER OF ADR REPORTS* 1489

Hopefully this will prove to the doubters that there are genetic reasons for the variation of efficacy and adverse side effective when taking Montelukast.

I have several areas of concern (concerned citizen is concerned). One of the main areas is the reliability of Montelukast due to differences in genetics among populations. The cysLT1 (Singulair) receptor is a GENE. As I said before, it would be possible to predict those patients for which Montelukast would and would not be effective and those patients whose gene expression profile would cause them to have unwanted side effectives.

I have been looking for a way to give reasonable proof of that which could be used to convince your doctors that Montelukast is not for everybody. I happened to locate a researcher who had invented and patented methods for predicting drug sensitivity and efficacy in inflammatory disease. I have quoted below from his patent application. He intended to provide a method for determining efficacy and drug sensitivity for pharmaceuticals which include leukotriene antagonists - Montelukast.

Quoted from:

Methods for predicting drug sensitivity in patients afflicted with an inflammatory disease
US Patent Issued on December 12, 2006

Methods are disclosed for predicting the efficacy of a drug for treating an inflammatory disease in a human patient, including: obtaining a sample of cells from the patient; obtaining a gene expression profile of the sample in the absence and presence of in vitro modulation of the cells with specific cytokines and/or mediators; and comparing the gene expression profile of the sample with a reference gene expression profile, wherein similarities between the sample expression profile and the reference expression profile predicts the efficacy of the drug for treating the inflammatory disease in the patient.

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The field of pharmacogenomics measures differences in the effect of medications that are caused by genetic variations. Such differences are manifested by differences in the therapeutic effects or adverse events of drugs. For most drugs, the genetic variations that potentially characterize drug-responsive patients from non-responders remain unknown.
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In another embodiment, the invention is directed to a method for predicting the efficacy in a human asthma patient of leukotriene antagonists including, but not limited to, montelukast (a.k.a., SINGULAIR™; Merck, Whitehouse Station, N.J.), zafirlukast (a.k.a., ACCOLATE™, AstraZeneca, Wilmington, Del.), and zileuton (a.k.a., ZYFLO™; Abbott Laboratories, Chicago, Ill.), comprising: obtaining a sample of cells from the patient; obtaining a gene expression profile from the sample in the absence and presence of in vitro modulation of the cells with specific mediators; and comparing the gene expression profile of the sample with a reference gene expression profile, wherein similarity in expression profiles between the sample and reference profiles predicts the efficacy in the human asthmatic patient of leukotriene antagonists.

Many of the cells involved in causing airway inflammation are known to produce signaling molecules within the body called "leukotrienes." Leukotrienes are responsible for causing the contraction of the airway smooth muscle, increasing leakage of fluid from blood vessels in the lung, and further promoting inflammation by attracting other inflammatory cells into the airways. Oral anti-leukotriene medications have been introduced to fight the inflammatory response typical of allergic disease. These drugs are used in the treatment of chronic asthma. Recent data demonstrates that prescribed anti-leukotriene medications can be beneficial for many patients with asthma, however, a significant number of patients do not respond to anti-leukotriene drugs.

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The genes selected are those that have been determined to be differentially expressed in either a disease, drug-responsiveness, or drug-sensitive cell relative to a normal cell and confer power to predict the response to the drug. By comparing tissue samples from patients with these reference expression profiles, the patient's susceptibility to a particular disease, drug-responsiveness, or drug-resistance can be determined.

http://www.patentstorm.us/patents/7148008-description.html

The inventor's website: Hakon Hakonarson M.D. The Children's Hospital of Philadelphia

http://stokes.chop.edu/research/profiles/?ID=251

Have any of you seen this site: http://www.askapatient.com/viewrating.asp?drug=20829&name=SINGULAIR - the side effects we all recently began discussing is documented from users and parents of users as far back as seven years ago!
Why is it that the FDA just became concerned and Merck had no clue of these reports?? Interesting and distressing wouldn't you say?

I think that I can get my head around certain things and try to explain to you that medications do not work for all people or affect all people the same way. Well, that sounds simple enough to say - DUH. But, it is actually quite complicated chemically. Human beings are not chemically the same because we have variations in our genes. Would you be surprised to learn that about 60% of adverse drug reactions involve certain chemicals (in some cases enzymes) that we already know what these chemicals or enzymes are and what the variants are among populations groups? Some times we can predict who would have an adverse reaction to what medications if we knew what gene subgroup the patient was part of. We could also predict whether the patient would metabolize a drug at the same speed as others or not. Metabolize means utilize the drug and then discard the by-products--mostly the liver is the recycling center of chemical waste. Anything that the liver cannot re-use, the kidneys gets rid of in the urine. Speed of metabolism is a very important thing because people who are slow metabolizers might actually experience over-dose. There are other differences caused by genes that can cause different reactions according to the individual person.

I am interesting in following this site because I am wondering if the concept is flawed meaning that other parts of the body were ignored at the expense of controlling asthma and allergies of the nasal passages and lungs. OR - is there just a problem that relates to genetic differences in something such as enzymes and certain populations groups do just fine on Singulair with no problems and other people have some awful problems?

This isn't my area. But, sadly, if I can spend two weeks looking at this and come up with at least a road map of what I am looking for to answer some important questions then people who do this for Merck already know the answers. Why do I say that? Because, the adverse side effects (major categories) correspond to important areas of leukotriene receptor location and activity. Maybe not necessarily this receptor but part of a chemical process that involves this receptor.

The bottom line is that Singulair is the wrong medication for anyone that has adverse reactions. OR, there is a problem regarding the dosage that involves how fast the patient metabolizes the medication. Considering that there is a link to psychiatric adverse drugs reactions in Singulair and some medications for depression are linked to differences in metabolism due to enzymes, then there could be possibly something important to be learned from Singulair adverse drug reactions.

The biggest problem is that pharmaceutical companies are not properly communicating with the doctors who prescribe their medications. Why not communicate to doctors to look out for side effects and be aware that there are gene variations among people that are directly linked to how the patient might respond to the medication?

What happens if the patient belongs to the gene group that will have problems? If the pharm company does not tell the doctor to be on the alert, then the doctor tells the patient that it is not the drug that is causing the problem. Then the gene groups with the problems, go on the war path.

The cholesterol theory on heart disease is now an old wives tale. We have been lowering cholesterol for about 35 years now, and heart disease marches on unabated.

If the populations had never latched onto the belief that cholesterol causes heart disease, statin drugs would have never been developed. After all, if there is no market for it, why develop it?

But we ( including myself) believed that cholesterol was an evil villain ready to strike us dead if we didn't control serum levels of this deadly substance. WE WERE WRONG!

Cholesterol is very important in maintaining proper nerve and muscle function. Cholesterol plays an important role in the production of steroid hormones including testosterone.