Dr. French has provided 2 articles, one on the Amplichip and another that reviews pharmacogenomics, that may be helpful as a start. Anything that mentions or applies to codeine is also relevant to hydrocodone (Vicodin) which is more widely prescribed than codeine.
The drug you are referring to is probably Ximelagatran (Exanta®). It has been approved for use in thromboembolic disorders in 7 European countries. It was submitted to the FDA, but approval was denied due to significant liver toxicity (1 in 200 patients, twice the rate of liver toxicity that forced the diabetes drug Rezulin off the market). A similar drug, that doesn’t require INR monitoring, is undergoing clinical trials in the US at this time – Rivaroxaban. It does NOT appear to have liver toxicity but an approval and release date has not been announced, maybe within a year. Stay tuned.
Whether drugs undergo significant storage in fat cells depends not on their toxicity, but on whether they are lipid (fat)-soluble. Isotretinoin is fat-soluble and can undergo significant binding in fatty tissue. Because this binding helps them remain in the body longer, whatever toxicity they do have may be enhanced by this potential accumulation. Little is known about the effects of isotretinoin on the adult brain. There are warnings about depression / suicidal thoughts / suicide (med guide attached), but the link is controversial as epidemiological studies have NOT shown an association. Acne itself may be a risk factor for depression.
Many reasons, two of the most common are: Take before food (empty stomach) is most commonly advised for drugs that are broken down by stomach acid (penicillin G) as a full stomach has more acid to aid in food digestion. Take with food or water is often recommended for drugs that are irritating to the stomach or tend to cause nausea and vomiting. The presence of food can moderate these problems. Also, some antibiotics (tetracycline) are not to be taken with dairy products or antacids because they contain calcium, which may bind the tetracycline and reduce its absorption in the blood.
We are at this time now. Colorado is one of 38 states that has a “Prescription Drug Monitoring Program” to track the prescribing (MDs and Dentists) and dispensing (Pharmacists) of Controlled Substances. All prescriptions for controlled substances in Colorado are required to be entered into a statewide data base. This can then be accessed by prescribers and pharmacists when there is concern that a patient may be receiving multiple prescriptions from multiple prescribers. This system has had a major impact in reducing drug abuse and diversion.
Yes, I've attached an excellent patient info sheet that should address this very issue.