RAY SUAREZ: Also included in the FDA recommendations, an attempt to ban Percocet and Vicodin. Why?
DR. SCOTT FISHMAN: Well, Percocet and Vicodin-type drugs are co-compounded drugs, meaning that they're drugs that package together two different drugs into one pill for the convenience of having them together, with the thinking being that the average person only needs a little bit of one and a little bit of the other.
The problem is that, when these compounds, which usually have, say, hydrocodone and acetaminophen, in a drug like Vicodin, when someone needs more of the hydrocodone, they are forced to take more of the Tylenol or the acetaminophen component, therefore pushing the patient into an optimal level of one and a toxic level of the other. That's the problem. I don't -- yes, go ahead.
RAY SUAREZ: I'm sorry. Go ahead, finish.
DR. SCOTT FISHMAN: Yes, I don't think the FDA is telling the public we need to get rid of these drugs. They're telling the public that we need to stop co-compounding them together, because while that is convenient, it's not necessarily safe.
RAY SUAREZ: Well, Vicodin is one of the most heavily prescribed drugs in the United States. If you split it apart from its acetaminophen component, will it be as useful? Will it be as widely effective as it's considered now?
DR. SCOTT FISHMAN: Well, you asked two questions there. It would certainly be as effective, because there's nothing limiting you from using hydrocodone and acetaminophen separately but at the same time, and they would be effective together. And each together allows you to use a little bit less of each one and spares you of risk.
But the problem with Vicodin is that there's no specific hydrocodone product that's compounded on the market today. So this will leave some patients without a hydrocodone product to use, but there are many other opioid-type medications that can be prescribed in its place that are equally effective.
And, again, I would stress that you can take the acetaminophen and the hydrocodone or oxycodone, which is found in Percocet, alone, in isolation, and then add the acetaminophen. So if the oxycodone or the hydrocodone needs to go up, the acetaminophen can still stay at safe levels.
RAY SUAREZ: So if you're sitting at home and watching television, if you're one of the tens of millions with acetaminophen product in their medicine chest, should you do anything differently from what you've been doing thus far?
DR. SCOTT FISHMAN: Well, I would suggest speaking to the prescribing physician and asking, "Am I taking too much acetaminophen with the dose that I'm taking right now of my hydrocodone or oxycodone in the Vicodin or Percocet?"
If the answer is yes, you should stop and switch to a product that gives you each drug individually and modulate them individually. If not, if you're not taking too much acetaminophen, I don't think there's anything wrong with that.
I think what the FDA is trying to say is that, in the future, we should be making these products in isolation so patients don't have to make these choices.
RAY SUAREZ: Dr. Fishman, thanks for joining us.
DR. SCOTT FISHMAN: A pleasure.