Launching in 1849 after the development of the first palatable form of the antiparasitic medication santonin into an almond-toffee candy cane, Pfizer has made their mark on the pharmaceutical industry in many ways, including helping to market, produce, and distribute some of the first antibiotics like penicillin – a major landmark in the field of medicine. A premier and innovative biopharmaceutical company with a healthy research and development department, and many important healthcare and pharmaceutical products on the market and in development, Pfizer strives to improve the quality of life of people and communities around the world through healthcare products and increased access to them.
In the 1860s, Pfizer worked to meet the medical needs of the Union Army during the Civil War, providing pain relievers, preservatives, and disinfectants. Pfizer discovered and developed a vitamin mix in 1938, and the company remains a leader in the field of multivitamins today, marketing both Centrum and Caltrate (calcium and vitamin D3).
The first pharmaceutical product to be developed and marketed under the Pfizer label in the United States was the broad-spectrum antibiotic Terramycin (oxytetracycline) in 1950. In the 1990s, the powerful antibiotic Zithromax (azithromycin) was rolled out and is still used widely today. In 1980, the first Pfizer product to garner $1 billion in sales was Feldene (piroxicam), a prescription anti-inflammatory medication.
In 1997, the cholesterol-lowering drug Lipitor (atorvastatin calcium) was approved and became the top-selling drug in the world while it was under patent protection through 2011, making Pfizer over $100 billion in revenue, per the Los Angeles Times. Looking to follow that success, Pfizer developed the drug torcetrapib to boost good cholesterol, HDL, (whereas Lipitor lowers “bad” cholesterol, or LDL) in order to have something in the pipeline that could make up for the lost sales that were sure to manifest when generic forms of Lipitor were allowed to be marketed. However, in 2006, the medication failed during clinical trials, causing many fatalities and cardiovascular events, leading to a halt in its development and production altogether as the $800 million Pfizer put into it swirled down the drain, FiercePharma publishes.
In 2009, Pfizer gained momentum again and increased its global reach by merging with another pharmaceutical giant, Wyeth. The acquisition of Wyeth makes Pfizer one of the biggest and most influential pharmaceutical companies in the world today, The New York Times reports.
Today, many recognizable pharmaceutical and healthcare products are marketed under the Pfizer label, including:
- Advil (ibuprofen): the popular over-the-counter (OTC) pain reliever
- Robitussin (dextromethorphan): a popular OTC cough and cold medication
- Emergen-C (vitamin C): a dietary supplement designed to boost the immune system and help fight off the common cold
- Viagra (sildenafil): prescription medication to treat erectile dysfunction (ED) in men, which has become a household name
- Xanax (alprazolam): a common benzodiazepine drug meant to treat anxiety and panic disorders on a short-term basis
- Zoloft (sertraline HCL): prescription-based antidepressant drug
- Celebrex (celecoxib): prescription medication for the treatment of arthritis pain
- Epipen (epinephrine injection): a lifesaving tool to manage anaphylactic shock due to allergies
- Lyrica (pregabalin): a prescription pain medication for the treatment of fibromyalgia and nerve pain
- Enbrel (etanercept): medication for the treatment and management of rheumatoid arthritis
- Prevnar (pneumococcal conjugate vaccine): an innovative approach to prevent the onset of pneumococcal strains of pneumonia
- Premarin (conjugated estrogen tablets): a prescription medication to manage hot flashes that can occur during menopause in women
Pfizer and Anti-Smoking Measures
Addiction is a real issue in the United States, as more than 21 million Americans struggle with the disease, according to the 2014 National Survey on Drug Use and Health (NSDUH). Smoking cigarettes results in nearly a half-million deaths in the United States every year, making it the number one cause of preventable death in America, the Centers for Disease Control and Prevention (CDC) publishes.
In 2006, Pfizer released Chantix (varenicline), a prescription-based medication to help people quit smoking. Chantix blocks nicotine from binding to specific sites in the brain, reducing the pleasure people may get from smoking, thus helping to dispel the cravings and make the action less desirable. Over the years, however, the U.S. Food and Drug Administration (FDA) has released many safety warnings about Chantix, ranging from its potential negative cardiovascular interactions, to adverse reactions when mixed with alcohol, to psychiatric and mental health effects that can occur when taking the drug. Chantix should therefore only be used under the direct and close supervision of a medical professional. While it can be helpful for quitting smoking, it may not be right for everyone.
Pfizer’s Work against Opioid Abuse
Opioid addiction continues to be a major problem around the world. Between 26.4 million and 36 million people worldwide abuse these drugs, and in the United States, over 2 million adults battle opioid addiction, the National Institute on Drug Abuse (NIDA) publishes. Prescription opioids are widely abused and tightly regulated within the United States. These medications are often medically necessary, however, as they are very effective pain relievers. Many people need around-the-clock pain management as well.
In 2014, the FDA approved Pfizer’s Embeda (morphine sulfate and naltrexone hydrochloride), the third product of its kind to include information about its abuse-deterrent properties in its labeling. The morphine component of Embeda is an opioid analgesic designed to be released in a slow and controlled extended-release format for the relief of constant or chronic pain. Naltrexone, on the other hand, is an opioid antagonist, meaning that it blocks opioid receptors from receiving opioid drugs and renders them ineffective. The naltrexone component of Embeda is designed to remain dormant when the drug is taken as directed. If the medication is to be chewed, or crushed to be snorted, smoked, or injected, then the naltrexone becomes active, thus making it harder to abuse the drug in this manner. Embeda can still be abused by swallowing larger amounts of the drug. Pfizer reports that this is the only extended-release morphine medication with these abuse-deterrent properties; however, they still warn that due to the high risk for abuse and addiction to opioids, it should be used only when other alternative forms of treatment are ineffective.
In 2016, the FDA approved another extended-release opioid analgesic developed and marketed by Pfizer, Troxyca ER (oxycodone hydrochloride and naltrexone hydrochloride). Similar to Embeda, the naltrexone antagonist component of Troxyca ER remains dormant unless the drug is taken by a route other than as intended (e.g., chewing, crushing, snorting, smoking, or injecting the drug). When taken as directed, the oxycodone is released slowly and continually to provide around-the-clock pain relief. The Formulary Journal publishes that Troxyca ER may still be abused, however, and as such, Pfizer has recommended that the drug be prescribed sparingly and when there are no other viable alternative treatment methods.
Both oxycodone and morphine are considered highly addictive and have a high rate of abuse, which is why the Drug Enforcement Administration (DEA) lists them as Schedule II controlled substances. These medications increase levels of dopamine in the brain and thus heighten pleasure while slowing down functions of the central nervous system and enhancing relaxation. They can become habit-forming very quickly and can also be the cause of a life-threatening overdose when abused. Opioid addiction requires specialized treatment and often medical detox protocols for recovery. Pfizer is working toward stemming the tide of opioid abuse by introducing abuse-deterrent versions of these powerful narcotics.
Highs and Lows of Gabapentin
In 1993, gabapentin (Neurontin) was approved for the treatment of epilepsy and seizures as an adjunct medication, meaning that the drug was to be used in conjunction with other treatments and medications. In 2000, when Pfizer acquired Warner-Lambert, Pfizer also got the rights to Neurontin. Even though gabapentin is approved for the treatment of seizures, epilepsy, and neuropathic pain related to shingles, the drug is actually used more often off-label for other purposes, the Mayo Clinic Proceedings reports, such as to treat nerve pain, migraines, bipolar disorder, alcohol and drug withdrawal symptoms, cravings related to drug addiction, hot flashes, restless leg syndrome, and pain in general. Pfizer faced criminal charges in 2004 that accused the company of marketing Neurontin for purposes other than what it is medically approved to treat, including to treat migraines and pain. The company paid out $430 million, Reuters publishes. This was the second largest fine of its type in industry history, but despite the admission of fraud, sales of Neurontin continued to rise, BMJ reports.
Lawsuits and legal issues surrounding Neurontin continued, however. Within a six-week period in 2014, Pfizer was first forced to pay $190 million to settle charges that it actively worked to prevent generic versions of Neurontin from reaching the market, and then paid $325 million in a settlement for defrauding healthcare providers and insurers for aggressively marketing the drug for unapproved uses.
Gabapentin may regularly be used off-label to treat pain as a potentially “safer” alternative to opioid drugs. Unfortunately, it also has some risk of abuse. The Pain News Network warns that diversion and abuse of the drug are increasing and that gabapentin is actually one of the most diverted and commonly abused drugs in the US prison system.
People may be taking gabapentin in conjunction with other drugs like opioids or benzodiazepines to cause a euphoric and mellowing “high.” When crushed and snorted, Neurontin may create a buzz similar to stimulant drugs, and in large amounts, it may have psychedelic effects. Gabapentin may also be used to counteract the negative side effects, or “crash,” of other drugs like methamphetamine or cocaine. Gabapentin, and therefore Neurontin, is not a controlled substance by the DEA, which may make it seem less dangerous and make the drug more accessible. When used outside of a legitimate prescription, and especially in conjunction with other drugs, it can have hazardous side effects, however, including both a potentially fatal overdose and the risk for addiction.
Gabapentin may be helpful when used during addiction treatment, as the drug may aid in counteracting seizures and tremors that can occur during withdrawal and may also minimize drug cravings. Neurontin may be beneficial when used off-label during addiction treatment if taken under the close supervision and monitoring of highly trained medical professionals and providers. When used as part of a comprehensive addiction treatment program, Pfizer’s Neurontin may be a helpful tool. It is used in conjunction with other medications and therapeutic methods and not as a standalone treatment, however.
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