Wednesday, February 25, 2009

Snake Venom Is 100% Natural As Well.

Alternate Post Title: Love Your unregulated free market capitalism? Well then I Hope you have a home blood potassium monitoring kit. 

Because you're on your own my friends. Think we have an FDA that evaluates which drug products are safe enough to be sold without a prescription and which aren't? Well then meet Ameal bp and be enlightened. God where to start with the Ameal bp:

The key ingredient is AmealPeptide®, which consists of two bioactive tripeptides that are extracted from milk proteins during a patented production process. These natural, milk-derived tripeptides are safe and have no side effects.


Anytime you see the words, "no side effects" my friends, run. Run far away. Because you are being lied to. A sugar pill has side effects. Increased blood glucose levels. Water has side effects. Increased urine production. The only way for a substance to have no side effects would be for it to do absolutely, positively, nothing. 

Ameal bp, on the other hand, does claim to do something. It doesn't claim to diagnose, treat, cure, or prevent any disease, because any claim like that would classify it as a drug, and Ameal bp is a dietary supplement. Ameal bp makes it crystal clear that it makes no claims to treat, cure, or prevent any disease by including this handy chart on it's website and in its advertisements:



This chart looks nothing like Ameal bp is trying to say it lowers your blood pressure, which would prevent many diseases like heart attacks, strokes, or congestive heart failure. I totally don't get that impression at all when I see this chart. It looks to me like Ameal bp is kinda like whey protein or some other type of dietary supplement I would take to build my muscles after a good workout. That's what this chart says to me.

Specifically, Ameal BP  claims to be "a naturally occurring ACE inhibitor derived from enzymatically hyolized casein (milk proteins)" that has been "clinically shown to maintain healthier blood pressure"

Some of you in the professions just saw the words "ACE inhibitor" and shot scotch through your nose. If you are drinking scotch at the moment that is. Which you should be. You may have thought about the effects prescription ACE inhibitors, which don't try to bullshit their way through the "dietary supplement" loophole, have on pregnancies. Or of that annoying dry hacking cough that can happen with the prescription ACE inhibitors.  A cough that Ameal bp tries to tell you magically won't happen if you use an ACE inhibitor made from rotten milk. Just remember that claim comes from the same people who so convincingly say they are making no claims that they are preventing disease. 

While they are smart enough to not say anything about the pregnancy issue, they do come out and say their product inhibits the reaction that converts angiotensin I to angiotensin II. You know what happens when you do that? Your body secretes less of a hormone called aldosterone. Then you know what can happen? The level of potassium in your bloodstream can go up. 

That would be a side effect. One you can die from. I can guaranfuckingtee you if this shit in a box catches on, somebody, somewhere, who's having a hard time managing their hypertension with a slew of medications that includes a 20mEq daily dose of potassium chloride will see this in the vitamin section of a GNC store somewhere and end up dead.

In my perfect world, that person would be a card carrying member of the Libertarian party, whose philosophy makes things like Ameal bp possible.

To the rest of you I would say be careful, because you're on your own out there. 

29 comments:

Christine said...

I had a patient get so upset when he found out we couldn't give him potassium without an order. Mind you, we have a protocol we follow where our patients get their potassium levels checked twice a day and get supplements for anything under 4. He called and told us he felt like his potassium was low (an hour after he was like 4.2 or something) and would like a potassium pill. Uhm, no.

"What do you mean, no? Just go get me some. It's just a nutrition supplement."

Sorry dood, no.

I can't believe people actually buy what these ads are selling.

Anonymous said...

There website says:
"Ameal bp® is not a prescription drug and is not indicated to replace your current medications. Although studies have shown that Ameal bp® is safe to take in addition to your current medication, talk to your doctor. He or she will be able to determine if Ameal bp® is right for you."

How many patients are going to talk to their doctors? How many doctors have the time to talk to patients or even know what Ameal bp® is? WTF? There ARE asking for a law suit when somebody dies!

ariel said...

Best. Post. Ever.

Anonymous said...

And the 2 pharmacy giants, WAGS and CVS are happy to sell you this "great" product...

Unknown said...

"Or of that annoying dry hacking cough that can happen with the prescription ACE inhibitors. A cough that Ameal bp tries to tell you magically won't happen if you use an ACE inhibitor made from rotten milk."

I don't know why but this made me almost spit soda on my screen. Great post.

Anonymous said...

I hate unregulated BS. more than that, I hate the fact that they take advantage of the uneducated in society. I seriously had to talk my backwoods father in law out of using http://www.colonblow.com/
which claims to be good for just about everything.

Improved colon health may help address some of the following, just to mention a few:

Headaches
Sinus pressure
Fatigue, Lethargy
Potbelly
Prolonged constipation
Weight loss

Nate said...

The graph, those stats are rather improperly done. You can't do repeated t-tests like that. I'm not postive what you would want. Maybe ANOVA. They probably had to do repeated t-tests because that was the only thing that would meet significance. But if they can't even manage to do that stats correctly, imagine what else is screwed up in their study and literature

Thom Foolery said...

The saddest thing about the unregulated supplements industry is that they cash in on our rightful suspicion of Big Pharma. Too bad they forget to mention that they are Big Supplement.

And for the record, I only used Colon Blow once, because I just had to see one of those black, plasticine, rope-like dumps.

Anonymous said...

^^^^^^^^^

Exactly. Statistics in the wrong hands are very, very dangerous.

Anonymous said...

You should name the zit Krang from the ninja turtles.
http://www.acampos.eu/blog/wp-content/uploads/2008/06/krang.jpg

I had a young female patient, who seemed very surprised that I was a phamacist, tell my tech to go away the other day because she had something she had to tell me. Then the tech wasn't far enough away so she told the tech to back up even more. She proceeded to wisper to me that "you are the hottest pharmacist I've ever seen." I just laughed so hard and told her she made my day. So you may have some competition Drug monkey. Although, I'm breaking out right now too, damn it all

Anonymous said...

I have no idea how they determined significance at all. If they are comparing their crap supplement to a placebo, their confidence intervals on each are overlapping... majorly overlapping, meaning that there most likely isn't a difference at all...

¬_¬

Anonymous said...

Boner. Name it boner.

I'm calling it boner no matter what you say. Look at that swollen boner next to your lip.

Anonymous said...

For what it's worth, I have sent ameal bp an email addressing these concerns. I'll be interested in seeing if they respond.

Nate said...

You can pass pretty much anything with a t-test when your n is like 75/per group (606 subjects, 303 control, 303 tx. 4 in initial blood pressure groups, 300/4). Which is why I imagine they had to use a t-test to pass significance. Try it out.

This following scenario passes with a t-test.
group 1, n=75, mean 50, SD 15
group 2, n=75, mean 55, SD 15
p=0.04

Anonymous said...

My wife, who regrettably is a believer in these sorts of supplements, recently came home with a big bottle of acai juice for me, recommended by some herbalist as being good for my kidneys (I have PKD).

As is my custom with such things, I looked this stuff up before consuming any. According to Wikipedia, juice from the berries of the acai palm is a COX-1 and COX-2 inhibitor. For those readers not up on this stuff, this means it's an NSAID and *strongly* contraindicated for anyone with compromised kidney function. Like me.

The good news is that we were able to return it and get a refund.

Anonymous said...

I'll have to remember the title of this post. So often, people will be talking (not necessarily patients) and say the "it's natural so it must be safe" line, and I always have to butt in. "Tobacco is natural, cocaine is natural, lead is natural - does that mean they're safe?" I HAVE to remember to add snake venom!

Anonymous said...

The title and subtitle are perfect!

Reminds me of when a patient asked me to explain the difference between 2 kinds of vitamin E. I explained that the difference had to do with the chemical structure (for you chemistry weenies, the d- and l- enantiomers), and she yelled at me for daring to sell a product touted as "all natural" when it had CHEMICALS in it! My response: "Salt is natural. The chemical formula for salt is NaCl." I then turned around and walked away because I couldn't trust myself with continuing the conversation.

Lipstick said...

Nice post Drug Monkey.

Anonymous said...

Hey Monkey, can you please post something on the newest purple sensation, MonaVie? Said to lower BP, cholesterol, costs >$40 per bottle...I want to hear a rant on this snake oil.

Anonymous said...

"In my perfect world, that person would be a card carrying member of the Libertarian party, whose philosophy makes things like Ameal bp possible."

Let's face it, the only reason you made that comment is because you know good and well that if/when this product kills someone, there is a 99.9% chance that the someone will be a registered Democrat (see keywords natural, green, organic, etc). I wonder if you would have warned the public about this threat if it was something that was more appealing to Republicans than to Democrats.

Anonymous said...

If any of my patients buy trexemet I am going to slap them in the face with a fly swatter

Anonymous said...

FWIW, Monavie is the acai berry extract I was talking about in my earlier post. Anyone who can't take NSAIDs should be careful with this stuff.

DrugMonkey, Master of Pharmacy said...

Anonymous #7,

I wonder if you would have warned the public about this threat if it was something that was more appealing to Republicans than to Democrats.

Probably not. You evidently noticed my lack of warning about the collapse of Lehman Brothers.....:)

Actually, now that I think about it.....I wonder if there is some sort of "teacher who cooked up Airborne" future in store for me if I can come up with a supplement that makes no claims to prevent, treat, or cure any disease, but has been shown to promote a healthy ability to orchestrate hostile corporate takeovers.....

Từ Thanh Giác said...

The mention of snake venom brought to mind my visit to the Medical and Pharmacy College in Vietnam.
The last time I saw snake venom was during my visit to my friend Dr. Trinh Xuan Kiem at the Medical School in Ho Chi Minh City. He is head of the venomous research unit and at his lab he makes the anti venom serum for all the land snakes in Vietnam. He has quite a collection of deadly snakes that he milks for the venom.
An interesting note is that if you go to Vietnam, do not get bitten by a poisonous sea snake. He doesn’t make anti venom for them because the fisherman will not take it. When a fisherman is bitten by a sea snake he is brought to a cove, where he is offered to the snake god. If he doesn’t die the snake god will come for another person. Trinh stopped making anti venom for seas snakes because they are never used.

Anonymous said...

FDA warns "(Posted 01/27/2009) consumers [should] not to take Venom HYPERDRIVE 3.0, a product sold as a dietary supplement but containing sibutramine, an undeclared drug product and a controlled substance with risks for abuse or addiction. When present in a dietary supplement, it may harm unsuspecting consumers because sibutramine can substantially increase blood pressure and heart rate, and may present a significant risk for people with a history of heart disease, heart failure, irregular heart beats or stroke. The product was sold via distributors and in retail stores nationwide and was packaged in red plastic bottles containing 90 capsules each with the UPC# 094922534743", etc..

We're not done with snake oil or serpentine matters.

Anonymous said...

As many folks on here have heard me note, I left retail pharmacy in 1993. My timing was perfect. OBRA'90, the Internet, Drive-Thrus, DTC advertising, and all of these bastardized supplement remedies (natural ACE inhibitor? Give me a break and a half!) were just coming in. But, in particular, I don't miss having to deal with the suspicions patients have of mainstream medications, suspicions they satisfy with the OTC "natural" remedies. Hey, isn't poison ivy oil also natural?

Dragonfly said...

Gah. Just like St Johns wort for depression. (Bring on those serotonin syndromes).

Anonymous said...

I'm surprised no one mentioned the obvious fault of this and similar supplements - namely, that it's a polypeptide. Unless you're going to be giving it via parenteral routes, it's completely useless. You'll just digest it like any other whey protein.

Anonymous said...

At least some bloggers can write. My thanks for this piece!