September 30, 2009

FDA Warns Doctors and Parents About Dosage Discrepancy for Liquid Form of Tamiflu

As a dangerous drug attorney, I was very interested to see a series of warnings from the U.S. Food and Drug Administration about the drug Tamiflu. Tamiflu (oseltamivir) is an antiviral drug that fights the flu; it has been in the news recently because of its use to fight the H1N1 virus, also known as the swine flu. The FDA warning is not about the efficacy of the drug, but about its dosage in liquid form, which is intended for children. The prescription labeling information for Tamiflu is generally given in teaspoons or milliliters (by volume), the FDA said, but the dosing dispenser that comes with the drug is marked in milligrams (by weight). This can confuse parents and may lead to a toxic overdose or an underdose that can’t protect the child.

The discrepancy was first revealed in a letter published in the New England Journal of Medicine Sept. 23, WebMD reported Sept. 25. One of the authors of that letter was Kara Jacobson, a health researcher at Emory University. Jacobson’s six-year-old daughter was prescribed Tamiflu for H1N1, but her prescription was for three-fourths of a teaspoon twice a day. Because the dispenser was measured in milligrams, Jacobson and her husband, a doctor, had to track down and solve the equations to translate their daughter’s dosage, a process that took thirty minutes. Many other families wouldn’t have the awareness to identify that problem or the time and resources to solve it, Jacobson and her co-authors warned in their letter.

Both the FDA and Tamiflu’s manufacturer, Roche, have asked doctors to write their prescriptions in milligrams. They also asked parents and caregivers to be aware of the problem and if necessary, replace the included dosing dispenser with a syringe or other measuring device that uses milliliters. The FDA’s public health alert includes a chart giving the recommended dosage in both milligrams and milliliters according to the child’s weight.

The consequences of an incorrect dose can be serious. An overdose of Tamiflu is literally toxic; parents are advised to call a poison control center if they believe their children have been overdosed. Rare but serious adverse effects of Tamiflu can include liver problems, cardiac arrhythmia, seizure, aggravation of diabetes and a life-threatening skin condition called Stevens-Johnson syndrome. Meanwhile, an underdose of Tamiflu can make the drug ineffective, which puts the patient at risk for the worst symptoms of H1N1, including acute respiratory distress that leads to death in about half of those affected. While scientists still don’t fully understand the disease, children may be at special risk from the flu because studies show they don’t have the antibodies older people have.

As a defective prescription drug lawyer, I am happy to see that this problem was addressed before any reported cases of serious side effects from Tamiflu. Busy working parents with no special scientific or math training may not even notice the problem (especially since it uses the metric system), and if they do, it doesn’t seem likely that they’d come up with the equation Jacobson used. Thanks to worries about H1N1 spreading among children, the drug has sold so well that pharmacies briefly ran out of it, so there’s a lot around. With millions of parents stockpiling Tamiflu for use as a prophylactic, it’s not hard to imagine that a few might make mistakes that could seriously harm their children -- with the best of intentions.

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September 10, 2009

Drug Maker Pfizer to Pay Largest Criminal Fine Ever to Settle Allegations of Off Label Marketing

Pharmaceutical company Pfizer Inc. will pay $2.3 billion to the federal and state governments over allegations that it illegally marketed several drugs for off-label uses, the New York Times reported Sept. 2. The fine settles both criminal and civil allegations against the giant manufacturer for illegal off-label marketing of Bextra (gabapintin), a painkiller that is now discontinued, as well as Zyvox, an antibiotic; Lyrica, a nerve pain medication; and and Geodon, an antipsychotic. Whistle-blowing former employees and government regulators accused Pfizer of pushing doctors to prescribe Bextra for levels of pain beyond its FDA approval and at higher doses than approved, even though risks of the drug increased with the dosage. Bextra was withdrawn in 2005 because of reports that it increased risk of heart attacks and potentially fatal skin disorders.

This is actually the fourth off-label marketing fine for Pfizer. Most recently, the company was accused of pushing Neurontin, a drug approved for treating epileptic seizures and nerve pain, for off-label use to treat psychiatric disorders from the depression and anxiety spectrums. One of the six whistle-blowers in the current case was a sales representative for Pfizer while it was settling the Neurontin allegations. He said managers told him and his colleagues to ignore the controversy and the companywide integrity agreement Pfizer signed, and continue to market Bextra for illegal uses. “The whole culture of Pfizer is driven by sales, and if you didn’t sell drugs illegally, you were not seen as a team player,” he told the newspaper.

Despite the huge size of the fine, the Times said, the $2.3 billion payment represents fewer than three weeks of Pfizer’s sales. This incongruity, as well as Pfizer’s history of recidivism when it comes to illegal marketing practices, left prosecutors, drug safety advocates and pharmaceutical liability attorneys feeling cynical. Almost every major drug maker has been accused of paying kickbacks to doctors or hurting federal health programs financially -- in fact, Pfizer’s behavior in this most recent case allegedly cost Medicare and Medicaid millions of dollars. However, Pfizer general counsel Amy W. Schulman said consumers and regulators can still trust Pfizer because “the vast majority of our employees spend their lives dedicated to bringing truly important medications to patients and physicians in an appropriate manner.”

As a dangerous drug lawyer, I believe every part of that statement except the last clause -- “in an appropriate manner.” It is difficult to believe that the manufacturer is committed to appropriate drug marketing when it has now been fined four times for the same illegal marketing. Even though this fine set new records for its size, I do not believe that the company’s behavior will change until the fines get even higher -- or affect its profits in another substantial and long-term way. If the former employee is right that sales are the most important consideration at Pfizer, regulators must take actions that hurt sales and profits before this company, and others engaged in the same practices, will ever truly change. Until then, consumers trying to protect themselves have little choice but to question their doctors closely about FDA approval for the drugs they are prescribed.

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August 28, 2009

FDA Announces Investigation Into Reports That Weight-Loss Drug Caused Liver Failure

The U.S. Food and Drug Administration announced Aug. 24 that it is looking into safety problems with a popular weight-loss drug. According to the Los Angeles Times, the agency has received at least 32 reports of liver problems with orlistat, sold over the counter as Alli and as the prescription drug Xenical. The FDA is analyzing data included in those reports, as well as data from manufacturers, and said it would announce results as soon as the study is complete. The agency is not taking any enforcement action yet and did not tell patients to stop taking the drugs, but it did tell them to talk to their doctors if they see signs of liver problems.

The FDA’s press release said the agency received the 32 reports of problems with orlistat between 1999 and October of 2008. Of those patients, 27 had to be hospitalized, and six suffered liver failure. The most common liver problems reported to the FDA as side effects of orlistat were weakness, abdominal pain and jaundice, which is a yellowing of the eyes and skin. Other signs of liver problems include fatigue, fever, brown urine, pale stools, nausea and vomiting, itching and loss of appetite.

Orlistat helps patients lose weight by stopping the digestive tract from absorbing about 25% of the fat they eat. The 2007 approval of the over-the-counter version, Alli, was widely anticipated by the weight-loss community because of its apparent effectiveness. However, Alli was not without side effects even before the recent reports of liver problems. In fact, the drug is somewhat famous for having an embarrassing, though minor, side effect -- fecal incontinence, or loss of control over the bowels, especially in people who eat too much fat. Alli’s manufacturer, GlaxoSmithKline, went so far as to tell users to carry a change of clothes for the first few days they use the drug, in case of an “accident.” Long-term studies have also linked orlistat to cancer, although not definitively.

As a dangerous drug lawyer, I am much more concerned about these new reports of possible liver damage than I am about fecal incontinence. Liver problems can lead to liver failure, and liver failure is a serious, life-changing health problem with a high chance of death. People with liver failure require hospitalization, close monitoring, special diets and, in cases where the organ cannot recover, liver transplants. This is an unacceptable risk to exchange for the opportunity to lose a few pounds. Orlistat is very popular, with more than 22 million users worldwide. That means that even if only a fraction of those users develop serious liver problems, thousands of people could still develop life-threatening illnesses or lifelong, disabling organ damage -- all to lose a few pounds.

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July 22, 2009

Merck and Schering-Plough Pay $5.4 Million to Settle Drug Cover-Up Suits

As a St. Louis drug liability lawyer, I was scandalized but not surprised by a recent revelation that Merck & Co. and Schering-Plough Corp. actively suppressed evidence about their drugs’ efficacy in order to prtect their bottom lines. The two New Jersey companies last week stated they would pay $5.4 million to settle civil claims that they had buried test results suggesting two of their new cholesterol drugs were less of a breakthrough than they were purported to be. The 5.4 million sum only represents only the costs of the investigations, which came from 35 states plus the District of Columbia. The two companies need not make any other payments, or admit to any sort of wrongdoing -- despite some pretty damning evidence.

In January of 2008, Merck and Schering-Plough released studies showing that Vytorin and Zetia were no more effective at reducing plaque buildup in neck blood vessels than Zocor, an older drug that is now available in a vastly cheaper generic form. The trouble is, these studies were completed in 2006 -- two years prior to the results' release. In other words, plenty of time was allowed for consumers and their doctors to be misled into spending more money than they really needed to. With sales of Vytorin at $2.78 billion and Zetia at $2.41 billion in 2007, that means thousands or even millions of people were misled by these companies’ failure to warn them. They may also have assumed unnecessary risks of serious side effects, including muscle disease and even cancer.

In fact, a 2007 piece in the New York Times suggested that Merck and Schering-Plough may have also suppressed evidence from clinical trials that found a connection between the drugs and liver problems. But even if there were no evidence of safety problems, it’s disturbing that drug companies would choose to bury negative information about their products in order to protect their profits. If they are willing to hide information about comparative efficacy and liver disease, what else might they be hiding? This deception alone is enough to form the basis of a strong St. Louis defective medication lawsuit claiming damages for the drug companies’ failure to warn consumers.

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June 30, 2009

FDA Calls for Reduced Maximum Dosage of Common Pain Reliever Acetaminophen

A panel of experts convened by the U.S. Food and Drug Administration has voted to lower the maximum dosage of pain reliever acetaminophen, HealthDay reported June 30. The vote made big news because acetaminophen is an extremely common ingredient in over-the-counter cold and flu medicines taken by millions of Americans each year, including Tylenol and Excedrin. The panel acted out of concerns about liver damage, a known side effect of acetaminophen overdose. The FDA is not required to follow its panel’s recommendations, but it typically does.

Doctors have known for years that an acetaminophen overdose can cause liver damage. In fact, the FDA says acetaminophen is the leading cause of liver failure in the U.S., contributing to 200 deaths a year and sending 56,000 to emergency rooms. Acetaminophen is safe for most people at recommended doses, but an FDA report issued in May says many consumers don’t realize they’re endangered when they go over the recommended dosage, or combine multiple medications containing acetaminophen. That concern drove the vote to lower the recommended dosage, which is currently 4 grams daily and 1,000 milligrams in any individual pill. The panel did not set a daily maximum, but reduced the per-pill maximum to 650 milligrams for over-the-counter medicines.

This video from the Associated Press explains the issue:
Video from the Associated Press:

Of course, the pharmaceutical industry resisted the panel’s efforts to further regulate acetaminophen, arguing that the high doses currently allowed are necessary for patients treating chronic pain. According to the AP, acetaminophen-containing drugs saw $2.6 billion in sales last year, with over-the-counter medicines representing 80% of those sales. However, as a dangerous drug lawyer, I’m pleased that the panel took steps to keep American consumers safe. Many millions of Americans keep these medications in their homes as medicine-cabinet staples, and some use acetaminophen every single day. That means millions of people are exposed to injuries from acetaminophen overdose. Even if only a fraction of these end up accidentally overdosing, they could still represent thousands of unnecessary and preventable deaths.

When most people think of dangerous drugs, they think of medications that are defective by design or manufacture, like Vioxx -- that is, the medicine is dangerous no matter how it’s used. But manufacturers of drugs (and other consumer products) can also be legally liable if they fail to give consumers sufficient warning of a serious safety problem with their products. Consumers need clear information to make informed decisions about what medications are safe for them. If manufacturers fail to warn patients about the dangers of their products in a way that meets FDA standards, and patients are hurt as a result, those patients have the right to hold the manufacturer legally responsible with a defective drug lawsuit.

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May 19, 2009

Watchdog Group Asks FDA to Add Warning on Label of Constipation Drug That May Cause Miscarriage

Consumer advocacy group Public Citizen has asked federal regulators to require a black box warning on the label of a drug it says may induce miscarriage or premature labor, the Associated Press reported May 6. Amitiza (lubiprostone) is prescribed to people who suffer from chronic constipation, but it is chemically similar to misoprostol, which can induce labor and miscarriage in pregnant women. Amitiza’s label currently warns that the drug has not been tested in pregnant women and that they should use it only if the benefits outweigh the risk to the fetus, but Public Citizen wants a stronger label. Neither the FDA nor the drug’s maker, Sucampo Pharmaceuticals, commented for the story.

Amitzia, which is considered less addictive and easier to tolerate than older laxatives, was prescribed more than a million times in 2008. Its chemical cousin, misoprostol, is approved for treatment of gastric ulcers in the United States. However, misoprostol also causes uterine contractions and thins the cervix, which is why it is widely used off-label, and approved in other countries, to induce labor and end pregnancies. In fact, it may be prescribed with the abortion drug RU-486. It is also used when a natural miscarriage or other obstetric problem leaves tissues in the uterus.

It is unclear whether Amitzia has similar effects. No studies have been done examining the drug’s effect on human pregnancies, but studies with Guinea pigs have shown a 4% miscarriage rate. For that reason, it is still available to pregnant women, although its label suggests that they weigh the risks of using Amitzia against its benefits. A spokesman for Public Citizen called that label “grossly inadequate” and lacking in useful information.

As a defective prescription drug attorney, I agree. While I am sure most patients will do what’s best for their unborn children, they must be armed with good information to do so. As things currently stand, they must rely on a doctor or their own self-directed research to find that information. History has shown over and over again that pharmaceutical companies cannot be trusted to disclose information that might hurt their drugs’ sales. Pregnant women taking Amitzia could run extremely serious risks -- inducing a miscarriage or giving birth prematurely, which can cause death and serious birth defects in the baby and is also extremely expensive. Until quality studies in humans establish that Amitzia is safe, women should at least be clearly warned of the risks.

The dangerous pharmaceutical lawyers at The Lowe Law Firm represent victims of just this kind of oversight -- people who were hurt by a drug that was supposed to help. Based in St. Louis, we handle defective medication lawsuits for victims in Missouri, the Midwest and around the United States. If you’ve been seriously harmed or lost a loved one to a defective prescription drug, we would like to help. To learn more, please contact us online today or call toll-free at 1-877-678-3400.

April 30, 2009

Over-the-Counter Painkillers Must Carry Stronger Warnings of Potential Organ Damage, FDA Decides

In a decision that affects nearly every home in the United States, the U.S. Food and Drug Administration required stronger warnings Tuesday for labels on several common over-the-counter painkillers. According to Forbes magazine, the rules require pharmaceutical companies to display the chemical name of the product prominently on its label and warn of any potential interactions with other drugs or common consumables like alcohol. Products containing acetaminophen must also warn about the risk of severe liver damage, and products containing non-steroidal anti-inflammatory drugs must warn about the risk of stomach bleeding. Manufacturers have one year to change their labeling to comply.

The labeling change affects multiple common over-the-counter pain relievers, including Advil, Tylenol, Bayer, Aleve, Excedrin and Motrin. The generic names of the affected products include aspirin, acetaminophen, ibuprofen, naproxen and ketoprofen. All of those drugs but acetaminophen are in a category of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are associated with an increased risk of bleeding in the stomach, particularly in people over 60, those who are taking blood thinners or steroids or people with ulcers or other stomach problems. Heavy use of NSAIDs also contributes. Labels will soon warn consumers about the potential for stomach problems and common risk factors.

Acetaminophen, which is in a category of drugs by itself, does not carry a risk of stomach bleeding. Rather, the new FDA rule will warn consumers of the increase risk of severe liver damage from taking acetaminophen, especially for exceeding the maximum recommended does. According to an FDA press release, research shows that some people take more acetaminophen than the label recommends, while others may take several acetaminophen-containing products at once without realizing the risk. Having three or more alcoholic drinks on the same day can also increase the risk of liver damage. In addition, taking acetaminophen with the blood thinner warfarin may increase the chances of serious bleeding problems. An FDA advisory committee plans to meet in late June to discuss

As an dangerous drug injury attorney, I am pleased at the FDA’s announcement. The problems with both kinds of medicines have been understood for decades, and in fact, acetaminophen overdose is the most common cause of acute liver failure in the United States. Unfortunately, many consumers don’t realize this, so they feel free to take another dose if the first does not work to relieve their pain. As the FDA press release notes, manufacturers have voluntarily added some amount of safety labeling to address the issues, but not as many as the agency now requires. With literally millions of Americans of all backgrounds and states of health taking these medications every day (at a cost of billions of dollars annually), we need clear safety information on their labels.

The pharmaceutical liability lawyers at The Lowe Law Firm represent people who have suffered serious illnesses or injuries because they took a dangerous over-the-counter or prescription medication. In a defective drug lawsuit you can win back the cost of the drug and all of the treatment it necessitated, as well as compensation for a serious injury, permanent disability or the loss of someone you love. If this sounds like your situation and you’re ready to take the next step, you can learn more about your rights and your options at a free, confidential consultation. To set one up, please contact our main St. Louis office or call toll-free at 1-877-678-3400.

February 25, 2009

FDA to Study Effects of TV Ads for Prescription Drugs on Consumers -- Missouri Pharmaceutical Liability Law Firm

The FDA plans to study how well consumers absorb information and respond to television advertisements for prescription drugs, American Medical News reported Feb. 2. The agency is interested in how well consumers learn about the risks and benefits of drugs they see on television, the article says, with the goal of setting standards for the ads. To study this, the FDA will produce television ads for a fictional blood pressure medication and recruit 2,400 people to watch them and tell researchers what they've learned. The study's start date was not announced, but the FDA was taking public comments until the end of January.

Television ads that market directly to consumers -- rather than to the doctors responsible for prescribing drugs -- have been controversial throughout their 12-year lifespan. The ads were not allowed on the air or in print at all until 1997, and only one other country, New Zealand, allows them on television. Since TV pharmaceutical ads were introduced in the U.S., doctors and consumer activists have repeatedly complained that the ads encourage patients to ask for drugs that they don't really need, wasting doctors' time and raising the risk of over-medication. Another concern is that direct-to-consumer ads gloss over the risks of a drug and spend more time on their benefits, presenting a biased view. And one study showed that the ads aren't very effective, raising concerns about wasted millions that are built into the cost of the drugs.

In response, the American Medical Association has called for drug makers to submit to mandatory FDA review of the ads; allow doctors to learn about a drug before advertising it to consumers; and make a more balanced presentation of drug risks and benefits. Congress is also concerned about the safety of drug ads, which is why it asked the FDA to set drug advertising standards in the FDA Amendments Act of 2007. The FDA's advertising study was launched in response to that legislation, in hope of eventually devising standards.

As a Missouri drug injury attorney, I am concerned about the possible over-medication effect of prescription drug advertising. Statistics show that prescription drug errors are already responsible for more deaths each year than illegal drugs, so we hardly need to create more unnecessary prescriptions. Furthermore, the drugs that are most likely to be advertised on television are the newer drugs, which means we still have relatively limited information on their safety and efficacy. Among recent heavily advertised drugs that turned out to have serious problems are Vioxx, a painkiller now withdrawn from the market after strong links to heart attacks and strokes, and Zyprexa, a psychiatric medication that may cause diabetes and was allegedly illegally marketed for off-label uses.

The Lowe Law Firm has active pharmaceutical liability practices for victims of both Vioxx and Zyprexa. If you or someone you love developed serious health problems after taking these drugs -- or other dangerous pharmaceuticals -- we would like to hear from you. Based in St. Louis, we help clients in the Midwest and throughout the United States. To schedule a free consultation, please contact us online or call us at 1-877-678-3400 as soon as possible.

February 20, 2009

FDA Panel Recommends Davron and Darvocet Be Removed From Market -- St. Louis Defective Prescription Drug Lawyer

An FDA panel, citing safety risks, voted Jan. 30 to remove a pair of painkillers from pharmacy shelves. According to the Associated Press, the panel of outside experts voted to end sales of Davron and Davrocet because of concerns that their safety risks outweigh their benefits. The FDA is not bound by the decision, but it frequently follows the recommendations of its outside panels.

Davron (propoxyphene) is a opioid painkiller used for mild to moderate pain. Davrocet is a combination of Davron and acetaminophen, the active ingredient in Tylenol, and is now more frequently prescribed then Davron alone. Like all opioids, both drugs carry a high potential for addiction and abuse and are not safe when combined with alcohol. They have also been linked with serious health problems, including heart problems, respiratory disorders and kidney and liver problems. And in the 1970s, studies linked the drug with suicide, prompting an unsuccessful drug recall campaign from watchdog group Public Citizen. Complaints from the same group spurred the current review.

Davron has been on the market since the 1950s and is now among the 25 most commonly prescribed drugs in America, with 20 million prescriptions written in 2007. However, because it is a relatively weak painkiller competing in a field that includes newer, stronger drugs, experts are concerned that its risks are now greater than its benefits. A limited federal study showed about 500 Davron-related deaths in 2007; 20% of these were suicides. In Florida, medical examiners found Davron in the bodies of 341 people who died of any cause and cited it as the cause of death in 85 cases (about a quarter of the total). The British version of the drug was banned outright in 2005.

The FDA may not take such a drastic step; it could choose to strengthen the warnings on Davron's label or further restrict its use. However, the controversy over this drug dates back more than 30 years -- making its risks older than some of the patients taking it. As a Missouri defective drug lawyer, I know that the FDA is currently very reluctant to recall prescription medications, sometimes even when there's strong evidence that they have serious defects. However, when the doubts about a drug have persisted for so long, it may be time for serious action. Thanks to advancements in medical science, doctors now have a variety of safer or more effective drugs to replace it with.

If it turns out that Davron has been putting patients at serious risk of suicide, heart problems and other serious side effects for decades, its manufacturers could be legally liable to thousands or even millions of families in a defective prescription drug lawsuit. If you believe you or someone you love was hurt by Davron, Davrocet or another potentially dangerous medication, The Lowe Law Firm can help. Based in St. Louis, we help clients in Missouri and throughout the nation who have lost a loved one or sustained permanent injuries because of a drug company's carelessness.

To learn more about your rights at a free consultation, please contact the Lowe Law Firm online today or call toll-free at 1-877-678-3400.

December 22, 2008

Drug Maker Wyeth Under Fire for Use of Ghostwriters -- St. Louis Defective Drug Lawyers

Pharmaceutical company Wyeth is the subject of a Congressional investigation for its use of ghostwriters to publish favorable articles in medical journals, the New York Times reported Dec. 12. The newspaper reported that Sen. Chuck Grassley, a Republican from Iowa, has asked With and its ghostwriting services company to disclose the roles of the doctors and the amounts of payments made for the articles.

The ghostwritten articles were on hormone replacement therapy Prempro, for women undergoing menopause. The drug’s sales dropped sharply after a federal study linked it to an increased risk of breast cancer, heart attacks and strokes. However, the ghostwritten articles were favorable to the drug. One that was published more than a year after the federal study said that there was no definitive evidence that the drug caused cancer, and that hormone users had a better chance of surviving cancer.

The senator requested the disclosures after Congress received documents from a personal injury lawyer investigating ghostwriting by Wyeth. According to those documents, Wyeth planned and commissioned at least 10 medical journal articles before those articles were even seen by the doctors who “wrote” them. Revisions by those doctors were subject to Wyeth’s final approval, the documents said. This contradicts medical journals’ ethical standards, which generally forbid ghostwriting, according to the New York Times.

As a Missouri dangerous drug attorney, I am extremely interested in this ongoing story, but not as surprised as I could be. Thanks to my pharmaceutical liability practice, I’ve known for some time that some drug makers are willing to actively mislead the public about their drugs’ safety. In fact, this isn’t the first dangerous drug that has benefited from medical ghostwriting -- articles have also been ghostwritten for Redux and Pondimin (also Wyeth products) and Vioxx (Merck). All three of these have since been withdrawn from the market after being linked to serious heart and lung problems.

Prempro is still on the market, but doctors have been advised to prescribe it only at low doses and for patients with severe symptoms. If the Congressional investigation finds that Wyeth knew about its health problems and intentionally covered them up by paying for favorable reports, the drug manufacturer may be hit with a new round of Prempro lawsuits. There is also anecdodal evidence that breast cancer rates in woman over 50 are declining because of reduced use of Hormone replacement therapy to "treat" the symptoms of menopause.The Lowe Law Firm represents clients who have been hurt by a prescription drug whose dangers were hushed up in this manner by manufacturers eager to protect their profits. If you believe you may have a defective medication case and you’d like to talk more about your options, please contact our firm online or call us at 1-877-678-3400 to set up a free initial consultation.