Pharmacy Podcast Network

This podcast is sponsored by YARAL Pharma.  In this episode, we are focusing on the management of hypothyroidism -- a treatable, but not curable condition – and will explore unique challenges for patients with hypothyroidism in long-term care – from tolerability and formulation considerations to consistent dosing and patient needs. Dr. Tamara Ruggles is not affiliated with YARAL Pharma. All views and opinions regarding hypothyroidism are solely her own and are not attributable to YARAL or the Pharmacy Podcast Network. IMPORTANT SAFETY INFORMATION for levothyroxine sodium capsules INDICATION AND USAGE Levothyroxine sodium capsules are L-thyroxine (T4) indicated for adults and pediatric patients 6 years and older with: Hypothyroidism - As replacement therapy in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism Pituitary Thyrotropin (Thyroid-Stimulating Hormone, TSH) Suppression - As an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well differentiated thyroid cancer Limitations of Use: Levothyroxine sodium capsules are not indicated for suppression of benign thyroid nodules and nontoxic diffuse goiter in iodine-sufficient patients as there are no clinical benefits and overtreatment with Levothyroxine sodium capsules may induce hyperthyroidism. Levothyroxine sodium capsules are not indicated for treatment of transient hypothyroidism during the recovery phase of subacute thyroiditis WARNING: NOT FOR THE TREATMENT OF OBESITY OR FOR WEIGHT LOSS Thyroid hormones, including levothyroxine sodium capsules, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Contraindications Uncorrected adrenal insufficiency Warnings and Precautions Cardiac adverse reactions in the elderly and in patients with underlying cardiovascular disease: Initiate Levothyroxine sodium capsules at less than the full replacement dose because of the increased risk of cardiac adverse reactions, including atrial fibrillation Myxedema coma: Do not use oral thyroid hormone drug products to treat myxedema coma Acute adrenal crisis in patients with concomitant adrenal insufficiency: Treat with replacement glucocorticoids prior to initiation of levothyroxine sodium capsules treatment Prevention of hyperthyroidism or incomplete treatment of hypothyroidism: Proper dose titration and careful monitoring is critical to prevent the persistence of hypothyroidism or the development of hyperthyroidism Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing, or discontinuing thyroid hormone therapy Decreased bone mineral density associated with thyroid hormone over-replacement: Over-replacement can increase bone reabsorption and decrease bone mineral density. Give the lowest effective dose Adverse Reactions Common adverse reactions with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage. They include the following: General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating Central Nervous System: headache, hyperactivity, nervousness, anxiety, irritability, emotional ability, insomnia Musculoskeletal: tremors, muscle weakness Cardiovascular: palpitations, tachycardia, arrythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest Respiratory: dyspnea Gastrointestinal (GI): diarrhea, vomiting, abdominal cramps, elevations in liver function tests Dermatologic: hair loss, flushing Endocrine: decreased bone mineral density Reproductive: menstrual irregularities, impaired fertility Adverse Reactions in Children Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height. Seizures have been reported rarely with the institution of levothyroxine therapy. Hypersensitivity Reactions Hypersensitivity reactions to inactive ingredients (in this product or other levothyroxine products) have occurred in patients treated with thyroid hormone products. These include urticaria, pruritis, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur. Drug Interactions: Many drugs and some foods can exert effects on thyroid hormone pharmacokinetics (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to Levothyroxine sodium capsules. Administer at least 4 hours before or after drugs that are known to interfere with absorption. See full prescribing information for drugs that affect thyroid hormone pharmacokinetics and metabolism. To report SUSPECTED ADVERSE REACTIONS, contact Yaral Pharma Inc. at 1-866-218-9009, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. For Full Prescribing Information, including Boxed Warning, go to www.yaralpharma.com/levothyroxine-pi.

In part one of our special three-part series, join host Todd Eury as he takes you inside the 2025 FrameworkLTC Innovation Conference. Recorded live on-site, this episode features conversations with long-term care (LTC) pharmacy leaders, partner exhibitors, and members of the SoftWriters team. Hear firsthand insights and success stories that highlight innovation, collaboration, and the future of LTC pharmacy.

In this episode of The Executive Dose, host Stephen Beckman, CEO of YARAL Pharma, sits down with Tom Napolitano, Senior Vice President and General Manager of Real Value Rx. With more than 30 years of experience across distribution, purchasing, and pharmaceutical operations, Tom brings unmatched perspective on how strategy, partnerships, and execution define success in the pharmacy supply chain. Guest Spotlight – Tom Napolitano Current Role: SVP & General Manager, Real Value Rx – overseeing nationwide sales, purchasing, and operations. Previous Leadership: Chief Operating Officer at Praxis Med, driving national partnerships with retailers and suppliers. Industry Roots: Over two decades at Cardinal Health in senior roles across purchasing, distribution, and pricing innovation. Key Themes in This Episode How distribution partnerships shape the economics and stability of the pharmacy industry. The balance between generic and brand purchasing strategies for long-term growth. The evolving role of technology and data in supply chain decision-making. Lessons from Tom on drug shortages, preparation, and aligning with flexible organizations in drug wholesale.  Why collaboration between distributors, manufacturers, and pharmacies is critical to serving patients effectively. Why Listen This conversation provides rare insights into the strategic decisions that drive pharmacy distribution and supply chain resilience. Whether you’re a pharmacy executive, supplier, or healthcare innovator, Tom Napolitano’s perspective offers practical lessons on partnership, scale, and operational excellence.

REFERENCES 1. Miller RV. Tylenol autism lawsuit. Lawsuit Information Center. September 21, 2025. Accessed September 25, 2025. https://www.lawsuit-information-center.com/tylenol-autism-lawsuit.html 2. Gerstein AS, Niederhelman EF. Harvard’s public health dean was paid $150,000 to testify Tylenol causes autism. The Harvard Crimson. September 24, 2025. Accessed September 25, 2025. https://www.thecrimson.com/article/2025/9/24/autism-dean-public-health/ 3. Poll: Most Americans encounter health misinformation, and most aren’t sure whether it’s true or false. News Release. KFF. August 22, 2023. Accessed September 26, 2025. https://www.kff.org/covid-19/poll-most-americans-encounter-health-misinformation-and-most-arent-sure-whether-its-true-or-false/ 4. Prada D, Ritz B, Bauer AZ, et al. Evaluation of the evidence on acetaminophen use and neurodevelopmental disorders using the Navigation Guide methodology. Environ Health. 2025 Aug 14;24(1):56. doi: 10.1186/s12940-025-01208-0. 5. Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children’s risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172 6. Alemany S, Avella-García C, Liew Z, et al. Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood: meta-analysis in six European population-based cohorts. Eur J Epidemiol. 2021 Oct;36(10):993-1004. doi: 10.1007/s10654-021-00754-4. 7. Ji Y, Azuine RE, Zhang Y, et al. Association of cord plasma biomarkers of in utero acetaminophen exposure with risk of attention-deficit/hyperactivity disorder and autism spectrum disorder in childhood. JAMA Psychiatry. 2020;77(2):180–189. doi:10.1001/jamapsychiatry.2019.3259

Celebrating the Launch of American Pharmacists Month 2025 “Caring for our Communities” This Week in Pharmacy (TWIRx) Friday, October 3, 2025 Episode Overview Today marks the kickoff of American Pharmacists Month 2025, a time to recognize the essential role pharmacists play across all healthcare settings. This special TWIRx episode spotlights leaders and innovators shaping pharmacy practice, technology, and patient care — and challenges the profession to embrace a 31-day journey of advocacy, community connection, and transformation. TWIRx NEWS Former Rep. Tiahrt: Pharmacy Benefit Manager bill could shut down CVS in Kansas | Opinion Read more at: https://www.kansas.com/opinion/guest-commentary/article312355904.html#storylink=cpy Neronha lawsuit against CVS Caremark can help save my Middletown pharmacy: Guest View https://www.newportri.com/story/opinion/columns/guest/2025/10/03/neronha-lawsuit-against-cvs-can-help-save-middletown-pharmacy-guest-view/86471928007/    FDA Approves Lurbinectedin Combination Regimen in Extensive-Stage SCLC https://www.pharmacytimes.com/view/fda-approves-lurbinectedin-combination-regimen-in-extensive-stage-sclc  Building an Opioid Stewardship Program in Cancer Care: Pharmacist Roles, Challenges, and Patient Safety https://www.pharmacytimes.com/view/building-an-opioid-stewardship-program-in-cancer-care-pharmacist-roles-challenges-and-patient-safety  Featured Guests Dr. Jesse McCullough, PharmD Founder, Keystone Pharmacy Insights Introducing the American Pharmacists Month 31-Day Challenge, a call to action for pharmacists to engage, educate, and elevate their communities. Bil Schmidtknecht Patient Protector Sharing insights on patient advocacy, protecting access to care, and the pharmacist’s role in navigating today’s healthcare complexities.   Dr. Devin Bustin, MD Chief Medical Officer, OvaryIt Dr. Lissette Logan, PharmD COO, OvaryIt Together, Dr. Bustin and Dr. Logan discuss innovative pharmacist-driven care models, treatment tracking, and platforms like PRISM designed to ensure pharmacists are recognized — and reimbursed — for their expertise.   Dr. Jill Kolesar, PharmD Dean, College of Pharmacy, The University of Iowa Highlighting the future of pharmacy education and how academia is preparing the next generation for expanded clinical and community roles. Dr. Jason Lang, PharmD Wellgistics Exploring the logistics and supply chain innovations that keep pharmacies agile in serving patient needs, especially as new therapies and technologies emerge. WELLGISTICS News: https://www.accessnewswire.com/newsroom/en/healthcare-and-pharmaceutical/wellgistics-health-nasdaq-wgrx-and-theracosbio-partner-to-expand-nati-1079815  SUBSCRIBE TO TWIRx HERE:  https://open.spotify.com/show/52NZjr9asE8fLrrbsMvBlQ  Celebrating the Launch of American Pharmacists Month 2025 | TWIRx 

Tune in to a multi-episode recap of the Retail Business Conference with returning special guest host Adam Robinson, Owner of Save-Rite Drugs in Lexington, Kentucky. Receive the highlights from Cardinal Health customers, employees, services and more at RBC 2025. The final episode's topic is on the importance of celebrating women in pharmacy, elevating your leadership skills, differentiating in the community and overcoming challenges.

In this episode, Tamara sits down with Carrie Krebs, PharmD, to talk about the important role pharmacists play in hospice care. Together, they cover commonly used medications, key regulations, deciding when to stop certain drugs, and more. Carrie also opens up with a personal story about her own loved one’s hospice journey.

Financial pressures, reimbursement challenges, and adapting to new regulations Brian reflects on his transition from VP at Bi-Mart to owner of Caris Pharmacy, sharing insights on managing margins, operations, and strategy Spotlight on Indiana’s Disclosure of Actual Acquisition Cost (Indiana Code § 27-1-24.2) effective Jan 1, 2026, and what it means for independents and regional chains alike

This episode dives into the future of pharmacy through the lens of pharmacogenomics (PGx). Dr. Melissa Smith speaks with Dr. Vanessa Lesneski about the steep decline in pharmacy school enrollment and how PGx could reignite interest in the profession. They explore how PGx has rapidly evolved from an elective to a core component of pharmacy education, the rise of certification and training pathways, and the expanding career opportunities in diverse care settings. The discussion also tackles critical questions around pharmacists’ role in test interpretation, skepticism about PGx adoption, and what it will take for the field to move from niche to mainstream.

On "This Week in Pharmacy" for September 26th, we're talking about Trust in Healthcare, World Pharmacists Day, and Cell & Gene Therapy. Today's co-host is Dr. Melissa Smith, PharmD CPH with Florida PGx Consulting LLC. https://www.floridapgxconsulting.com/  First, #TWIRx News - the FDA approves Inluriyo imlunestrant on 9/25/2025 which is to treat estrogen receptor-positive, human epidermal growth factor receptor 2-negative, estrogen receptor-1-mutated advanced or metastatic breast cancer with disease progression following at least one line of endocrine therapy. (https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2025)  Second, Nested-Knowledge - is going to revolutionize information access and leverage. This is a powerful tool with evidence synthesis tools for medical researchers. This will help accelerate, collaborate, automate and share the latest and personalized treatment plans. (https://nested-knowledge.com/) Next, announcing "Evidence based Podcasting", the new standard in audio learning for Providers and next level in podcast Continuing Medical Education (CME). (https://pharmacypodcast.com/2025/09/26/evidence-based-podcasting-and-the-future-of-medical-education/ ) Shout out to Nick Calla with Orsini, a leader in rare disease pharmacy solutions, has been chosen by Crinetics Pharmaceuticals, Inc., as a specialty pharmacy partner for PALSONIFY™ (paltusotine), a nonpeptide, selectively-targeted somatostatin receptor type 2 nonpeptide (SST2) agonist. (https://www.wvnews.com/news/around_the_web/partners/pr_newswire/subject/licensing_marketing_agreements/orsini-selected-as-specialty-pharmacy-partner-for-crinetics-palsonify-paltusotine/article_9b42bfe7-69a6-58be-98ff-5e2245145415.html) Today we have two guest Pharmacists to dig into the "Trust in Healthcare" theme of today's #TWIRx -- the godfather of Functional Pharmacy Robert Kress RPh., and Dr. Lauren Castle, PharmD, MS, AFMC - Founder & CEO of Functional Medicine Pharmacists Alliance. Who do you trust? What information is trustworthy and why?  Our special feature is updates on 'Cell & Gene Therapy' with McKesson's Head of Cell Gene Advanced Therapies, Joe DePinto at InspiroGene!  (https://inspirogene.com/)  Today's TWIRx is sponsored by 'Sykes & Company' the Pharmacy Accounting Jedi Masters and Independent Pharmacy Cooperative (IPC) and how they're revolutionzing digital health and new revenues with the iCare+ System!    Trust Matters, Cell and Gene, & World Pharmacists Day | TWIRx