Category Archives: Pharmacy

Pharmacy

People’s Pharmacy: Statin interaction proved fatal

Q: At age 71, my mother was taking medicine for diabetes, high cholesterol and a few other conditions. Her doctor changed her statin drug but didn't modify the dose.

Within a few months, she lost the ability to move from the neck down and was in the hospital going through test after test after test. I started looking into her meds and discovered the reason for her rhabdomyolysis: The effect of the more potent statin was eight times higher than it should have been. This was in part because it interacted with other medications she was on.

She was in the hospital for three months. After she got out, she survived at home for just six more months.

A: Rhabdomyolysis is a potentially fatal reaction in which the muscles break down and the kidneys fail. Older people may be particularly susceptible to such rare but dangerous side effects from statins. We are so sorry to learn that your mother suffered this deadly consequence.

Statin drugs vary in their potency. More powerful statins are generally prescribed at lower doses. Some statins interact with other medications and require dosage adjustment. Lower doses of simvastatin are needed, for example, when people are also taking blood-pressure medicines such as amlodipine, diltiazem or verapamil or a heart drug such as amiodarone.

Q: Getting off Cymbalta is challenging but not impossible. I experienced lightheadedness, dizziness and "brain zaps." These felt like being able to hear my eyes move. It sounded like the lightsabers on "Star Wars" very strange and disconcerting.

The key is to reduce the dosage very, very slowly. Take the capsules apart and begin by removing 5 or 10 of the tiny balls inside. Do this for a week or so, then slowly increase the amount you remove each week or two as you can tolerate it.

Your doctor may not be of any help. Mine wasn't. He instructed me to wean off over a two- to three-week period, and I almost lost my mind. I did it myself over a year or more.

A: We appreciate your detailed description of how you got off Cymbalta (duloxetine). The Food and Drug Administration does not require manufacturers of antidepressants such as citalopram, duloxetine, paroxetine, sertraline or venlafaxine to provide detailed instructions on gradual withdrawal. We think this is a serious oversight, since "discontinuation syndrome" is common and challenging.

Q: I have developed an addiction to crushed ice in the past year. I crave it and consume three to four huge cups of ice a day. One of my friends said my body must be missing something it needs, and that's what is causing this problem. Do you have any suggestions?

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People's Pharmacy: Statin interaction proved fatal

Pharmacy

People’s Pharmacy: Do caffeine pills have health benefits?

Q: You've written about the health benefits of coffee. I don't like the taste, so I get my caffeine from tablets (NoDoz). Am I getting the same benefits as those who drink coffee?

A: Coffee is much more than a caffeine delivery vehicle. There are at least 1,000 different compounds in a cup of brewed coffee, and it's hard to tease out the effects of caffeine from all the other chemicals.

Epidemiological studies have shown that coffee consumption is linked to a lower risk of type 2 diabetes (American Journal of Clinical Nutrition, April 2010) and heart failure (Circulation: Heart Failure online, June 26, 2012).

Regular coffee can delay Alzheimer's disease progression (Journal of Alzheimer's disease online, June 5, 2012). Other chemicals in coffee may enhance the effects of caffeine on the brain (Journal of Alzheimer's disease, July 2011).

A recent study found serendipitously that regular coffee reduced neck and shoulder pain triggered by computer work (BMC Research Notes online, Sept. 3, 2012). Whether the subjects would have gotten the same results from a caffeine tablet is unknown.

Q: My sister (60 years old) just broke her femur without any trauma. She simply stepped down, and as she stepped, her femur snapped.

She had taken Fosamax for five years and stopped last year when she heard of possible side effects such as broken femurs and deteriorating jaws. What can you tell us about this problem in otherwise healthy women?

A: The Food and Drug Administration approved Fosamax in 1995 to treat osteoporosis. A decade later, the first reports of unusual thighbone fractures began to surface. These breaks often occurred without a preceding fall or other trauma.

Someone who is exposed to this type of drug (bisphosphonates such as alendronate, ibandronate or risedronate) for more than five years may be at risk. Because the drugs linger so long in the body, the danger may persist even after the medication has been discontinued.

Q: For more than 30 years, my husband dealt with IBS (irritable bowel syndrome). He came to suspect that the problem might have been triggered by overprescription of antibiotics.

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People's Pharmacy: Do caffeine pills have health benefits?

Pharmacy

People’s Pharmacy: Testosterone not right for woman’s low libido

Q: At age 29, I had to have a hysterectomy that included my ovaries. After the fat-stored estrogen left my body (producing horrid hot flashes), I complained to my OB-GYN about my missing libido. He wrote me a prescription for an estrogen and testosterone mix.

I began taking the pills, but I had strange changes in my body. I developed acne, facial hair, body hair and a low voice. I even began to walk differently. It helped some with sex drive, but I felt less and less feminine and more masculine. I hated it. I don't think testosterone is worth the worry, even for women without ovaries.

A: You experienced predictable side effects of testosterone. The Food and Drug Administration has not approved testosterone to lift libido in women. If physicians prescribe this male hormone off label for women, they should use the lowest dose that works to boost sex drive without producing masculine characteristics. This requires careful follow-up. In your case, that doesn't appear to have happened.

Q: I have been a type 1 diabetic for 66 years. Because diabetes can lead to kidney problems, my doctor prescribed a blood-pressure drug that helps protect the kidneys.

I had no side effects, but when my blood pressure increased to 130/75, my doctor doubled the dosage. My blood pressure improved, but I started having terrible dizziness. At present, I often have a blood pressure like 120/58. If I take half the dosage, it measures around 135/65.

At half dosage, I am not nearly as dizzy. On a full dose, I stagger or fall down.

My doctor wants me to continue the high dosage even though my kidneys are fine and I am miserable. Is this reasonable?

A: Any medicine that causes dizziness and falls is probably doing more harm than good. A hip fracture can be life-threatening.

A recent analysis of well-controlled studies revealed shocking results. The rigorous and independent Cochrane Collaboration concluded that drug treatment of mildly elevated blood pressure (below 159 systolic and 99 diastolic) does not prevent heart disease and death (Cochrane Library online, Aug. 15, 2012).

Q: A couple of years ago, I had a bad fungal infection in my toenail, and it was about to fall off. My GP recommended Vicks VapoRub, and it worked great. It took several months for the new nail to grow out, but once it did, it was perfect. Because I work as a nurse and am on my feet all day, I am prone to these infections. Now I use VapoRub a couple of times a week to keep the problem from returning. It may not work for everyone, but it's worth a try.

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People's Pharmacy: Testosterone not right for woman's low libido

Pharmacy

Oxycodone stolen from Crystal Lake pharmacy

The Talker: Should Mayor Emanuel attend the DNC? The Talker: Should Mayor Emanuel attend the DNC?

Updated: Monday, September 3 2012 11:05 PM EDT2012-09-04 03:05:25 GMT

You've heard of the old rap group Run DMC, but now, "Rahm DNC" will be a topic of discussion this week.

You've heard of the old rap group Run DMC, but now, "Rahm DNC" will be a topic of discussion this week.

Updated: Monday, September 3 2012 10:40 PM EDT2012-09-04 02:40:03 GMT

Prosecutors have rested their case in the Drew Peterson trial and the judge says closing arguments will take place Tuesday after the holiday weekend.

Prosecutors have rested their case in the Drew Peterson trial and the judge says closing arguments will take place Tuesday after the holiday weekend.

Updated: Monday, September 3 2012 10:39 PM EDT2012-09-04 02:39:24 GMT

Academy Award nominee Michael Clarke Duncan was born and raised in Chicago.

Academy Award nominee Michael Clarke Duncan was born and raised in Chicago.

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Oxycodone stolen from Crystal Lake pharmacy

Pharmacy

People’s Pharmacy: Coffee has benefits, but not French press

Q: Years ago, I heard you on the radio praising the benefits of coffee. You made an exception for French press coffee, though. I never understood why this would pose a problem when regular coffee doesn't. I really like French press coffee, but I wonder if it could do me harm.

A: Research during the past decade suggests that coffee drinkers are less likely to be diagnosed with heart failure (Circulation: Heart Failure online, June 26, 2012) or develop type 2 diabetes (American Journal of Clinical Nutrition, April 2010).

Regular coffee consumption also seems to delay the onset of Alzheimer's disease (Journal of Alzheimer's disease online, June 5, 2012) and may help to protect against prostate and uterine cancers (Journal of National Cancer Institute online, May 17, 2011; Cancer Epidemiology, Biomarkers and Prevention online, Nov. 22, 2011).

The problem with French press and other types of unfiltered coffee techniques lies with blood lipids. Compounds from coffee can raise total cholesterol, triglycerides and bad LDL cholesterol (European Journal of Clinical Nutrition, August 2012). The culprits are in coffee oils that get trapped by filters, so people drinking filtered coffee should get the benefits without the higher cholesterol.

Q: Three times I have been forced by my insurance company to switch from Wellbutrin XL to generic bupropion. Each time, depression reared its ugly, gloomy head, and darkness descended again. Wellbutrin XL works, but the generic is a disaster for me.

Where is the accountability? Generic drugmakers should refund the money we waste on ineffective products.

A: Hundreds of others have reported similar problems with generic bupropion. Not only have they experienced a return of their depression, they also have reported side effects such as headaches, dizziness, nausea and insomnia.

Despite the Food and Drug Administration's claim that there are no problems with the generic antidepressant bupropion, there are substantial variations in resulting blood levels between the brand name and some generic formulations. We discovered that the FDA never required testing of one 300 mg long-acting formulation it approved. Dozens of other generic drugs also may pose problems.

Q: I have had stomach pain and diarrhea for years, but during the past few months it reached a crisis. The pain was so bad that I couldn't get comfortable sitting or even lying down. My stomach swelled up like a beach ball.

My doctor didn't know what was wrong. I finally asked my pharmacist if any of my pills had milk sugar (lactose). Every single one of the half-dozen pills I take contains lactose. Even though I am extremely careful about my diet (no dairy), I had no idea that my pills were poisoning me.

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People's Pharmacy: Coffee has benefits, but not French press