Your pharmacist can help answer medicine queries
Q: When my pharmacist dispensed a prescription for the antifungal drug fluconazole, he included the official prescribing information. It boggles my mind.
First, the print is too small to read without a magnifying glass. Second, the details are beyond my comprehension. After all, I only have a Ph.D. in atmospheric sciences. What are we supposed to do with this useless paper?
A: We agree that the print is too small and the words are too big on the package insert you sent us. Sometimes pharmacies offer more patient-friendly printed information that can be read without a magnifying glass or a Ph.D. of any sort.
Even some TV commercials use technical language that most people won’t understand. For example, an ad for the diabetes drug Jardiance states: “Ketoacidosis is a serious side effect that may be fatal. A rare but lifethreatening bacterial skin infection in the skin of the perineum could occur Taking Jardiance with a sulfonylurea or insulin may cause low blood sugar.”
Many viewers are not familiar with terms such as “ketoacidosis,” “perineum” or “sulfonylurea.” Symptoms of ketoacidosis include nausea, stomach pain, fatigue and trouble breathing. The perineum is the area between the genitals and the anus. A sulfonylurea drug is a diabetes pill, such as glimepiride or glyburide.
Ask your pharmacist for the patient information about your prescription.
Q: We’re still hearing about hydroxychloroquine as a treatment for the coronavirus. Most medical authorities have concluded it is neither safe nor effective as a treatment for the virus.
Observational studies report it can be effective when used early on for treating the coronavirus — together with zinc and azithromycin — but it has limited effectiveness when a COVID-19 patient is seriously ill.
Have any researchers studied prescribing hydroxychloroquine prophylactically to at-risk people, such as frontline medical workers?
A: We could find only one randomized controlled trial of hydroxychloroquine to prevent
COVID-19 in exposed individuals (New England Journal of Medicine, Aug. 6, 2020). The investigators recruited over 800 people exposed for more than 10 minutes at a distance of less than 6 feet to infected coronavirus patients. Many were health care workers exposed on the job.
The volunteers started taking HCQ or placebo within four days of their exposure. After two weeks there was no significant difference between the two groups in terms of symptoms or COVID-19
test results.
Q: Six years ago, my doctor prescribed Voltaren Gel for arthritis in my knee. She assured me that the warnings only applied to the oral form of the drug. I got excellent relief.
After three weeks, however, I suddenly developed swelling in that leg. My blood pressure went up to 220/110 and I ended up in the emergency room. They monitored me for six or seven hours until my blood pressure returned to normal. Voltaren, even topical, can cause some serious side effects.
A: Voltaren Gel for arthritis pain is now available without a prescription. The Food and Drug Administration has warned that both oral and topical NSAIDs like diclofenac (Voltaren Gel) can lead to edema and high blood pressure.
People who cannot tolerate NSAIDs like diclofenac, ibuprofen and naproxen may benefit from nondrug approaches to manage joint pain.