PHARMACIST FIBBED ABOUT SOURCE OF MEDICINE

Q: I received a call from my pharmacy that my blood pressure medicine, valsartan, was being recalled. They replaced it with a safer alternative. When I picked it up, I specifically asked the pharmacist if the valsartan was made by a U.S. company and if it had been manufactured in the USA.

She was emphatic that the Macleods valsartan was from a U.S. company and the pills were made in the United States.

When I got home I got out my magnifying glass and discovered that the pills were “manufactured for Macleods Pharma USA, Inc.” The address was Plainsboro, N.J. That was reassuring until I looked a little closer. The label also stated that my pills were “Manufactured by Macleods Pharmaceuticals Ltd. Damon (U.T.) INDIA.” Shouldn’t the pharmacist have told me the truth?

A: It is not unusual for foreign pharmaceutical companies to have U.S. subsidiaries. According to the company, Macleods Pharma USA is the U.S. division of Macleods Pharmaceuticals, LTD, based in Mumbai, India.

According to the Food and Drug Administration, this company’s valsartan products are “not currently recalled.” That means they should be considered a safe alternative. We do think the pharmacist should have been truthful and told you that the parent company was in India and the pills were made there. Perhaps she had not taken the time to look it up, so she just assumed “Plainsboro, N.J,” meant “Made in the USA.”

Q: I took Zyban to quit smoking in 1997. Other than it slowing me down, I had no side effects. After about two weeks on it, I had no desire for any more cigarettes.

I’ve been tobacco-free since then. Prior to that, I had smoked for over 30 years. Why are people still taking Chantix, which is known to cause side effects, when older drugs that work are still available? My guess is that Zyban also would cost less than Chantix.

A: The active ingredient in Zyban is bupropion, the same compound found in the antidepressant Wellbutrin. Bupropion was tested against placebo or nondrug treatment in 44 randomized trials for smoking cessation (Cochrane Database of Systematic Reviews, Jan. 8, 2014). People taking Zyban were 60 percent more likely to have quit after at least six months.

Despite their success, a more recent review of realworld smokers found that neither Zyban nor Chantix made a significant difference in long-term smoking cessation ( Journal of the National Cancer Institute, June 2018). The authors of this analysis suggest that the support and counseling provided in clinical trials may account for the discrepancy.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www. PeoplesPharmacy.com.