Substitute to opioids for pain has some severe side effects
Q: I was given gabapentin in the hospital following surgery. A few days after, the doctor removed drains along with a pressure bandage. I began to feel light-headed and had diarrhea.
At home, I had more episodes of dizziness and diarrhea. On the fourth day home, I felt extremely light-headed and called to my husband. He caught me as I was passing out, cracking my head on the kitchen counter as I went down.
My primary care physician immediately took me off gabapentin. I will never take that drug again. A: Doctors are turning to gabapentin for relieving pain after surgery, so that they can prescribe fewer opioids. Dizziness is a fairly common side effect of the drug, and diarrhea has also been reported.
A recent review in
JAMA Internal Medicine (Nov. 1, 2022) criticized the prescribing of gabapentin to control pain in older adults after surgery. The authors noted this medication is associated with delirium, dizziness, visual problems and pneumonia.
Q: My son kept his acne under control with our dermatologist’s recommendation: niacinamide gel and a prescription topical Retin-A cream, alternating with benzoyl peroxide. The benzoyl peroxide and niacinamide were over the counter.
The doctor said that niacinamide is an antiinflammatory that often helps with skin conditions. When my son ran out for a week, the acne started coming back, so I know it really made a difference.
Acne responds well to topical combination therapy. Tretinoin (Retin-A) was introduced over 40 years ago and remains a key acne treatment. Skin irritation, redness and sensitivity to sunlight are possible side effects.
Benzoyl peroxide can cause redness, burning, itching and peeling. Niacinamide is a kind of B vitamin and is indeed anti-inflammatory.
Q: I started taking CoQ10. To my surprise, my home blood pressure readings, which had been in the 160/80 range, dropped immediately to 130/80 or lower. My daily blood sugar readings are lower without any change in diet.
My primary care provider has never objected to my supplements, which include a multivitamin for women over age 50, krill oil, vitamin B complex and garlic. In addition to low thyroid and high blood pressure, I have chronic kidney disease, diabetes and gout. All of these developed after I took “preventive” statin drugs at 55. The statins caused agonizing pain and partial paralysis.
A: Your fascinating testimonial
sent us to the medical literature. There we found research confirming that Coenzyme Q10 (CoQ10) can lower blood pressure in people with cardiometabolic disorders (Advances in Nutrition, Sept. 20, 2022).
We were surprised to find that CoQ10 supplements can also assist in blood sugar control and lower triglycerides in Type 2 diabetes (International Journal of Endocrinology, Sept. 16, 2018).
The body makes Coenzyme Q10, a compound crucial to the energy factories of cells called mitochondria. This fat-soluble molecule has a structure similar to that of vitamin K. That is why people taking the anticoagulant warfarin should not take CoQ10, as these might reduce the effectiveness of the drug.
Statins are known to lower CoQ10 levels (Journal of the American Heart Association, Oct. 2, 2018). Since your body reacted so strongly to statins, you may be at risk of this effect.