PRESCRIPTIONS AND HOME REMEDIES Reader masks metallic taste of Paxlovid with cottage cheese

Thank you for sharing your experience with the antiviral drug Paxlovid. We made sure your strategy would not interfere with absorption. The official prescribing information states: “Take Paxlovid with or without food.” It also states, however, “Swallow the tablets whole. Do not chew, break, or crush the tablets.”

Paxlovid can increase blood levels of some corticosteroids. If your husband needs another course of Paxlovid, his doctor should monitor his steroid dose carefully.

Q: I have never had high LDL cholesterol, but my doctors have prescribed statins for years. I am currently taking atorvastatin.

Despite having taken these cholesterol-lowering drugs, I have coronary artery disease. I needed several angioplasties and stents placed after my heart attack. My cardiologist is now planning bypass surgery. In my case, lowering LDL cholesterol did not protect my heart. A:

Heart disease is complicated. Some people experience heart attacks even though their cholesterol levels are normal. Another blood lipid called lipoprotein a, or Lp(a), is rarely tested but may contribute to clogged arteries. This risk factor usually runs in families. Somewhat surprisingly, statins may actually increase Lp(a) rather than lowering it.

Q: Do you have any information about the diabetes drug Farxiga, which I am currently taking? I’d like to know the pros and cons.

A:

Farxiga is the brand name for dapagliflozin. It was approved to treat Type 2 diabetes in 2014. More recently, this medication has also received a green light from the Food and Drug Administration to reduce complications of kidney disease and heart failure.

A study published in the Journal of General Internal Medicine (Dec. 14, 2023) found that Farxiga reduced the risk of premature death, cardiovascular complications and the worsening of chronic kidney disease. Even people in their 70s and 80s experienced benefit.

One of the drawbacks is a susceptibility to urinary tract and genital yeast infections. TV commercials mention a rare, life-threatening bacterial infection of the skin of the perineum (the area between the anus and genitals). Because this is a sensitive part of your body, any discomfort in that area must be reported to a physician.

Other risks of Farxiga and similar drugs (Brenzavvy, Invokana, Jardiance, Steglatro) include nausea, dry mouth, fatigue, low blood sugar and ketoacidosis. This latter complication is rare but serious. Symptoms include nausea, vomiting, stomachache and trouble breathing.

Q: I read that vitamin D paired with a probiotic could help prevent infections. Does it? I’m worried about respiratory problems this winter.

A:

There isn’t a lot of research on this combination. Individually though, each supplement does appear to have immune boosting capability.

A review of the medical literature published in the journal Nutrients (September 2023) concludes that “Vitamin D adequacy is critical to overcoming infections and autoimmunity.” The author suggests that keeping 25-hydroxyvitamin D above 40 to 50 ng/ mL is a cost-effective way to reduce chronic diseases and overcome viral epidemics.

A review of randomized controlled trials found that probiotics “were better than placebo or no treatment in preventing URTIs (upper respiratory tract infections). This analysis was published in the Cochrane Database of Systematic Reviews (Aug. 24, 2022).

In their column, Joe and Teresa Graedon answer letters from readers. Send questions to them via www. peoplespharmacy.com.

Q: My husband and I came down with COVID-19 even though we’d had our shots and boosters. Both of us were given Paxlovid because we are older people. My husband has COPD, so he was also given a steroid pack. I was told Paxlovid could leave a metallic tast If you’re bothered by the metallic flavor that can accompany Paxlovid, cottage cheese may help cover up the taste.