The Dallas Morning News

Stopping antihistam­ine led to ‘crazy’ itching

- JOE & TERESA GRAEDON peoplespha­

I have been taking Xyzal, and it’s only recently that I figured out what the crazy itching is from. I stopped the drug three days ago and have been suffering ever since.

Before that, I was taking it for about a year. Whenever I missed, I would itch but taking it again stopped the itching. I did not realize that it was withdrawal itching. I have missed work, lost sleep and was once misdiagnos­ed with shingles because of this. I appreciate knowing this, too, shall pass.

We encouraged the Food and Drug Administra­tion to investigat­e “withdrawal itching” with both cetirizine (Zyrtec) and levocetiri­zine (Xyzal). The agency acknowledg­ed this reaction in the journal Therapeuti­c Advances in Drug Safety (July 5, 2019). Gradual tapering over several weeks may reduce the discomfort.

When the air gets dry in the winter, my husband uses a neti pot to rinse his nasal passages. This year, I switched him to Xlear sinus rinse packets. They contain xylitol, which is a natural anti-bacterial product.

He also uses homeopathi­c sinus and allergy sprays as well as homeopathi­c remedies for seasonal allergies and sinus headaches. They work well; he’s had no sinus infections since implementi­ng these measures.

A neti pot is a traditiona­l method for being able to rinse out the nose and sinuses. An alternativ­e would be a plastic device designed to wash the sinuses.

Xylitol is also known as birch sugar. This natural product inhibits the growth of some common bacteria found in the nose. Utilizing Xlear or other preparatio­ns for rinsing the sinuses makes sense, but we urge everyone to dissolve the packets in sterile water so as not to introduce new pathogens.

I have had severe scalp psoriasis for many years. Home remedies, injections, UV light therapy, medication­s and shampoos have not helped.

My dermatolog­ist recently prescribed Sotyktu. Do you think this is safe for me to use?

When I read the info included with the medication, I saw a couple of red flags. I am over 50, and I have had high blood pressure that I keep under control with medication.

Sotyktu (deucravaci­tinib) is a relatively new psoriasis medicine. It is in a somewhat similar category as some other biologic medication­s such as upadacitin­ib (Rinvoq) or tofacitini­b (Xeljanz).

In a four-month trial of this drug for psoriatic arthritis, the most common side effects were sore throat, respirator­y infection, sinusitis, bronchitis, rash, headache and diarrhea (Annals of the Rheumatic Diseases, June 2022).

Sotyktu lowers the ability of the immune system to fight infections and must not be used in combinatio­n with other drugs that affect immune response.

Some people react to this drug by developing angioedema (which can be life threatenin­g).

There are also concerns about serious infections such as tuberculos­is as well as the blood cancer lymphoma.

The price also might be a worry, unless your insurance plan will cover Sotyktu. Goodrx reports the monthly price without coverage or coupons is more than $11,000.

I am a naturopath­ic physician and find the info in your column quite useful. This week in your column, you recommende­d HPF Cholestene brand red yeast rice. Unless its position has changed recently, the Food and Drug Administra­tion recommends people not buy this brand because lovastatin is one of the ingredient­s.

You are correct. The FDA “is advising consumers not to purchase or use Cholestene, a product promoted and sold for cholestero­l management ... FDA laboratory analysis confirmed Cholestene contains lovastatin, the active ingredient in the Fda-approved prescripti­on drug Mevacor, used to treat patients with high blood cholestero­l levels.”

We have always found the FDA’S position puzzling.

It’s OK for people to take lovastatin as a prescripti­on drug, but the same ingredient is inappropri­ate in a dietary supplement.

A meta-analysis and systematic review of 30 studies of red yeast rice preparatio­ns concluded that this natural product can reduce risk factors associated with heart disease (Frontiers in Pharmacolo­gy, Feb. 21, 2022). People taking RYR were less likely to die during the studies.

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