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 life-threatening 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. Then talk to him or her about any questions you may have.
Q: What can you tell me about the safety and long-term use of Ozempic to treat Type 2 diabetes? My husband’s A1C is around 7.2. The endocrinologist wants to try Ozempic along with his metformin and glimepiride to see if he can do better. He is not overweight and is careful with his diet. I’m worried about injectables at his age of 64. What are the long-term effects?
A: Ozempic (semaglutide) is prescribed to improve blood sugar control for people with Type 2 diabetes. It was approved in the U.S. in 2017, so we have only three years of experience on long-term effects.
We worry that your husband’s glimepiride, a sulfonylurea medicine, could interact with the Ozempic injection. This combination could increase the risk of a serious episode of low blood sugar (hypoglycemia). Symptoms can include fatigue, confusion, blurred vision, seizures and coma.
A common side effect is digestive distress. Other adverse reactions may include thyroid cancer and pancreatitis. If your husband has the eye disease diabetic retinopathy, using Ozempic might make it worse.
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.