Q: I was prescribed pregabalin (Lyrica) for fibromyalgia. It did not relieve my pain. Worse, it made me narcoleptic, more or less. I was standing at the kitchen sink, actively washing dishes, and walking down the hallway carrying a basket of folded laundry to a bedroom and BAM! I was instantly asleep and dreaming while still in motion.
I shook myself awake both times, alarmed at what had happened. There was no forewarning other than feeling a bit tired.
I told the doctor that Lyrica had not worked and about the side effects it caused. I find all too often that even otherwise great doctors seem to rely on info from drug reps. I wish they would check drug studies to see what the potential side effects can be.
A: The prescribing information for Lyrica lists “sleep disorder” as a rare side effect. There is no explicit reference to narcolepsy in the medical literature. Such sudden sleep attacks during the day could be dangerous. Thank you for letting us know about your experience.
Q: My cardiologist prescribed Repatha. This drug lowered my LDL cholesterol significantly, but I cannot keep taking it because of its cost.
My insurance will cover Repatha, but I have a copay of $488 per month. I’ve tried every statin on the market and have experienced bad reactions to every single one of them. What can I do now?
A: Evolocumab (Repatha) is a new way to lower bad LDL cholesterol dramatically. A study in the New England Journal of Medicine (online, March 17, 2017) demonstrated that this injected medication reduced the risk of a heart attack or stroke when added to a statin.
The Food and Drug Administration has approved Repatha for use only in conjunction with other cholesterol-lowering drugs. We suspect, however, that many physicians are prescribing it for people like you, who cannot tolerate statins.
Repatha has a list price of around $14,000 per year. As a result, it’s not surprising that your copay is so high.
The manufacturer, Amgen, offers financial assistance to patients like you who find the copay on their insurance unaffordable. If you go to Repatha.com, you could sign up for the program. It would require you to pay the first $5 on your monthly copay, and the program would pay up to $5,500 a year. To learn more, you could call the company at 844-737-2842.
Q: When I was 18 years old, I went to join the Army Reserve. I weighed 165 pounds and was in great physical condition, but when they took my blood pressure, it was 200/70.
I was told to go straight to my doctor. The blood-pressure pill he prescribed made me feel like a zombie.
I bought a home blood-pressure monitor; my pressure was 130/70 when I took it. I recently purchased a digital blood-pressure unit and log my pressure regularly. To this day, 35 years later, I still have white coat hypertension. Last week my blood pressure was 200/90 in the doctor’s office and 125/80 at home.
A: Yours is indeed a classic case of white coat hypertension. Most experts believe that home blood-pressure readings (especially continuous 24-hour monitoring) are better at determining the actual risk from elevated blood pressure (Current Opinion in Cardiology, online March 16, 2017).
We discuss white coat hypertension, proper blood-pressure measurement and ways to get high blood pressure under control with and without drugs in our Guide to Blood Pressure Treatment. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
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. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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