Q: My naturopath prescribed licorice to ease nausea and acid reflux. A month later, I was in the emergency department with high blood pressure, irregular heartbeat, chest pain and lightheadedness.
My potassium was too low, whereas a month earlier it was within normal limits. I searched licorice and potassium and found a link. I have thrown away the licorice pills, and after a few days of potassium pills prescribed by the ER doctor, I am starting to feel normal.
A: Your naturopathic doctor was irresponsible to prescribe licorice without careful monitoring. Although natural licorice might help with stomach upset, its active ingredient, glycyrrhizin, can cause fluid retention, hypertension and low potassium. This could lead to irregular heart rhythms that could be life-threatening.
A safer alternative might be deglycyrrhizinated licorice (DGL). With the glycyrrhizin mostly removed, it is less likely to cause dangerous side effects. Don’t take potassium pills indefinitely, since too much can be as dangerous as too little. A blood test will tell your doctor when your potassium is back to normal.
Q: As a pharmacist, I see the impact of high drug prices every day. People on Medicare Part D are reaching the “doughnut hole” earlier every year due to the high cost of their meds.
I have customers on insulin pens who can’t afford their prescriptions because the cost has gone from a copay of $47 to a copay of $204 every month. It doesn’t help when I tell them that the “usual and customary” price is $489, and they are getting a discounted price.
Many times people go without their meds because they can’t afford them. Switching to vials and syringes might save some, but it is the cost of the insulin that is so high.
A: People with Type 1 diabetes cannot survive without insulin. Like so many other medications, insulin has been soaring in price. An article in JAMA (April 5, 2016) noted that the cost more than tripled from 2002 to 2013. In some instances, out-of-pocket expenses can be as much as $400 a month.
Some people are now buying their insulin from Canada. Others utilize patient-assistance programs provided by the manufacturers (888-477-2669). You can learn more about Canadian pharmacies and shopping strategies in our Guide to Saving Money on Medicines at www.PeoplesPharmacy.com.
Q: You’ve written about the side effects of tamsulosin, prescribed for frequent nighttime urination. You said nothing about sexual problems.
I have been using drugs for erectile dysfunction for several years. When one ED drug stopped working, my doctor switched me to another, but it didn’t help.
I thought perhaps the problem was a side effect of another drug I am taking. When I researched this online, I found these side effects listed for tamsulosin: lack of interest in sex, difficulty getting or keeping an erection and abnormal ejaculation. I stopped taking tamsulosin for a week, and my sexual problems weren’t as bad. I’ll discuss this with my doctor soon.
A: Tamsulosin (Flomax) and similar drugs (doxazosin, terazosin) are prescribed for men with enlarged prostate glands. They make urination easier.
Side effects of these alpha blockers can include sexual difficulties such as the ones you have mentioned. Please discuss your concerns with your doctor. Tadalafil (Cialis) has been approved for both urinary problems and erectile dysfunction.
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