People’s pharmacy

Q: I’ve been a longtime user of Celebrex. Then my pharmacy gave me the generic.

After the first week, I had pain all over and found I could do fewer and fewer things I’ve always found easy. My hour of tai chi was nearly impossible.

My insurance will cover Celebrex, but not until the three-month supply of celecoxib is gone. So I have three months of misery in store.

A: Celecoxib (Celebrex) is a kind of nonsteroidal anti-inflammatory drug (NSAID) called a COX-2 inhibitor. Supposedly, it is less likely to cause gastrointestinal irritation and ulcers than classic NSAIDs such as diclofenac, ibuprofen and naproxen.

There is controversy about its safety. The manufacturer warns that: “Serious skin reactions, or stomach and intestine problems such as bleeding and ulcers, can occur without warning and may cause death.” Celebrex also may increase the risk for heart attacks or strokes.

Generic celecoxib is a relatively recent introduction, with four different companies making a formulation. The Food and Drug Administration is quite interested in hearing from people having trouble with celecoxib. Please make a report to MedWatch at the FDA website (http://www.fda.gov/Safety/MedWatch/).

Q: I have been taking acid-suppressing drugs like omeprazole for more than 20 years. After reading about the side effects of such drugs, I am ready to quit.

I understand that this can be painful. I read about persimmon punch on your website and would like to try it to avoid heartburn. How often should I drink it?

A: People who take proton-pump inhibitors such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) may experience rebound hyperacidity if they stop their drug abruptly (Gastroenterology, July 2009). Symptoms of reflux can last for weeks.

One reader phased off Prilosec over seven months by reducing the dose gradually. According to people who have used persimmon punch in this effort, it helps to drink 2 ounces before each meal.

We are sending you our Guide to Digestive Disorders, with a discussion of the pros and cons of proton-pump inhibitors and tips for getting off PPIs. It includes a recipe for persimmon tea and details on using natural approaches for heartburn. 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. G-3, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Q: I got my flu shot Sept. 15, 2014. Since then, the pain in my arm, shoulder and collarbone has progressively gotten worse.

I can no longer sleep lying down. I’ve had two cortisone shots in my shoulder, but my arm continues to get worse. I’m still trying to find a doctor to figure out the problem.

It seems to me that six months is too long to be in pain constantly when trying to do simple things. Just trying to blow-dry my hair or even put on eyebrow pencil causes me extreme pain.

A: We have heard from scores of others who have reported persistent shoulder pain from the flu shot this year. Although the Centers for Disease Control and Prevention says that pain at the injection site usually goes away in a week or less, many people have found that their arms are still very tender months later. Like you, some are in pain despite receiving cortisone shots.

Joe and Teresa Graedon answer letters from readers via their website at www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”