Q: I live on a remote island in the South Pacific that is almost a 12-hour flight from Los Angeles. A week ago, I ran out of Zyrtec. During the next four days, I experienced some of the worst hives and itchy symptoms in my entire life. Benadryl was my only relief, and working three jobs is difficult enough without the drowsiness Benadryl causes.
Then I read all the stories on your website about people experiencing unbearable itching when they stopped Zyrtec. I immediately ran out to the only place on the island that sells Zyrtec and found instant relief. When I am finally ready to take the plunge of quitting Zyrtec, at least I have an idea what kind of punishment to expect.
A: We have received so many reports of itching and hives associated with stopping cetirizine (Zyrtec) that we contacted the Food and Drug Administration. The agency has not responded.
Like you, most people don’t realize that running out of Zyrtec could trigger prolonged itching. If enough individuals tell the FDA about this complication, perhaps a warning will be included on the label. The best way to report such an adverse drug reaction is at www.FDA.gov/MedWatch.
Q: I have Parkinson’s disease (PD), and it is getting progressively worse. My hands shake so much that it is almost impossible to hold a cup without spilling its contents.
Given the recent study using reduced doses of the FDA-approved anti-leukemia drug nilotinib to successfully treat PD, should I ask my neurologist to prescribe it off-label?
A. Nilotinib (Tasigna) is a leukemia medicine that has shown promise in a pilot study of 12 people with Parkinson’s disease. Some demonstrated impressive improvement, but the research is still in its early days.
Your neurologist could legally prescribe Tasigna for Parkinson’s disease, but most physicians are cautious about prescribing unproven medications. It would be worth a conversation, though.
Although the dose for Parkinson’s disease was much lower than the dose for leukemia, the drug would still be expensive. Cancer treatment with Tasigna costs more than $10,000 a month. Insurance rarely covers off-label prescriptions.
We don’t know whether the people in the pilot study experienced serious complications from taking low-dose Tasigna for six months. Used in higher doses for cancer, Tasigna can cause rash, elevated blood sugar, headache, blood disorders, digestive upset, fatigue, high cholesterol, fever and painful joints, along with other side effects.
Q: My wife and I are in our 70s. She has been taking Nexium for years. We recently read that this kind of medication could increase her risk for bone fracture. How could this be true?
A: Acid-suppressing drugs such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) interfere with the absorption of minerals such as calcium and magnesium. A recent article in the Journal of the American Geriatrics Society (November 2015) suggests that taking such proton-pump inhibitors for more than two months is risky for older people. It can lead to C. diff intestinal infections as well as bone loss and fractures.
We are sending you our Guide to Digestive Disorders with a discussion of the pros and cons of these medications and the alternatives. 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.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
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