You can learn more about pharmacy errors and how to protect yourself in our book “Top Screwups Doctors Make and How to Avoid Them.” It is available at the library or online at www.PeoplesPharmacy.com.
Q: You recently had a question from a pharmacist whose sister developed ulcers taking Excedrin Migraine for her headaches. She should consider using the new Food and Drug Administration-approved injectable called Aimovig. This is a medicine to prevent migraines.
I just had my fifth dose yesterday, and my migraines have improved greatly. The only real side effect is constipation, which can be managed with MiraLAX.
I also have been using Botox every three months, along with trigger point injections and nerve blocks for the past couple of years. I take almotriptan for the migraines I do get now, but they aren’t as bad as they were by a long shot since taking the Aimovig.
My heart breaks for anyone who suffers with debilitating migraines — they are the worst thing I’ve had to deal with.
A: Erenumab (Aimovig) is an important new advance for migraine prevention. The FDA approved it earlier this year. Two similar drugs were approved even more recently: fremanezumab (Ajovy) and galcanezumab (Emgality). These all are injections that patients administer themselves to prevent recurrent migraine headaches.
Q: I have a problem with dry mouth because several of the medications I take cause this side effect. My dentist's assistant told me about a wonderful product line. I have found Biotene mouthwash and toothpaste to be extremely helpful.
A: Biotene products contain water, glycerin, xylitol, sorbitol and other ingredients designed to lubricate the mouth. Thanks for sharing your success.
Drug-induced dry mouth is a tipoff that you may be taking anticholinergic medications. Such drugs can cause dry mouth, dry eyes and constipation. They also impact brain neurochemistry, which in turn may increase the risk of cognitive impairment and dementia (JAMA Internal Medicine, March 2015). We have included a comprehensive list of anticholinergic drugs at www.PeoplesPharmacy.com. Ask your doctor if she could substitute alternate medicines that will not cause dry mouth symptoms.